Submission Type
Case Report
Abstract
Introduction: Primary headache associated with sexual activity (PHASA) is an uncommon but benign headache disorder that may mimic life-threatening causes of thunderclap headache. Careful diagnostic evaluation is essential at first presentation.
Clinical Findings: Two women aged 40 and 42 years presented in a family medicine setting with abrupt-onset headaches that occurred exclusively during sexual activity and strenuous exercise. Findings from the neurologic examinations were normal in both cases. Brain magnetic resonance imaging with and without contrast showed no acute abnormalities.
Clinical Course: Neither patient underwent lumbar puncture or vascular imaging. Both were treated with pre-emptive therapy using indomethacin or triptans, and both reported symptom improvement without neurologic complications at follow-up.
Conclusions: These cases illustrate probable PHASA in women who present to outpatient primary care. Although typically benign, first-onset headaches during sexual activity require exclusion of secondary causes. Recognition of PHASA allows for appropriate reassurance, pre-emptive therapy, and patient counseling while acknowledging diagnostic limitations.
Recommended Citation
Kabat, Natalia M. and Mope, Melodie
(2026)
"Diagnostic Considerations for Primary Headache Associated With Sexual Activity in Women in Outpatient Primary Care: A Case Series,"
Journal of Maine Medical Center: Vol. 8
:
Iss.
1
, Article 24.
Available at:
https://doi.org/10.46804/2641-2225.1256
