These headaches are usually benign, but occasionally are caused by intracranial hemorrhage and cerebral infarction, especially if the pain is sudden and severe.
[1] They may be caused by general exertion, sexual excitement, or contraction of the neck and facial muscles.
[4] For other patients, the pain appears to be specifically activated by sexual excitement and contraction of facial and neck muscles.
[1] Sporadic case studies have linked sexual headaches to the use of certain drugs, including amiodarone, pseudoephedrine, birth control pills, and cannabis.
[1] Anecdotal and indirect evidence suggests a trial of magnesium supplementation may improve symptoms (in subjects with known or suspected low Mg levels).