Q. When I have sex or masturbate, I get severe headaches as I get close to orgasm. The pain is behind my left ear and in the back of my head and neck. This headache sometimes makes me sick to my stomach. The first time I got this headache, I heard a pop in the back of my head. What is causing this, and how can I get rid of it?

A. I would recommend you see a neurologist as soon as you can. You see, during ejaculation, a man’s blood pressure and heart rate both rise. This is normally part of the nervous system’s response to the climax. This is why some men who have coronary artery disease suffer heart attacks during sex. In your case, I am concerned that you might have an aneurysm in one of small blood vessels in your brain. An aneurysm is a weak spot in a blood vessel wall. When your blood pressure goes up during sexual activity, such an aneurysm might swell, causing pain and pressure.

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