Exertional headaches are brought on by strenuous activities, such as running, swimming, or weight lifting, as well as sexual activity. It occur during or after sustained, strenuous exercise. Doctors divide exercise headaches into two categories. Primary exercise headaches are usually harmless, aren’t connected to any underlying problems and can often be prevented with medication.
Secondary exercise headaches are caused by an underlying, often serious problem within the brain — such as bleeding or a tumor — or outside the brain — such as coronary artery disease. Secondary exercise headaches may require emergency medical attention.
Treatment of these headaches should be conservative according to Dr Winnie Lim Khoo, An adult neurologist in Manila. In many patients, headaches disappear spontaneously. Long-acting nonsteroidal anti-inflammatory drugs, such as indomethacin, can be used chronically and/or prior to specific activities. If indomethacin is taken chronically, monitoring for side effects is mandatory.
If headaches occur only with exertion and are not associated with neurologic signs or symptoms, imaging studies may not be necessary. If neurologic signs and symptoms are present, medical evaluation is needed.