We have been taught that a headache surrounding sexual activity is a problem that is purely psychological, purely an excuse and purely female," says neurologist Jerome Goldstein, M.D., director of the San Francisco Headache Clinic.

But in reality, none ofthe above is true. Throbbing headaches that occur just before or during sex - known as benign sexual headaches, or coital cephalagias in high medicalese - are caused by real physical problems. They're not an excuse, because people who have them would usually like to have sex as much as anybody else. (Whicl1 is not to suggest that a "headache" isn't sometimes used dishonestly as a convenient means of avoiding a sexual encounter.) But most surprising of all, sexual headaches are actually four times more common among men than wornp-' The typical sufferer, in fact, is not the frigid, fussy housewife ofthe carton
middle-aged man who is slightly overweight, has mildly elevated bJr and may have a family history of migraines but is otherwisp well adjusted.