A not so happy ending! Woman, 61, suffers BRAIN BLEED while having sex - as experts warn it's way more common than you'd expect

Doctors have urged Americans to seek help for a little-known sex problem - migraines triggered by sex, known medically as coital cephalgia. 

The warnings were sparked by an alarming case of one 61 year-old woman who   suffered a massive brain bleed immediately after intercourse. 

The  woman visited a South Dakota emergency room suffering vision loss and a debilitating headache, doctors from the University of South Dakota Sanford School of Medicine wrote in a case report.

She reported that the head pain began during intercourse and would not abate even after taking three aspirin. In fact, it got worse - she began losing sight. 

This scan shows the clotted blood, called a hematoma, in the South Dakota patient's brain

Doctors initially believed this was a simple case of 'sex headaches' - which affects up to 200,000 Americans. 

The cause of the problem is not fully understood, but it is thought to be a kind of exertion headache - which happens due to rising blood pressure during activities like running, weight lifting or sneezing. 

The dilation of blood vessels is thought to tighten muscles in your head, neck and shoulders, causing a headache, explained Dr Nestor Galvez-Jimenez, a neurologist at the Cleveland Clinic. 

While very rare, doctors believe that this pressure could cause a vessel to burst in those with unhealthy blood flow, leading to a brain bleed.  

Doctors in South Dakota performed a scan of their patient's brain and discovered a large mass of blood compressing her occipital lobe, the region of the brain responsible for sight. 

They concluded she'd suffered a hemorrhagic stroke, otherwise known as a brain bleed. The other, more common form of stroke is the ischemic type - in which a blood clot blocks or plugs an artery leading to the brain.

A brain bleed of this sort can happen when an increase in blood pressure during sex causes blood vessels pre-weakened by existing conditions, like heart disease, to burst, Dr Hafez Mohammad Ammar Abdullah, internal medicine specialist at the South Dakota hospital, wrote in the case report. 

Remarkably, the woman survived and made a full recovery without any treatment. 

Still, doctors have urged people with sex-related headaches to check for underlying problems that may result in a lethal event. 

Up to one in 12 patients who come into the emergency room with a brain bleed say they were having sex when the pain set in, Dr Ammar Abdullah wrote. 

He and colleagues advise that 'all patients with a severe non-resolving sexual headache should be evaluated to rule out any underlying secondary cause'.

Sexual headaches can occur at any age, but in this case study, it occurred in a 61 year old woman

In order to be diagnosed with coital cephalgia, you need to have experienced an intense headache at least twice during sexual activity.

The pain must last at least 24 hours and needs to not be attributable to other conditions like chronic migraines.

Sexual headaches can occur at any point during sex, but generally increase in intensity with increasing sexual excitement. 

They can happen at any age, but since circulation problems tend to get worse with age, the problem may be more prevalent in older people. 

If you're having sexual headaches, you can try taking over the counter pain medications before you get lucky, Dr Galves-Jimenez said, though he recognized it might be difficult to know that ahead of time. 

In other cases, unfortunately, Dr Ammar Abdullah wrote, abstinence is the only option.