{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:45:41Z","timestamp":1777005941742,"version":"3.51.4"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the prevalence of primary headache associated with sexual activity (PHS) among adults seeking medical help for a headache in clinic\u2010based settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary headache associated with sexual activity is a benign primary headache disorder currently recognized as one of indomethacin\u2010responsive and exercise\u2010related cephalalgias. The epidemiology of PHS among adult patients assessed for headache in the tertiary headache centers is yet to be established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE, Embase, and ScienceDirect databases were thoroughly searched for observational studies published since January 1, 1988, to November 11, 2024, that reported the relative frequency of PHS among adult patients evaluated for a headache in a clinic\u2010based setting. The additional search of CINAHL (EBSCO) was performed on January 28, 2025, to see whether any relevant articles could have been omitted during the initial search process. The Meta\u2010Analyses of Observational Studies in Epidemiology Guidelines were strictly followed by the study's design. Risk of bias was assessed using Joanna Briggs Institute Checklist for Studies Reporting Prevalence Data. The study's protocol was pre\u2010registered on PROSPERO (ID: CRD42024611082).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the original 854 records, 10 research articles (40,702 total individuals, 129 patients with PHS) satisfied all eligibility requirements. The majority of the studies showed a low risk of bias. The prevalence of PHS among adult patients evaluated for a headache in a tertiary care setting was 0.37% (95% confidence interval [CI], 0.17\u20130.81; 95% prediction interval [PI], 0.02%\u20136.20%; Luis Furuya\u2010Kanamori index\u2009=\u20090.58) with substantial heterogeneity noted across the studies (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200991.66%). Interestingly, unlike in other primary headache disorders, males have been diagnosed with PHS considerably more often than females (0.28% [95% CI, 0.12\u20130.63; 95% PI, 0.02%\u20134.10%] vs. 0.18% [95% CI, 0.09\u20130.37; 95% PI, 0.02%\u20131.65%]). Moreover, sex\u2010specific subgroup analysis revealed that PHS was more common among males (1.54%; 95% CI, 0.26\u20138.57), in comparison to female\u2010specific subgroup (0.61%; 95% CI, 0.22\u20131.71). The pooled mean age of onset of PHS was 37.35\u2009years (95% CI, 35.35\u201339.35; 95% PI, 34.01\u201340.69).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results showed that PHS is a rare headache disorder among adults evaluated for a headache in a clinic\u2010based setting. Furthermore, PHS is more frequent among males and is diagnosed predominantly in males, typically in their mid\u201030s.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.15049","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:54:49Z","timestamp":1756306489000},"page":"1850-1859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology of primary headache associated with sexual activity: A meta\u2010analysis with diagnostic and management considerations"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4197-1115","authenticated-orcid":false,"given":"Aleksander","family":"Osiowski","sequence":"first","affiliation":[{"name":"Faculty of Medicine Jagiellonian University Medical College  Krakow 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