Hello, You have history of vertigo and problems with the neck. You should get clinically examined by an ENT specialist, get your vertigo and neck issue treated. Sexual excitement causes contraction of the muscles in the head and neck. Spike in the blood pressure causes the blood vessels to dilate and cause headache, it may get severe if you are already suffering from vertigo. Sexual headache is commonly a benign headache but sometimes it may be indicative of intracranial hemorrhage, cerebral infarction, etc. Get CT, MRI, cerebral angiogram and spinal tap, etc done to detect the pathology causing you the discomfort. You will get relieved after the causative factor is treated. You can take pain relieving medicines or you may be able to avoid one if you stop having sex before you climax. You could also take a more passive role during sex to reduce or ease the pain of a sex headache. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician