We present a 44-year-old woman who was admitted to our hospital after three episodes of coital headache. Magnetic resonance imaging (MRI) and angiography (MRA) revealed no vascular abnormality. She was discharged with a diagnosis of primary headache associated with sexual activity (PHSA). Although she abstained from sexual activity after discharge, she experienced recurrent headaches several times a day, whenever there was a change in her emotional state. This case implies that emotional changes can trigger headache attacks during headache-prone state in PHSA.