My wife has begun having extremely painful headaches immediately after achieving orgasm. she is in her early 50s and never had this problem before. ?

Should be evaluated: Although coital headaches can be severe, they are usually not dangerous. However, since these headaches recently started, and given your wife is in her early 50's, i would recommend a neurological evaluation to include imaging studies such as an MRI of the brain or other imaging studies to make sure these headaches are not due to something more serious. These headaches can be treated , prevented.