Death during consensual sex explained

Death can occur during sexual intercourse for a number of reasons, generally because of the physical strain of the activity, or because of unusual extenuating circumstances. There are various euphemisms for death during sex, including "dying in the saddle" or the French "la mort d'amour".^[1]

Health and physiology

Sexual intimacy, as well as orgasms, increases levels of the hormone oxytocin, also known as "the love hormone", which helps people bond and build trust.^{[2] [3] [4]} Sexual activity is also known as one of many mood repair strategies, which means it can be used to help dissipate feelings of sadness or depression.^[5]

A 2011 meta-analysis in the Journal of the American Medical Association found that each additional hour of sexual activity per week resulted in an increased risk of 2–3 myocardial infarctions and one sudden cardiac death [SCD] per 10,000 person-years.^[6] Sexual intercourse can also trigger a subarachnoid hemorrhage via the Valsalva maneuver.^{[7] [8]} A 2011 meta-analysis published in Journal of Sexual Medicine found that men who were unfaithful were significantly more likely than those who were faithful to experience severe or fatal cardiac events during sex.^[9] Basilar artery dissection has also been reported in connection with sexual activity, though most coital cephalalgia is benign in nature.^[10]

Deaths during consensual sex account for approximately 0.6% of all sudden deaths.^{[8] [11]} In the UK, of all people under 50 who suffered SCD, 0.2% did so within an hour of sex.^[12] Sildenafil, although generally considered to be a safe drug, has been linked to SCD during sexual activity among elderly or otherwise infirm men.^[11] A number of deaths during consensual sex have been linked to the use of other prescription or recreational drugs, such as cocaine.^[13] The majority of deaths due to cardiovascular causes during sex occur in males.^[14]

The heart condition endothelial dysfunction is a contributing cause to both atherosclerosis and erectile dysfunction.^[15] Because of the link between these conditions, rates of coronary heart disease are higher among patients with erectile dysfunction.^[15] One treatment for erectile dysfunction is cGMP-specific phosphodiesterase type 5 inhibitors, which enable patients to resume having sex despite having a cardiac condition, by lowering blood pressure.^[15] These drugs, including sildenafil, inhibit the action of the phosphodiesterase, allowing for a higher concentration of cyclic GMP in the penis when it is physically stimulated. Cyclic GMP is a second messenger in the nitric oxide pathway, responsible for erections via the vasodilating function of nitric oxide.^[16] Sudden cardiac death can be caused by myocardial ischemia, and the physical activity of sexual intercourse in patients with coronary artery disease can result in myocardial ischemia.^[15] The phosphodiesterase can act as a potentiator for other drugs which lower blood pressure and which could be used to treat heart conditions, and so may be contraindicated to prevent negative health consequences.^[17]

Notable cases

• Pope John XII died on 14 May 964; one story relates that he died of a paralytic stroke suffered while having sex with a woman named Stefanetta. He may have died instead when the woman's husband defenestrated John or beat him to death with a hammer during the act.^{[18] [19]}
• Lord Palmerston, Prime Minister of the United Kingdom, died in 1865 following a brief illness; sources disagree about the immediate circumstances of his death. It is rumored that sex on a billiard table with a maid precipitated his demise,^[20] but this account is disputed, with other sources stating that he died of pneumonia.^[21]
• Félix Faure, president of France from 1895 to 1899, is widely reported to have died while receiving fellatio from his mistress, Marguerite Steinheil. The cause of death was listed as a cerebral hemorrhage. Eyewitnesses stated he was in a state of partial undress. This version is disputed by some historians.^{[1] [20] [22]}
• Cardinal Jean Daniélou, a prolific and renowned Jesuit theologian, died in 1974 inside a Paris brothel at 69 years of age. Although the prostitute he was visiting said he was delivering charity, this account was not believed by some.^[23]
• Nelson Rockefeller, former Vice President of the United States and heir to the Rockefeller family fortune, died in 1979 of a heart attack at age 70, rumored to be caused by an orgasm during intercourse with his secretary, Megan Marshack. The unusual circumstances surrounding his death caused New York magazine to quip, "Nelson thought he was coming, but he was going". Contemporaneous accounts of his death differed greatly and his hasty cremation left the exact cause of death uncertain.^[24]
• Japanese writer Isamu Togawa had heart failure in 1983 due to his chronic arrhythmia; according to Taro Maki, Togawa died during sexual intercourse at his hotel room.^[25] Togawa's younger brother Itaru Kikumura also said that Togawa died during sex, though this was denied by Tsuneo Watanabe.^[26]
• British actor Patrick Troughton, known for playing the Second Doctor in Doctor Who, died on 28 March 1987 of a heart attack in his hotel room. It was strongly rumoured that he died during intercourse with a fan he met at the convention he was attending.^[27]
• Sir Billy Snedden, Australian politician and former leader of the Liberal Party, "expired 'at the peak of physical congress' (as a policeman told Truth)"^[28] in 1987. Nineteen years later, his son (and lover of the same woman with whom Snedden was having sex at the time of his death) was quoted as saying "I'm sure the old man went out happy—anyone would be proud to die on the job."^[29]
• In 1997, a woman from Houston died after she fell from a balcony in Los Angeles during sex with her employer.^{[30] [31]}
• In Romania in 1999, a man and a woman died of carbon monoxide poisoning while having sex in a car which they had parked in a garage with the engine still running.^{[32] [33] [34]}
• In 2007, a man and woman, both 21, were discovered naked on an empty street in downtown Columbia, South Carolina, with multiple injuries resulting from a fall. Their clothes were later found on the roof of a four-story building adjacent to the road. Both died in the hospital after falling from the building.^[35]
• In 2008, a York County, Pennsylvania woman died when she was electrocuted by homemade nipple clamps, an example of an erotic electrostimulation practice.^[36] Her death was ruled a homicide.^[37]
• In 2009, an Atlanta Police Department officer died from atherosclerotic coronary artery disease while engaged in a threesome. His widow sued his doctor and was awarded a $3 million settlement, with the jury finding that the doctor did not properly diagnose and treat the police officer's pre-existing health issues.^[38]
• In 2013, a man and woman in Zimbabwe were having sex outdoors when they were attacked by a lion; the woman died.^{[39] [40]}
• In 2018, a 29-year-old prostitute died in Saint Petersburg, Russia, after choking on a condom while performing fellatio on a man. The condom slipped off the client during the act and blocked the prostitute's airways.^[41]
• In 2020, a 35-year-old man collapsed and died in the company of a prostitute in Phalombe, Malawi. Local police, and later the general practitioner of the nearby Migowi health centre examined his body, and determined the cause of death to be "excessive orgasm which caused blood vessels in the brain to rupture". Police said the sex worker would not be prosecuted, because she "committed no crime by being too sweet for the man".^[42]

See also

• Autoerotic fatality
• Accidental deaths during erotic asphyxiation
• Rough sex murder defense
• List of unusual deaths

Notes and References

1. Book: McConnachie, James. Sex: The World's Favorite Pastime Fully Revealed. 2010. Rough Guides. New York. 9781843537434. 181.
2. Lee . Heon-Jin . Macbeth . Abbe H. . Pagani . Jerome . Young . Walter Scott III . June 2009 . Oxytocin: the great facilitator of life . Prog. Neurobiol. . 88 . 2 . 127–51 . 10.1016/j.pneurobio.2009.04.001 . 2689929 . 19482229.
3. Riley . Alan J. . 1988 . Oxytocin and coitus . Sexual and Marital Therapy . en . 3 . 1 . 29–36 . 10.1080/02674658808407690 . 0267-4653.
4. Carter . C. Sue . C. Sue Carter . 1992 . Oxytocin and sexual behavior . Neuroscience & Biobehavioral Reviews . 16 . 2 . 131–144 . 10.1016/s0149-7634(05)80176-9 . 1630727 . 36207185.
5. Thayer . Robert E. . Newman . J. Robert . McClain . Tracey M. . 1994 . Self-regulation of mood: Strategies for changing a bad mood, raising energy, and reducing tension. . Journal of Personality and Social Psychology . en . 67 . 5 . 910–925 . 10.1037/0022-3514.67.5.910 . 1939-1315 . 7983582. 17422600 .
6. Dahabreh. Issa J.. Association of Episodic Physical and Sexual Activity With Triggering of Acute Cardiac Events. Systematic Review and Meta-analysis. JAMA: The Journal of the American Medical Association. 23 March 2011. 305. 12. 1225–33. 10.1001/jama.2011.336. 21427375. 5479331. Acute cardiac events were significantly associated with episodic physical and sexual activity; this association was attenuated among persons with high levels of habitual physical activity..
7. Book: Fisher, Mark . Stroke. Part III, Investigation and management . Handbook of Clinical Neurology. Elsevier Health Sciences . 2009 . 9780444520050 . 1240 . 370435311.
8. Banerjee . Ashis . 1996 . Coital emergencies . Postgraduate Medical Journal . 72 . 853 . 653–656 . 10.1136/pgmj.72.853.653 . 0032-5473 . 121117403 . 2398623 . 8944205.
9. Fisher . Alessandra Daphne . Bandini, Elisa . Rastrelli, Giulia . Corona, Giovanni . Monami, Matteo . Mannucci, Edoardo . Maggi, Mario . 1 June 2012 . Sexual and Cardiovascular Correlates of Male Unfaithfulness . The Journal of Sexual Medicine . 9 . 6 . 1508–1518 . 10.1111/j.1743-6109.2012.02722.x . 1743-6095 . 5154206822 . 22510301.
10. Delasobera . Bronson Elizabeth . Osborn . Scott R. . Davis . Jonathan E. . July 2012 . Thunderclap Headache with Orgasm: A Case of Basilar Artery Dissection Associated with Sexual Intercourse . The Journal of Emergency Medicine . 43 . 1 . e43–e47 . 10.1016/j.jemermed.2009.08.012 . 0736-4679 . 800147607 . 19818575.
11. Görge . Günter . Flüchter, Stephan . Kirstein, Michael . Kunz, Thomas . 1 June 2003 . Sexualität, erektile Dysfunktion und das Herz: ein zunehmendes Problem . Herz . 28 . 4 . 284–290 . 10.1007/s00059-003-2478-8 . 0340-9937 . 5648494326 . 12825143 . 27594566.
12. Finocchiaro . Gherardo . Westaby . Joseph . Behr . Elijah R. . Papadakis . Michael . Sharma . Sanjay . Sheppard . Mary N. . 2022-03-01 . Association of Sexual Intercourse With Sudden Cardiac Death in Young Individuals in the United Kingdom . JAMA Cardiology . 7 . 3 . 358–359 . 10.1001/jamacardio.2021.5532 . 2380-6583. 8756354 .
13. News: Wells. Jamelle. Surgeon jailed over prostitute cocaine deaths. 27 April 2013. ABC AU. 11 August 2011.
14. Chen . Xiaojun . Zhang . Qingying . Tan . Xuerui . December 2009 . Cardiovascular effects of sexual activity . Indian Journal of Medical Research . 130 . 6 . 681–688 . 0971-5916 . 566985307 . 20090128.
15. Cheitlin . Melvin D. . 2005 . Sexual Activity and Cardiac Risk . The American Journal of Cardiology . 96 . 12 . 24–29 . 10.1016/j.amjcard.2005.07.007 . 0002-9149 . 107147193 . 16387562.
16. Book: Becker . Wayne M. . The World of the Cell . Kleinsmith . Lewis J. . Hardin . Jeff . . 2003 . 9780805393934 . 7th . 269–270 . 175174348 . Wayne M. Becker.
17. Drory . Y. . 10.1016/S1520-765X(02)90047-7 . Sexual activity and cardiovascular risk . European Heart Journal Supplements . 4 . H13–H18 . 2002 . free .
18. Encyclopedia: Pope John XII . Catholic Encyclopedia . 1910 . Kirsch . JP . Robert Appleton Company . New York . 27 April 2013.
19. Book: Williams, George L. . Papal Genealogy: The Families and Descendants of the Popes . 2004 . McFarland . 9780786420711 . 15.
20. Book: Ceilan, Cynthia . Thinning the Herd: Tales of the Weirdly Departed . 109 . Globe Pequot . 2008 . 9781599216911.
21. Book: Brown, David . Palmerston . Yale University Press . 2011 . 9780300168440.
22. News: Caulcutt. Clea. Felix Faure - a victim of Cupid in the Elysée Palace. 27 April 2013. Radio France International. 4 March 2011. https://web.archive.org/web/20131019200153/http://www.english.rfi.fr/node/79115. 19 October 2013. dead.
23. Book: Shaw, Karl. 5 people who died during sex & 100 other terribly tasteless lists. 2007. Broadway Books. New York. 9780767920599. 60.
24. Rocks off! . 1 April 2012 . Lee . Siegel . . 27 April 2013.
25. Web site: Diary of Taro Maki 10 January 2001 . Maki-taro.net . 2017-06-23.
26. "戸川猪佐武が急逝の舞台裏 銀座ホステスとK女史対立 K女史は戸川の公私の秘書," Uwasa no Shinso, May 1983, 17.
27. Web site: Simmons . Jacob . 2022-11-16 . 10 Doctor Who Secrets Everyone Knows But You . 2024-07-25 . WhatCulture.com . en.
28. Web site: Frank Robson . 2014-09-27 . The greatest Australian scandals of the past 30 years . 2017-06-23 . Illawarra Mercury.
29. Web site: Robinson . Russell . 2009-03-17 . Sir Billy and son 'shared mystery lover' . dead . https://web.archive.org/web/20160415175326/http://www.news.com.au/national/sir-billy-and-son-shared-mystery-lover/story-e6frfkp9-1111112256521 . 15 April 2016 . 2017-06-23 . News.com.au.
30. News: Businessman Found Not Guilty in Fatal Fall Off Hotel Balcony . 6 November 2002. 14 November 2017 . Los Angeles Times.
31. News: A Deadly Passion. Wallstin. Brian. 7 September 2000. 27 April 2013. 20 September 2015. https://web.archive.org/web/20150920232306/http://www.houstonpress.com/news/a-deadly-passion-6574822. dead.
32. Web site: Couple Dies in Hearse . 1999 . 27 April 2013 . Darwin Awards.
33. News: Sporting Life . McClure . Geoff . The Age . 29 March 1999 .
34. News: Finding A Lawyer Won't Be Easy . Chuck . Shepherd . The Augusta Chronicle . 9 May 1999 .
35. Web site: WisTV news . Friends mourn couple who fell from Columbia roof . 30 June 2007 .
36. News: Police: Electric shock sex preceded woman's death . Stevens . Kathy . The York Dispatch . 25 January 2008 . 27 April 2013 . https://web.archive.org/web/20131011152054/http://www.yorkdispatch.com/yd/search/ci_8076525?iadid=search-yorkdispatch.inyork.com-yorkdispatch.inyork.com . 11 October 2013 . dead .
37. Web site: WGAL Susquehanna Valley . Coroner: Sex Electrocution Death Homicide . 27 March 2008 .
38. News: Stanglin. Douglas. Cop dies during 3-way sex; widow wins $3M lawsuit. 27 April 2013. USA Today. 11 June 2012.
39. News: Lion finds Kariba couple having sex in bush, kills girlfriend, boyfriend escapes wearing condom only. https://web.archive.org/web/20130830111407/http://www.myzimbabwe.co.zw/news/4564-lion-finds-kariba-couple-having-sex-in-bush-kills-girlfriend-boyfriend-escapes-wearing-condom-only.html. 2013-08-30. 27 April 2013. My Zimbabwe. 6 March 2013.
40. News: Marauding lions kill woman having sex in Zimbabwe bush . 27 April 2013 . Hindustan times . 7 March 2013 . dead . https://web.archive.org/web/20130416223122/http://www.hindustantimes.com/world-news/africa/marauding-lions-kill-woman-having-sex-in-zimbabwe-bush/article1-1022787.aspx . 16 April 2013 .
41. Web site: Call girl dies of asphyxia in bizarre sexual encounter. Pravda.ru. 15 January 2018. 3 September 2022.
42. Web site: Nyirongo . Thumbiko . Man dies of 'sexual sweetness': Malawi Police say prostitute committed no crime for being too sweet . . 11 November 2022.