Can You Die From an Orgasm?

A 45-year-old woman was on the verge of orgasm during sex with her husband when she felt a sudden "pop" in her chest. After being rushed to the emergency room, the patient was examined by doctors, who published their findings in July 2022 in the American Journal of Case Reports. They quickly found she was suffering from acute aortic syndrome (AAS), linked to her history of unmanaged high blood pressure.

'Several retrospective studies looking at this topic show a rate of death during sex between 0.19 and 0.26 percent.'

If you dig deep through the endless supply of online medical journals, you can find rare stories similar to this one. And you can find sensationalistic headlines claiming "lots of people die every year during or after having sex." If you actually read these articles, however, you find the real number of deaths is minuscule—and even in the exceptional examples, there's often more at play than headlines indicate.

What do studies say about death by orgasm?

Existing scientific inquiries into lethal sex have been prompted by concerns over "potency-enhancing drugs" such as sildenafil (Viagra). In June 2006, German scientists released the findings of forensic autopsies performed on about 32,000 bodies over a 33-year period. Each of these patients died of natural circumstances, but 68—five women and 63 men—died during sex. That's 0.22 percent of the deaths. Blood clots that blocked flow to the heart were the most common cause of death, and 19 of the 68 patients had a previous medical history of blood clots.

Overwhelmingly, deaths during sex aren't just about the sex. Zoya Ali, a reproductive health scientist and accredited sex educator in the United Kingdom, said the main case studies she's seen have been lethal due to too much prescription medication or illegal substances. There's also the occasional case of "kink exploration gone wrong," such as accidental hanging during autoerotic asphyxiation.

In the aforementioned study, there are examples of brain aneurysms or heart attacks occurring during sex, but these largely happen to patients with histories of poor health.

"Several retrospective studies looking at this topic show a rate of death during sex between 0.19 and 0.26 percent," said Vadim Fanous, M.D., an internal medicine specialist in California.

Most of these deaths were men of about 60 years old with existing health conditions, Fanous continued. In these cases, extreme physical exertion led to heart failure; these patients could have just as easily died during a run.

"The bottom line is that age, gender and the existence of preexisting cardiovascular conditions were the most important factors in the majority that died during intercourse," Fanous concluded.

Cultural context of death by orgasm

Headlines fail to communicate the rarity of these "extreme" or "lethal" orgasms, but why? Fanous' answer was simple: "They're clickbait stories trying to get attention," he said. "Any story making it sound like orgasms themselves put you at risk of death should not be taken seriously."

'The orgasm doesn't kill you; the increased cardiovascular activity triggers a heart attack which can kill you.'

There's a wider cultural context to explore here, too. Gigi Engle, a sex educator in London and the author of "All the F*cking Mistakes: A Guide to Sex, Love and Life," explained: "We live in a society that hates sex. We're told it's bad, dirty and even dangerous."

In her eyes, fear-mongering headlines about lethal orgasms play into the hands of "purity culture," which she said thrives on the idea that "sex is evil," and these misrepresented stories of deadly orgasms are framed as such to push an anti-sex agenda.

"These deaths were related to people who had poor heart health to begin with," she said. "The orgasm doesn't kill you; the increased cardiovascular activity triggers a heart attack which can kill you.

"[In most cases,] a healthy sex life has actually been linked to better heart health, improved immunity and decreased anxiety," Engle said. "An orgasm a day keeps the doctor away."

When should you avoid sex?

Of course, there are reasons to occasionally forgo sex.

Ali cautioned against sex under the influence of drugs and alcohol.

"They can influence decision-making abilities, which is why someone under the influence can't give their informed consent," Ali said.

Ali also said to look out for telltale signs of sexually transmitted infections (STIs).

"If you notice any signs of burning, itching, pain during peeing, fishy smell or abnormal discharge, it could be a sign of infection, so it's best to have it checked out by your doctor," she said.

Usually, you'll be asked to avoid sex until treatment is complete.

Engle echoed the message that safer sex—using everything from internal and external condoms to gloves, in extreme cases—is best, but took aim at the myth that masturbation can make orgasm more difficult.

"It puts you in touch with your body and teaches you what turns you on," she explained. "If you use a vibrating wand on its highest setting five times per day, you might experience some very temporary genital numbness."

But Engle said the numbness usually wears off within a day or two.

As for cardiovascular health, it's worth speaking to a doctor if you're in any way concerned, but it is entirely possible to maintain a healthy heart and, in turn, a healthy sex life as you age.

"According to all the medical professionals I've spoken to throughout my career, if you can climb a flight of stairs without getting completely winded, you're healthy enough for sex," Engle said.