Strangulation, use of stimulants among causes of non-natural death during sex

There is a wide variety of causes of non-natural deaths associated with sexual activities, a recent study has found. Strangulation and the use of stimulants are among such causes.

The postmortem, medicolegal, retrospective and prospective study included 74 cases (mean age, 43.6 years; 43 males) of non-natural deaths related to sexual activities. The primary outcome measures were the circumstances, gender distribution and sexual practices associated with these mortalities.

Twenty-one males and one female died during autoerotic sexual practices (group 1), while deaths during consensual sexual contact included nine males and fourteen females (group 2). Thirteen deceased males and 16 deceased females had performed sexual acts without mutual consent (group 3).

In group 1, the most common cause of death was accidental strangulation, brought about by throttling or hanging, followed by the consumption of lethal doses of 3,4-methylenedioxy-methamphetamine (MDMA), methamphetamine, cocaine and other stimulants. In comparison, lethal intoxication dominated group 2, with alcohol, heroin and cocaine as the leading substances.

Notably, five females in group 2 were killed intentionally by their male partners. Blunt or sharp force and drowning, in combination with strangulation, were the causes of death. In group 3, sharp violence with kitchen knives emerged as the main cause of death. The mortalities in this group included two 13-year-old boys and one 9-year-old girl.

“Deaths in connection with bodily injuries during [bondage and discipline, sadism and masochism] practices seem to be extremely rare; however, medical staff should be aware that strangulation as a pleasure-enhancing technique should be considered extremely dangerous, especially in the course of autoerotic practices,” said researchers.

“Future fatal incidents could perhaps be prevented by addressing this topic during the sex education of teenagers and older people or in discussions concerning sexual health issues with patients,” they added.