Scientists have found that non-natural deaths associated with sexual activity occur in a variety of scenarios, experts report.
Their recent Journal of Sexual Medicine study provided an overview of such deaths in Germany.
“These cases are not limited to autoerotic fatalities or sexual homicides and seem to be much more complex than natural deaths connected to sexual activity,” they wrote.
The researchers examined autopsy reports, along with available police and court records, for 74 non-natural sex-related deaths occurring between 1993 and 2017. These deaths represented 0.45% of all autopsies performed at the Institute of Legal Medicine in Frankfurt during that time period.
A total of 43 males (aged 13 to 78) and 31 females (aged 9 to 68) died. The researchers divided the records into three categories:
- Group 1 (22 people – 21 males and 1 female) included “autoerotic accidental deaths” in which no other person was believed to be present.
- Group II (23 people – 9 males and 14 females) included deaths with at least one other person present, with sexual activities performed with consensually.
- Group III (29 people – 13 males and 16 females) included deaths with at least one other person present, but sexual acts were performed without mutual consent.
Strangulation, usually by hanging or throttling, was the most frequent cause of death for Group 1 and the second-most common cause in Group II. The authors noted that pornographic materials often depict strangulation as a “pleasure-enhancing technique” and that teens and young adults may be in particular danger, thinking that it is safe.
“In our opinion, the prevention of such deaths could be aided by including this topic in the sex education of young people, alongside topics such as sexually transmitted diseases or pregnancies,” the researchers wrote.
Healthcare providers should also know that BDSM is a common sexual activity, the authors added.
In addition, they pointed out the frequency of drug use [including heroin, cocaine, and (meth)amphetamines] and “ChemSex” – using drugs and/or alcohol to enhance the sexual experience. Fatal intoxication was the most common cause of death for Group II. As more females than males died in that group, it’s possible that women did not have the tolerance for the substances used.
Other findings included the following:
- For deaths involving other people, most victims knew the other participant(s).
- Sharp violence, often with knives, was the most common cause of death in Group III.
- Similar rates of anogenital injuries (e.g., caused by objects such as sex toys, vegetables, the neck of a wine bottle, and the handle of a toilet plunger) were found in all three groups (Group I – 27%, Group II – 26%, and Group III – 24%.
- Semen was detected in females in Group II and Group III, but not in males.
- Group I consisted of almost all men, except for one woman. The authors explained that men may be more likely to “participate in risky pleasure-enhancing masturbation techniques,” although more female-related deaths may be unreported.
The authors suggested that “in cases of death associated with sexual activity, medical staff should perform thorough unbiased examinations and documentations.”
The Journal of Sexual Medicine
Bunzel, Lena, et al.
“Non-Natural Death Associated with Sexual Activity: Results of a 25-Year Medicolegal Postmortem Study”
(Full-text. Published online: August 22, 2019)