This is one sexual urge you may want to smother.
While Americans are, statistically speaking, losing interest in sex, one dangerous act is taking hold. The risky practice has been normalized by porn — despite the potentially fatal consequences of partaking.
And while it may seem like kinky fun to those who do it, it can actually lead to serious brain injury — and the results aren’t necessarily immediate, threatening to take hold days, weeks or even years later.
Even more startling, experts say you increase your harm every time you do it.
A study published in the journal the Archives of Sexual Behavior this week found that more than half of Australian adults age 35 and under reported being strangled by a partner during sex.
Sexual strangulation involves applying pressure to the neck and restricting blood flow or breathing to “enhance” a sexual experience. It often incorporates the dominant/submissive sexual dynamic and the use of hands, arms, feet, and binding agents like belts and ropes.
In sex play and porn, it’s usually referred to as “choking” — even though choking is different, and technically describes the partial obstruction of the trachea.
But experts are warning how dangerous it truly is, no matter how gentle couples may think they’re being — and regardless of whether both partners like it in the moment.
How dangerous is choking during sex?
“There is no zero-risk way of engaging in choking,” warned Dr. Debby Herbenick, a public health professor at Indiana University, in a recent presentation. “Though deaths from consensual choking are rare, they do happen.”
The neck is described by experts as “alarmingly fragile,” and no matter how briefly, restricting blood flow to the brain can cause permanent injury.
Even the “relatively low” amount of force it takes to open a can of soda, when applied to someone’s throat, is enough to cause unconsciousness and risk brain injury.
Immediate consequences of sexual strangulation include bruising or swelling of the neck, vision changes, dizziness or light-headedness and difficulty swallowing.
With arterial pressure, people can lose consciousness in as little as four seconds. Researchers at Bangor University and doctors at North Wales Brain Injury Service maintain that this loss of consciousness is — at the least — an indication that the person has suffered a mild brain injury.
While loss of consciousness can occur in seconds, death or paralysis is possible within minutes of strangulation.
Other consequences of sexual strangulation can take days, weeks or even years to manifest. These can take the form of a change in voice, incontinence, seizures, issues with memory, concentration and decision making, depression, anxiety and miscarriage.
There is also growing evidence that, much like the cumulative harm of repetitive head injuries, hypoxic/anoxic brain injuries from sexual choking can accumulate and lead to long-term cognitive problems.
“The risks associated with brain injury increase with each subsequent strangulation,” said study co-author Heather Douglas, from Melbourne University Law School.
“So it’s a little bit like head injury in that injuries can accumulate. Miscarriage can also result from strangulation, and can occur a week or months down the track. Strangulation can lead to a stroke. There can also be an incremental reduction in memory.”
A 2022 study found that strangulation — including as part of domestic violence — is the second most common cause of stroke in women under 40.
Further, separate research suggests that strangulation is more dangerous than waterboarding because strangulation affects both blood flow and air flow.
A paper published in May of this year compared blood samples from women who’d been strangled at least four times during sex in the last 30 days and those with no history of strangulation.
The strangled women’s blood showed elevated levels of S100B, a marker of brain damage.
Researchers believe the surge in strangulation is due in part to the prevalence of the intimate act in pornography.
Earlier this summer, the UK announced that it would criminalize pornography that depicts acts of strangulation after an independent review found that pornography has effectively made strangulation a “sexual norm” and a “safe” act to engage in.
Herbenick notes that the concept of “rough sex” continues to evolve and now, in addition to light spanking, hair pulling, biting and pinning a partner down, has grown to include sexual strangulation, slapping the face, torso and genitals, consensual nonconsent and punching.
Women are increasingly being injured and killed in seemingly consensual sexual situations. In the UK in 1996, two women per year were killed or injured during what the defendants referred to as “consensual rough sex,” but this figure had soared to 20 women by 2016.
For their part, the authors of this latest study are hopeful their research will educate young people on the dangers of sexual strangulation and encourage conversations about consent.
“Nonstigmatizing education strategies are needed to engage with young people so they have a better understanding of the risks involved and how to negotiate consent and safety regarding sexual strangulation,” they concluded.
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