Monday, May 23, 2022

Every year many people die during or after sex. A pathologist explains why

Sex has many beneficial physical and psychological effects, including lowering high blood pressure, improving the immune system, and aiding in better sleep.

The physiological function of sex and orgasm releases the hormone oxytocin, the so-called love hormone, which is important in building trust and bonds between people.

But it also has a dark side: People sometimes die during or shortly after sex. The incidence is, thankfully, extremely low and accounts for 0.6 per cent of all cases of sudden death.

There are many reasons why this happens to people. In most cases, it is caused by the physical stress of sexual activity, or by prescription drugs (drugs to treat erectile dysfunction, for example), or illicit drugs, such as cocaine – or both.

The risk of any sudden cardiac death increases as people age. A forensic postmortem study of 32,000 sudden deaths from Germany over a 33-year period found that 0.2 percent of cases occurred during sexual activity.

Sudden death occurred mostly in men (mean age 59 years) and the most frequent cause was heart attack, also known as myocardial infarction. Studies of sudden cardiac death and sexual activity from the US, France and South Korea show similar findings.

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Not just middle aged men

Recently, however, researchers from St George’s, University of London, found that the phenomenon is not limited to middle-aged men.

study, which is published in JAMA Cardiology, investigated in 6,847 cases of sudden cardiac death referred to the Center for Cardiac Pathology in St George between January 1994 and August 2020.

Of these, 17 (0.2 percent) occurred during or within an hour of sexual activity. The mean (median) age of death was 38 years, and 35 percent of cases occurred in women, which is higher than in previous studies.

These deaths are not usually caused by heart attacks, as seen in older men. In half of the cases (53 percent), the heart was found to be structurally normal and a sudden abnormal heart rhythm called sudden arrhythmia death syndrome, or SADS, was the cause of death.

Aortic dissection was the second most common cause (12 percent). This is where the wall of a large artery from the heart that supplies blood around the body ruptures and blood flows between the layers causing it to bulge and burst.

The remaining cases were due to structural anomalies such as cardiomyopathy (a disease of the heart muscle that makes it difficult for the heart to pump blood to the rest of your body), or from a rare group of genetic conditions known as channelopathies.

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This is where the ion channels that let sodium and potassium in and out of the cells in the heart muscle don’t work properly. Changes in sodium and potassium in cells can alter the electrical current through the heart muscle and change the way it beats.

An altered heart rhythm can cause a lack of oxygen (myocardial ischemia) and can lead to sudden heart failure where the heart stops beating.

This new study shows that sudden cardiac death in people under the age of 50 is mainly due to sudden arrhythmia death syndrome, or cardiomyopathy.

Younger adults diagnosed with these conditions should consult with their cardiologist on the risks associated with sexual activity.

However, the low incidence of death in these studies suggests that the risk is very low – even in people with existing heart conditions.

David C. Gage, Senior Lecturer in Chemical Pathology, University of Westminster.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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