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Stroke Health Center

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Stroke After Sex

Woman, 35, Suffers Rare Orgasm-Related Stroke

Stroke From Sex continued...

Most people with a PFO have no symptoms and don't know they have it. But 40% of people who suffer a cryptogenic stroke -- stroke of no known cause -- have a PFO.

Blood flow through a PFO increases when a person strains, such as bearing down during a bowel movement or breathing out with the mouth closed and nostrils pinched shut.

It also happens during sex, particularly during orgasm, says Brett L. Cucchiara, MD, director of the Penn Stroke Center at the University of Pennsylvania. Cucchiara was not involved in the Biller report, but studied two cases of sex-related stroke in 2006.

"In one of the cases we presented, it is a little embarrassing, one woman had stroke onset coincident with orgasm and having this sort of spontaneous guttural utterance or moan," Cucchiara tells WebMD.

But just having a PFO isn't enough to cause a stroke. A person also must have a blood clot, and that blood clot must break loose and enter the heart just in time to be sucked through the PFO during sex.

Normally a small blood clot would simply get stuck in the lungs and dissolve. But a blood clot that passes through a PFO can lodge in the brain and cause a stroke.

Biller's team did indeed find that their patient had a small blood clot in her leg, probably as a side effect of the oral contraceptives she used for birth control.

"This is a rare occurrence," Biller stresses.

"The vast, vast, vast majority of people with PFOs go through life and never have any problems," Cucchiara says. "You have to keep this risk of stroke during sex in perspective. The risk is very low.

"If you develop sudden neurological symptoms during sex, it could be a stroke and you need to seek help urgently and go to the emergency room," Cucchiara says. "But you should not spend a lot of time worrying about this. Even if you have a PFO, of all the things to worry about in life, this ranks near the bottom in risk."

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