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What is Sexual Asphyxiation?

Medically Reviewed by Dan Brennan, MD on June 29, 2021

Sexual asphyxiation is the act of choking someone for sexual pleasure. It falls under the umbrella of breath play. That’s any sex act that makes it hard for you to breathe. 

People may use their hands, plastic wrap or plastic bags, or specialized BDSM (bondage, discipline, sadism, and masochism) devices like hoods for breath play. They may choke someone by placing something around the neck or putting a barrier in front of the mouth and nose. 

Sexual asphyxiation is a dangerous activity. Minor health risks include broken blood vessels in the face, a hoarse voice, or trouble swallowing. Severe health risks include death. The risks are greater for people with certain health conditions like high blood pressure and high cholesterol.

Other Names for Sexual Asphyxiation

Sexual asphyxiation is also called erotic asphyxiation (EA). Autoerotic asphyxiation is when someone plays with their own air supply, without a partner present. People may refer to sexual asphyxiation more casually as choking.

How Sexual Asphyxiation Works in Relationships

Choking and breath play during sex is always a risky activity. Even experienced BDSM professionals recommend staying away from this type of play. 

Never do this type of play with someone you do not know or trust. Make sure to read about safety information and protocols so you know what to do if something goes wrong.

Safety Advice and Special Considerations

Erotic asphyxiation is one of the riskiest sexual activities a person can try. The only thing riskier is autoerotic asphyxiation. That is more dangerous because you’re alone, and no one is around to help you if something goes wrong. Experts say somewhere between 250-1,000 people die each year from autoerotic asphyxiation. 

Death from erotic and autoerotic asphyxiation usually happens because of pressure on the carotid arter ies (two large blood vessels in your neck that supply your brain with blood). This pressure causes you to pass out, making your body go limp.

Depending on the asphyxiation method used, going limp can tighten a ligature around the neck, causing death. It can also prevent removal of a barrier around the mouth and nose in time to avoid death.

Harm Reduction

Harm reduction means giving people the tools and knowledge to do something dangerous in a safer manner. Some people do dangerous things regardless. This can help lower the risks and save lives.

Harm reduction techniques for erotic asphyxiation with a partner include:

  • Learning about neck anatomy to avoid injury to essential parts
  • Using a safe word (if your partner says the safe word all play stops right away)
  • Using a safe gesture, such as holding up one finger, in case your partner can’t talk
  • Checking in with your partner a lot during breath play sessions
  • Doing something less risky, like ordering your partner to hold their own breath.

There are no harm reduction techniques for autoerotic asphyxiation.

WebMD Medical Reference

Sources

SOURCES:

Cosmopolitan: "What Is Breath Play and Why Is It So Dangerous?"

Dictionary: "autoerotic asphyxia."

Vice: "Erotic Asphyxiation: The Widespread and Potentially Fatal Fetish That Nobody Will Talk About."

Vice: "How Risky Is it to be Choked During Sex?"

ABC News: "Police: Carradine's Death Likely Sex Accident."

National Council for Biotechnology Information: "Sexual Masochism Disorder with Asphyxiophilia: A Deadly yet Underrecognized Disease."

National Council for Biotechnology Information: "Harm reduction: An approach to reducing risky health behaviours in adolescents."

Slate: "Strangle With Care."

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