Sexual activity and cardiovascular risks: in love, it is better to have a strong heart

If sexual activity can send you to 7th heaven, it can also send you 6 feet under. Even if in terms of physical expenditure, sexual intercourse is considered an activity of moderate intensity, it can still lead to death in people with heart disease, overweight or obese, this is shown by a large recently published post-mortem analysis.

In France, the case is famous, the President of the Republic, Félix Faure, died at the Elysée, one evening in 1899, of a cerebral congestion (a stroke) following a “treat” lavished by his young mistress, Marguerite Steinheil. This historical anecdote, which combines cardiovascular weakness and sexual activity, illustrates well the risks of death linked to sexual activity in people with cardiovascular disease. Sex then causes sudden death, the first and last manifestation of the disease in question. Numerous clinical studies have shown that sexual activity can be compared to the practice of moderate-intensity physical exercise, such as riding a bicycle, which is not neutral in people with heart disease.

Published on September 12, 2017 in The Journal of Sexual Medicine, a study identified the causes of natural deaths linked to sexual activity from autopsy data collected between 1972 and 2016. Approximately 38,000 deaths were thus analyzed on a 45-year period by Dr. Lena Lange and her colleagues from the Frankfurt Institute of Forensic Medicine (Goethe University Hospital).

Infarction, heart disease, stroke: sexual activity puts the heart to the test

A total of 99 sex-related deaths were identified, representing 0.26% of the 38,000 autopsies performed. These deaths occurred just before, during and shortly after sexual activity. They concerned only 8 women whose average age was 45 years. The men were 57 years old on average. The youngest woman was 22, the oldest man 92. The age of most of the deceased individuals was between 40 and 69 years old, but about 10% of them were over 70 years old.

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The causes of death associated with sexual practice were: coronary artery disease (narrowing by atherosclerosis of the arteries supplying the heart) (28 cases), myocardial infarction (21 cases), ruptured aortic aneurysm (tearing of a dilation of the aortic wall), cardiomyopathy (chronic damage to the heart muscle) (8 cases), myocarditis (inflammatory or infectious damage to the myocardium), sudden cardiac death (cardiac arrest without warning signs) (1 case). One death occurred in a man in the context of myocardial infarction and cocaine intoxication.

Weak heart, overweight and obesity: the risk is skyrocketing

The authors point out that 65% of those who died were overweight or obese. They also note that 60% of hearts examined at autopsy weighed more than 500 grams. One of the hearts weighed 1.1 kg. Remember that the heart of an adult reaches an average weight of 270 g in men and 260 g in women.

For 34 men, the death occurred during sexual intercourse with a prostitute. In 7 cases, death overwhelmed a man in the company of his mistress. Nine men died during or shortly after sex with their wives. Five men died during homosexual intercourse. Five women died during sexual intercourse with their companion. Thirty deaths occurred during masturbatory activity, with pornographic magazines found near the body. Most of the deaths therefore occurred in the presence of a mistress, a prostitute, or during solitary sexual activity.

A total of 50 deaths occurred during coitus or shortly thereafter. Five deaths occurred before intercourse. “Oral-genital intercourse preceded death in 3 cases, masturbation by the sexual partner in 7 cases. Three deaths occurred during caresses and/or massage. In one case, death occurred during a striptease show,” the authors add.

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Spring: the high-risk season

Of the 99 deaths recorded, 32 occurred in the spring (in March, April and May), 28 during the summer (in June, July and August), against 20 in winter and 18 in autumn. The authors see a seasonal influence on the frequency of sexual relations, especially during “spring fever”.

According to them, “even if the cases of natural deaths associated with sexual activity are rare, it should be kept in mind that sexual intercourse, even sexual arousal, can cause cardiovascular accidents, in particular in subjects with a high body mass index (BMI). And to conclude their article by taking care to indicate that the data do not make it possible to know if the rate of death in men is higher in the event of infidelity vis-à-vis the wife or the partner.


Lange L, Zedler B, Verhoff MA, Parzeller M. Love Death-A Retrospective and Prospective Follow-Up Mortality Study Over 45 Years. J Sex Med. 2017 Sep 12. pii: S1743-6095(17)31378-4. doi: 10.1016/j.jsxm.2017.08.007

Stein R, Sardinha A, Araújo CG. Sexual Activity and Heart Patients: A Contemporary Perspective. Can J Cardiol. 2016 Apr;32(4):410-20. doi: 10.1016/j.cjca.2015.10.010

Breitmeier D, Mansouri F, Albrecht K, Böhm U, Tröger HD, Kleemann WJ. Accidental autoerotic deaths between 1978 and 1997. Institute of Legal Medicine, Medical School Hannover. Forensic Sci Int. 2003 Oct 14;137(1):41-4. PMID: 14550612

Lecomte D, Fornes P, Nicolas G. Stressful events as a trigger of sudden death: a study of 43 medico-legal autopsy cases. Forensic Sci Int. 1996 May 17;79(1):1-10. PMID: 8635768


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