Erotic asphyxiation

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Erotic asphyxiation (variously called asphyxiophilia, hypoxyphilia or breath control play) is the intentional restriction of oxygen to the brain for the purposes of sexual arousal. The term autoerotic asphyxiation is used when the act is done by a person to themselves. Colloquially, a person engaging in the activity is sometimes called a gasper. [1] Erotic asphyxiation can lead to accidental death due to asphyxia.


The erotic interest in asphyxiation is classified as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association.


Concerning hallucinogenic states brought about by chronic hypoxia, Dr. E. L. Lloyd notes that they may be similar to the hallucinations experienced by climbers at altitude. He further notes that no such state occurs in hypoxia brought about by sudden aircraft decompression at altitude. These findings suggest to him that they do not arrive purely from a lack of oxygen. Upon examining the studies on hypoxia he found that "abnormalities in the cerebral neurochemistry involving one or more of the interconnected neurotransmitters, dopamine, serotonin, and beta-endorphin had been reported in all the conditions associated with hallucinations." [2]


Historically, the practice of autoerotic asphyxiation has been documented since the early 17th century. It was first used as a treatment for erectile dysfunction. The idea for this most likely came from subjects who were executed by hanging. Observers at public hangings noted that male victims developed an erection, sometimes remaining after death (a death erection), and occasionally ejaculated when being hanged. [3]


Various methods are used to achieve the level of oxygen depletion needed, such as a hanging, suffocation with a plastic bag over the head, self-strangulation such as with a ligature, gas or volatile solvents, chest compression, or some combination of these. [4] Sometimes, complicated devices are used to produce the desired effects. [5] The practice can be dangerous even if performed with care and has resulted in a significant number of accidental deaths. Uva (1995) writes "Estimates of the mortality rate of autoerotic asphyxia range from 250 to 1000 deaths per year in the United States." [6] Cases have also been reported in Scandinavia [7] and Germany. [8] [9] Swedish police reported in 1994 that the number of autoerotic asphyxiation fatalities in the Stockholm area (c. 1.7 million inhabitants) were at least five annually, but the number of unrecorded cases was assumed to be high. [10] Autoerotic asphyxiation may often be mistaken for suicide, which is a major cause of death in teenagers. [11]

Accidental death

Deaths often occur when the loss of consciousness caused by partial asphyxia leads to loss of control over the means of strangulation, resulting in continued asphyxia and death. While often asphyxiophilia is incorporated into sex with a partner, others enjoy this behaviour by themselves, making it potentially more difficult to get out of dangerous situations. [12]

In some fatality cases, the body of the asphyxiophilic individual is discovered naked or with genitalia in hand, with pornographic material or sex toys present, or with evidence of having orgasmed prior to death. [8] Bodies found at the scene of an accidental death often show evidence of other paraphilic activities, [13] such as fetishistic cross-dressing and masochism. [4] In cases involving teenagers at home, families may disturb the scene by "sanitizing" it, removing evidence of paraphilic activity. This can have the consequence of making the death appear to be a deliberate suicide, rather than an accident. [14]

The great majority of known erotic asphyxial deaths are male; among all known cases in Ontario and Alberta from 1974 to 1987, only 1 out of 117 cases was female. [4] Some individual cases of women with erotic asphyxia have been reported. [15] [16] [17] [18] The main age of accidental death is mid-20s, [4] [19] but deaths have been reported in adolescents [20] [21] [22] and in men in their 70s. [8] [19]

Autoerotic asphyxiation has at times been incorrectly diagnosed as murder and especially so when a partner is present.[ citation needed ]

Lawyers and insurance companies have brought cases to the attention of clinicians because some life insurance claims are payable in the event of accidental death, but not suicide. [23] [24] [25]

Famous cases

Newspaper photo taken shortly after the arrest of Sada Abe (center) in Tokyo on 20 May 1936 Sada Abe.jpg
Newspaper photo taken shortly after the arrest of Sada Abe (center) in Tokyo on 20 May 1936

Although Paula Yates contradicted earlier statements she had made by saying during a 1999 interview that Michael Hutchence's 1997 death might have been caused by autoerotic asphyxiation, [26] the coronial inquest found it to be suicide due to a combination of depression and intoxication with alcohol and other drugs. [27]

In fiction

The sensational nature of erotic asphyxiation often makes it the subject of urban legends. It has also been mentioned specifically in a number of works of fiction.

See also

Related Research Articles

Hypoxia (medical) Medical condition caused by lack of oxygen in the tissues

Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during hypoventilation training or strenuous physical exercise.

Paraphilia is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals.

Asphyxia Condition of severely deficient supply of oxygen to the body caused by abnormal breathing

Asphyxia or asphyxiation is a condition of deficient supply of oxygen to the body that arises from abnormal breathing. An example of asphyxia is choking. Asphyxia causes generalized hypoxia, which affects primarily the tissues and organs. There are many circumstances that can induce asphyxia, all of which are characterized by an inability of an individual to acquire sufficient oxygen through breathing for an extended period of time. Asphyxia can cause coma or death.

Positional asphyxia Inability to breathe due to body position or posture

Positional asphyxia, also known as postural asphyxia, is a form of asphyxia which occurs when someone's position prevents the person from breathing adequately. Positional asphyxia also may be a result of the policing technique known as "prone restraint", used by police, corrections, military, or health care staff. People may die from positional asphyxia accidentally, when the mouth and nose are blocked, or where the chest may be unable to fully expand.


Self-bondage refers to the use of restraints on oneself for erotic pleasure. It is a form of erotic bondage which can be practiced alone.

Autoerotic fatalities are accidental deaths that occur during sexual self-stimulation when an apparatus, device or prop that is being employed to enhance pleasure causes the death. Researchers only apply the term to unintentional deaths resulting from solitary sexual activity, not suicide or acts with a partner. The incidence of autoerotic fatalities in Western countries is around 0.5 per million inhabitants each year.

Sexual fantasy Mental image and thought that stirs persons sexuality and enhance sexual arousal

A sexual fantasy or erotic fantasy is a mental image or pattern of thought that stirs a person's sexuality and can create or enhance sexual arousal. A sexual fantasy can be created by the person's imagination or memory, and may be triggered autonomously or by external stimulation such as erotic literature or pornography, a physical object, or sexual attraction to another person. Anything that may give rise to a sexual arousal may also produce a sexual fantasy, and sexual arousal may in turn give rise to fantasies.

Suicide methods Means by which a person dies by suicide

A suicide method is any means by which a person chooses to end their life. Suicide attempts do not always result in death, and a nonfatal suicide attempt can leave the person with serious physical injuries, long-term health problems, and brain damage.

The choking game refers to intentionally cutting off oxygen to the brain with the goal of inducing temporary loss of consciousness and euphoria.

Autoeroticism Quality arousing corporeal self-lust

Autoeroticism is a practice of sexually stimulating oneself, especially one's own body through accumulation of internal stimuli.

Paraphilic infantilism, also known as autonepiophilia, psychosexual infantilism and adult baby syndrome, is a sexual fetish that involves role-playing a regression to an infant-like state. Behaviors may include drinking from a bottle or wearing diapers. Individuals may engage in gentle and nurturing experiences or be attracted to masochistic, coercive, punishing or humiliating experiences. Diaper fetishism involves "diaper lovers" wearing diapers for sexual or erotic reasons but may not involve infant-like behavior. Individuals who experience both of these things are referred to as adult baby/diaper lovers (AB/DL). When wearing diapers, infantilists may urinate and/or defecate in them.

Inert gas asphyxiation is a form of asphyxiation which results from breathing a physiologically inert gas in the absence of oxygen, or a low amount of oxygen, rather than atmospheric air. Examples of physiologically inert gases, which have caused accidental or deliberate death by this mechanism, are argon, helium, nitrogen and methane. The term "physiologically inert" is used to indicate a gas which has no toxic or anesthetic properties and does not act upon the heart or hemoglobin. Instead, the gas acts as a simple diluent to reduce oxygen concentration in inspired gas and blood to dangerously low levels, thereby eventually depriving all cells in the body of oxygen.

Ray Blanchard American-Canadian sexologist

Ray Milton Blanchard is an American-Canadian sexologist, best known for his research studies on transsexualism, pedophilia and sexual orientation. He found that men with more older brothers are more likely to be gay than men with fewer older brothers, a phenomenon he attributes to the reaction of the mother's immune system to male fetuses. Blanchard has also published research studies on phallometry and several paraphilias, including autoerotic asphyxia.

An asphyxiant gas, also known as a simple asphyxiant, is a nontoxic or minimally toxic gas which reduces or displaces the normal oxygen concentration in breathing air. Breathing of oxygen-depleted air can lead to death by asphyxiation (suffocation). Because asphyxiant gases are relatively inert and odorless, their presence in high concentration may not be noticed, except in the case of carbon dioxide (hypercapnia).

Aquaphilia is a form of sexual fetishism that involves images of people swimming or posing underwater, and sexual activity in or under water.

A suicide bag, also known as an exit bag or hood, is part of a euthanasia device consisting of a large plastic bag with a drawcord used to commit suicide through inert gas asphyxiation. It is usually used in conjunction with a flow of an inert gas like helium or nitrogen, which prevents the panic, sense of suffocation and struggling before unconsciousness, known as the hypercapnic alarm response caused by the presence of high carbon dioxide concentrations in the blood. This method also makes the direct cause of death difficult to trace if the bag and gas canister are removed before the death is reported.

Suicide by hanging Suicide via suspension from an anchor-point

Suicide by hanging is the intentional killing of oneself (suicide) via suspension from an anchor-point such as an overhead beam or hook, by a rope or cord or by jumping from a height with a noose around the neck.

Erotic target location error (ETLE) is a hypothesized paraphilia defined by having a sexual preference or strong sexual interest in features that are somewhere other than on one's sexual partners.

Death can occur during consensual sex for a number of reasons, generally because of the physical strain of the activity, or because of unusual extenuating circumstances. There are various euphemisms for death during sex, including "dying in the saddle" or the French "la mort d'amour".


  1. Roberts, Chris (30 January 2012). Lost English: Words And Phrases That Have Vanished From Our Language. Michael O'Mara Books. p. 66. ISBN   978-1843172789.
  2. Dr. E L Lloyd (29 March 1986). "Points: Hallucinations, hypoxia, and neurotransmitters". British Medical Journal Volume 292: 903.Cite journal requires |journal= (help)
  3. "Erotic Asphyxiation". Lust Magazine. 1997. Archived from the original on 31 August 2006. Retrieved 2 September 2006.
  4. 1 2 3 4 Blanchard, R.; Hucker, S. J. (1991). "Age, transvestism, bondage, and concurrent paraphilic activities in 117 fatal cases of autoerotic asphyxia". British Journal of Psychiatry. 159 (3): 371–377. doi:10.1192/bjp.159.3.371. PMID   1958948.
  5. O'Halloran, R. L.; Dietz, P. E. (1993). "Autoerotic fatalities with power hydraulics". Journal of Forensic Sciences. 38 (2): 359–364. doi:10.1520/JFS13416J. PMID   8454997.
  6. Uva, J. L. (1995). "Review: Autoerotic asphyxiation in the United States". Journal of Forensic Sciences. 40 (4): 574–581. doi:10.1520/JFS13828J. PMID   7595293.
  7. Innala, S. M.; Ernulf, K. F. (1989). "Asphyxiophilia in Scandinavia". Archives of Sexual Behavior. 18 (3): 181–189. doi:10.1007/BF01543193. PMID   2787626. S2CID   42384991.
  8. 1 2 3 Janssen, W.; Koops, E.; Anders, S.; Kuhn, S.; Püschel, K. (2005). "Forensic aspects of 40 accidental autoerotic death in Northern Germany". Forensic Science International. 147S: S61–S64. doi:10.1016/j.forsciint.2004.09.093. PMID   15694733.
  9. Koops, E.; Janssen, W.; Anders, S.; Püschel, K. (2005). "Unusual phenomenology of autoerotic fatalities". Forensic Science International. 147S: S65–S67. doi:10.1016/j.forsciint.2004.09.095. PMID   15694734.
  10. Olof Westerberg: "Sexlekar allt vanligare dödsorsak", Vasabladet 31 August 1994.
  11. Downs, Martin (1 January 2005). "The Highest Price For Pleasure: A Deadly Turn-On". WebMD. Retrieved 4 October 2011.
  12. Autoerotic Asphyxiophilia on 'Sexinfo' website, University of Santa Barbara, Ca.
  13. Bogliolo, L. R.; Taff, M. L.; Stephens, P. J.; Money, J. (1991). "A case of autoerotic asphyxia associated with multiplex paraphilia". American Journal of Forensic Medicine and Pathology. 12 (1): 64–73. doi:10.1097/00000433-199103000-00012. PMID   2063821.
  14. Downs, Martin. The Highest Price for Pleasure, featured by WebMD
  15. Danto, B. (1980). "A case of female autoerotic death". American Journal of Forensic Medicine and Pathology. 1 (2): 117–121. doi:10.1097/00000433-198006000-00004. PMID   7246503. S2CID   40463465.
  16. Behrendt, N.; Buhl, N.; Seidl, S. (2002). "The lethal paraphilic syndrome: Accidental autoerotic deaths in four women and a review of the literature". International Journal of Legal Medicine. 116 (3): 148–152. doi:10.1007/s00414-001-0271-x. PMID   12111317. S2CID   24969597.
  17. Martz, D. (2003). "Behavioral treatment for a female engaging in autoerotic asphyxiation" (PDF). Clinical Case Studies. 2 (3): 236–242. doi:10.1177/1534650103002003006. S2CID   145098915.
  18. Sass, F. (1975). "Sexual asphyxia in the female". Journal of Forensic Sciences. 2: 181–185.
  19. 1 2 Burgess, A. W.; Hazelwood, R. R. (1983). "Autoerotic deaths and social network response". American Journal of Orthopsychiatry . 53 (1): 166–170. doi:10.1111/j.1939-0025.1983.tb03361.x. PMID   6829721.
  20. Shankel, L. W.; Carr, A. C. (1956). "Transvestism and hanging episodes in a male adolescent". Psychiatric Quarterly. 30 (3): 478–493. doi:10.1007/BF01564363. PMID   13359556.
  21. Sheehan, W.; Garfinkel, B. D. (1987). "Adolescent autoerotic deaths". Journal of the American Academy of Child and Adolescent Psychiatry. 27 (3): 367–370. doi:10.1097/00004583-198805000-00017. PMID   3379021.
  22. Edmondson, J. S. (1972). "A case of sexual asphyxis without fatal termination". British Journal of Psychiatry. 121 (563): 437–438. doi:10.1192/bjp.121.4.437. PMID   5077101.
  23. Cooper, A. J. (1995). ""Auto-erotic asphyxial death: Analysis of nineteen fatalities in Alberta": Comment". Canadian Journal of Psychiatry. 40 (6): 363–364. doi:10.1177/070674379504000626. PMID   7585413. S2CID   41699554.
  24. Cooper, A. J. (1996). "Auto-erotic asphyxiation: Three case reports". Journal of Sex and Marital Therapy. 22 (1): 47–53. doi:10.1080/00926239608405305. PMID   8699497.
  25. Garza-Leal, J. A.; Landrom, F. J. (1991). "Autoerotic death initially misinterpreted as suicide and a review of the literature". Journal of Forensic Sciences. 36 (6): 1753–1759. doi:10.1520/JFS13200J. PMID   1770343.
  26. "Paula challenges Hutchence verdict". BBC News (BBC). 10 August 1999. Retrieved 9 December 2010.
  27. Hand, Derrick; Fife-Yeomans, Janet (2008) [2004]. The Coroner: Investigating Sudden Death. Sydney, NSW: Allen & Unwin. ISBN   978-0-7333-2221-1.
  28. John W. Williams (1990). "Can the media kill? A syndrome, a case study and the law". Archived from the original on 9 June 2009. Retrieved 23 March 2009.
  29. "Police probe MP's suspicious death". BBC News, 8 February 1994
  30. Joel Selvin (16 September 1996). "More Than 'The Piano Player'". San Francisco Chronicle . Retrieved 4 January 2009.
  31. Orloff, Brian. "David Carradine Died of Accidental Asphyxiation". People, 2 July 2009.
  32. "David Carradine's Official Cause of Death was Asphyxiation". 2 July 2009. Retrieved 28 February 2014.
  33. Goldman, Russell (4 June 2009). "Police: Carradine Found Naked, Hanged in Closet". ABC News . Retrieved 4 June 2009.
  34. "Actor David Carradine Found Dead". CNN. 4 June 2009. Retrieved 4 June 2009.
  35. "Forensic Scientist Says Carradine Death May Be Linked to Auto-Erotic Asphyxiation". Fox News. 5 June 2009.
  36. "Carradine Death 'Erotic Asphyxiation'". Bangkok Post . 6 June 2009. Retrieved 5 June 2009.
  37. Drummond, Andrew (5 June 2009). "Kung Fu Star David Carradine Died 'When Auto Erotic Sex Game Went Wrong'". Daily Record . Archived from the original on 12 June 2009. Retrieved 5 June 2009.
  38. James, Susan Donaldson (9 June 2009). "Ex-Wife Reveals David Carradine's 'Kinky' Habits". ABC News . Retrieved 9 June 2009.
  39. "David Carradine Branded 'Strange' by Ex". . 9 June 2009. Retrieved 11 June 2009.
  40. McShane, Larry (5 June 2009). "David Carradine a Fan of 'Potentially Deadly' Deviant Sex Acts, Ex-Wife Said in Court Papers". New York Daily News . Retrieved 10 June 2009.
  41. Darwar, Anil (8 June 2009). "Carradine Loved Deadly Sex Games, Says Ex-Wife". Daily Express . Retrieved 10 June 2009.

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