Can Sexual Activity Cause a Stroke?

A stroke is a sudden and serious life-threatening event. We know that a stroke may be caused by a number of health problems, such as heart disease, high blood pressure, bleeding disorders and other stroke risk factors. People have questioned for years whether sex can cause a stroke. To answer that common question, there have been several scientific research studies that have evaluated whether sexual activity can cause a stroke and who is at risk.

Sex as a Stroke Trigger

Overall, it is quite unusual for someone to experience a stroke during sexual activity. In fact, it is rare for a stroke to be provoked by any immediate trigger. The vast majority of the time, a stroke is the result of a build-up of long-term health problems such as smoking, high blood pressure, elevated fat and cholesterol levels, poorly controlled diabetes, blood clotting abnormalities and heart disease.

However, there have been documented instances of a stroke occurring during or shortly after sexual activity. The case reports in the medical literature that describe stroke happening during or within 2 hours after sexual activity interestingly point to a higher likelihood of sex-related stroke in the context of extramarital relationships. It has also been noted that extramarital sexual activity increases the risk of stroke-related death. Whether this is due to an increased stroke rate associated with emotional or psychological factors related to extramarital sexual activity, or to a reluctance to call for urgent medical attention is not clear.

How Often Does a Stroke Occur During Sexual Activity?

It is probably impossible to obtain entirely accurate data about this question. In general, people are less likely to admit that a stroke occurred during sexual activity than they are to report that a stroke occurred during another less private activity, such as driving or jogging.

A recent scientific article published in the February 2015 issue of the Journal of Stroke and Cerebrovascular Disease evaluated 290 patients who were diagnosed with stroke and reported that only 5 of the patients specified sexual activity as a triggering event. This relatively low number is consistent with the previous research on the triggering events associated with stroke.

Who Is at Risk?

Warning signs

People who experience a stroke during or within a few hours of sexual activity generally experience certain warning signs weeks or even months ahead of time. One of the most common warning signs is a thunderclap headache. A thunderclap headache is a sudden, severe, explosive and excruciating headache.

If you ever experience a thunderclap headache or any variation of a severe headache during sexual activity, you need to call your doctor, who will perform a thorough medical evaluation. Some people who experience a thunderclap headache during sex do not go on to suffer from a stroke, but about 30-50% are at risk of having an ischemic stroke. 

Brain aneurysm

Sexual activity is also a risk factor for those who have a brain aneurysm, which is a type of abnormally shaped blood vessel in the brain.

A brain aneurysm may leak or rupture, triggering a hemorrhagic stroke.

Age

It does not appear that older age is necessarily a risk factor for a stroke caused by sex. It has been reported that young people without the typical stroke risk factors have been among those who experience a stroke during sexual intercourse. Blood clotting disorders, serious inborn heart defects, brain aneurysms, contraceptive use and a smoking history seem to play a role in these rare situations.

Drug Use

Recreational drug use has been associated with stroke during or after sexual activity. The use of herbal substances to enhance sexual function has also been linked with strokes.

What Should You Do?

If you ever experience headaches, dizziness or any neurological symptoms during or after sexual activity, you should have a medical evaluation right away. If your partner has symptoms such as headaches, dizziness, vision changes, slurred speech, weakness or confusion during or after sexual activity, it is vital for you to make sure your partner receives urgent medical attention right away. Ischemic stroke and hemorrhagic stroke are uncommon during sexual intercourse but are more likely to occur if you or your partner experiences these neurological warning signs.

Sources

Ischemic stroke occurring during intercourse in young women on oral contraceptives, Miller PE, Brown L, Khandheria P, Resar JR, Am J Cardiol. 2014 Aug 1;114(3):491-3

Ischaemic stroke provoked by sexual intercourse, Calabrò RS, Pezzini A, Casella C, Bramanti P, Triolo O, Journal of Clinical Neuroscience, September 2013

Prevalence of Triggering Factors in Acute Stroke: Hospital-based Observational Cross-sectional Study, Sharma A, Prasad K, Padma MV, Tripathi M, Bhatia R, Singh MB, Sharma A, Journal of Stroke and Cerebrovascular Disease, February 2015

Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case-crossover study, Vlak MH, Rinkel GJ, Greebe P, van der Bom JG, Algra A, Stroke, July 2011