Imagine a medical advisory discreetly mailed to unfaithful men everywhere. “Warning,” it says. “Extramarital sex can kill.”

The medical staff of the Andrology Clinic at the University of Florence has never distributed any such advisory. But maybe someone should. In an International Society of Sexual Medicine review of the literature on infidelity, members of the clinic’s staff presented intriguing evidence that sudden coital death in men is largely the problem of adulterers.

Since the 1970s, physicians have known that, for most men, sex is safe, and even life-prolonging. But in 1963 a Japanese pathologist reported that, of 34 men who had died during intercourse, most had died of cardiac causes, and nearly 80% had died during extramarital sex.  In 2005 Korean pathologists documented 14 cases of sudden coital death and found that all had died of cardiovascular causes, and only one consorting with the woman known to be his wife. In 2006 researchers from the University of Frankfurt published an analysis of sex-related autopsy reports for 68 men. Ten had died with a mistress, and 39 with a prostitute. Only 40 of the autopsies included significant medical history, but almost all of those indicated strong cardiovascular risks. And the University of Florence team’s own 2011 statistical analysis of health outcomes for almost 1700 male patients seen at their clinic showed that being unfaithful represents an independent risk factor for cardiovascular emergencies.

“We were surprised,” says Alessandra Fisher, the study’s lead author, “especially given the fact that we had recently documented unfaithful men in our patient population as having, in general, better vascular flow, larger testicles, and higher levels of male hormones.”

If unfaithful men are hale and hearty, why do they die doing what they love to do?

One clue may lie in a 2011 University of Maryland School of Medicine study of blunt trauma injuries to the penis. Penile fractures, it said, usually result from sex in “unusual social situations” like an elevator or public restroom. More than half of the 16 patients who required reparative surgery had been injured during extramarital affairs.

“Extramarital sex may have its own hazards,” says Fisher. “For example, the lover might be much younger. Sex might be particularly athletic or follow excessive drinking or eating.”

Does secrecy also add to the cardiovascular load? Can guilt cause fatal physiological stress? Is there something moderating about sex with someone who really cares about you? Is that necessary for met with less sthan brillilant hearts?  

Fisher says that more studies are needed.

FOR MORE INFORMATION 1. Alessandra D. Fisher, Elisa Bandini, Giulia Rastrelli, Giovanni Corona, Matteo Monami, Edoardo Mannucci, and Mario Maggi, “Sexual and Cardiovascular Correlates of Male Unfaithfulness,” The Journal of Sexual Medicine, first published online April 17, 2012.


Copyright Rebecca Coffey. Photo courtesy of The Freud Museum
Source: Copyright Rebecca Coffey. Photo courtesy of The Freud Museum

By day Rebecca Coffey is a science journalist, contributing to Scientific AmericanDiscover, and Vermont Public Radio. She also presents a weekly radio spot, Family Friendly Science, on the nationally syndicated  show, Daybreak USA. By night she is a novelist and humorist. Hysterical: Anna Freud's Story is due out in May 2014 from She Writes Press. Nietzsche's Angel Food Cake: And Other "Recipes" for the Intellectually Famished was published in October 2013 by Beck & Branch. 

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Twitter: @rebeccacoffey

About the Author

Rebecca Coffey

Rebecca Coffey is a science journalist and broadcast commentator with Vermont Public Radio. 

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