When Sex Leads To Stroke

Little did a 35-year old Illinois woman know that a normal bout of sex with her boyfriend would trigger of a life threatening stroke, leaving the left side of her face numb, slurred speech and weakness in her left arm.  Treating her, Jose Biller, MD, Professor and Chair of the Neurology Department at Loyola University, Chicago was puzzled to find that his patient did not fit the profile of a typical stroke sufferer.  A young, healthy, non-smoking woman with no known cardiovascular risk factors, Biller found it too late to inject her with tPA, a clot-busting drug that must be administered within three hours of a stroke.  Instead, taking a risky decision, Biller ran a catheter from an artery in the groin to her brain, applying tPA directly to the clot.  Her symptoms improved almost immediately and within an hour she was out of danger.

So, what was the reason for this stroke after sex?  As a rule, sex and orgasm triggered strokes are rare in young men and women, though not unheard of.  For such a stroke to occur in a relatively young person, requires a combination of factors and events, not unusual in themselves, but extremely unlikely to occur at the same time.  Biller found his patient along with six other young people who suffered similar sex related strokes, had a small opening in the wall between the two upper chambers of her heart.  Called Patent Foramen Ovale (PFO), one in four adults suffer from this minor heart defect, which allows some blood to flow from the right to the left side of the heart, bypassing lungs only to go straight to the brain.  As there are no symptoms, most people with PFO do not know realize they have it, and 40% of people suffering a cryptogenic stroke i.e. a stroke with no known cause, have been found to have PFO.

According to Brett L. Cucchiara, MD, Director of the Penn Stroke Centre at the University of Pennsylvania, strain can cause increased blood flow through a PFO e.g. the strain of bearing down during a bowel movement, strain of breathing out of a shut mouth with nostrils pinched, and strain during sex, particularly during orgasm,.  However, strokes are not caused by PFOs alone, there must be a blood clot present, which must break loose and enter the heart, after being sucked through the PFO during sex.  Normally, the rule of thumb is that small blood clots stuck in the lungs dissolve, but a blood clot that passes through a PFO lodges itself in the brain and causes stroke.

Biller’s young patient to suffer from sex-related stroke was found to have a small blood clot in her leg, the possible side effect of oral contraceptives taken for birth control.  However, for those who love to tussle between the sheets, there is good news, with doctors corroborating that a vast majority of people with PFOs, often go through life without any problems, and while the risk of stroke during sex must be kept in perspective, the risk is low, very low, indeed.  Fortunately, according to stroke experts, sexual intercourse, in itself, is not likely to trigger a stroke without accompanying risk factors.

According to the National Institute of Neurological Disorders and Stroke, over 700,000 Americans suffer a stroke each year and approximately 160,000 die of it.  Risk factors for stroke in young people can be linked to migraines, drug use, coagulation diseases, including athletic injuries that cause a tear in the neck arteries.  However, chances of a young person suffering from stroke are extremely small.