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Being choked during sex just a handful of times could lead to permanent brain damage, alarming study shows
It is the increasingly popular sexual act that has sparked concern among doctors across the country.
Choking, medically known as sexual strangulation, during intimate moments has been experienced by a staggering 58 percent of female college students, according to a recent study.
But now the bizarre 'turn on', popularized by Gen Z television shows like HBO's Euphoria and box office hit Fifty Shades of Grey, has been shown to cause alarming damage to the brain — which could be permanent.
Research has shown that women who had been choked four times over the previous 30 days experienced changes in their brain structures that affected their abilities to perform working memory tasks.
The research was carried out by Dr Debbie Herbinick, a sexual and reproductive health researcher, who is one of the scientists leading the investigations into the harms of choking.
Dr Debbie Herbinick, a sexual and reproductive health researcher, is one of the scientists leading the investigations into the harms of choking.
Other studies she's led have showed that choking and other forms of rough sex are not only common among young people, but expected of them.
Restricted blood flow to the brain can cause it to stop operating at normal capacity immediately and can suffer necrosis, or tissue death, as soon as five minutes due to a lack of oxygen and glucose supply.
The risks of the sex act lie in the harms of depriving the brain of oxygen.
Even if this is only for a short periods of time, such as 10 seconds, it can cause someone to pass out. Minutes without oxygen can lead to permanent brain damage.
Neurons, or brain cells, begin to shrivel and die. To survive, they tap into emergency fuel stores, which generate lactic acid in the bloodstream, eventually leading to tissue damage in the heart, kidneys, and liver after around 20 minutes.
The allure, advocates say, is the elation felt with the sudden rush of oxygen that is triggered when the partner lets go.
Dr Herbernick said: ‘There’s big concern about teenagers and young people doing this, who don't really yet have full knowledge and information about these behaviors, who maybe have very limited practice or experiencing or experience communicating about sexuality.
‘Even historically, in kink and BDSM communities, strangulation, which is what choking really is, has been off limits for most and seen as a really sort of rare or niche behavior that a small subset of people were interested in, and that they needed very careful consent, communication, education.’
Areas lit up in red and orange represent the choking group which had thicker brain areas in many regions, including parts of the frontal, temporal, parietal, and occipital lobes, in both hemispheres involved in a long roster of processes including face recognition, decision-making, self-awareness, and motor movements
The choking group showed significant changes in fractal dimensionality (A measure of the complexity of brain structures, indicating how intricate and detailed the surface of the cortex is) in various brain regions compared to the choking-naïve group, with increases in some areas and decreases in others
The areas in blue represent the choking group which exhibited significantly less brain folding (gyrification) compared to the choking-naïve group in several brain regions involved in decision-making, planning, emotional regulation, reward processing, language processing, and speech
A study in the journal Brain Behavior looked at two groups of 41 women, one group that had been choked in the past 30 days and another that hadn’t, to see how the practice affected the structure of their brain.
The choking group exhibited significantly increased cortical thickness in multiple brain regions involved in face recognition, visual processing and memory compared to the choking-naïve group, suggesting the structure of their brains had changed, perhaps permanently.
These structural changes could be associated with differences in cognitive functions or sensory processing.
Measures of the complexity of brain structures were mixed: the choking group had increased volume in regions involved in processing touch, emotional processing, recognition of other faces and bodies, but decreased sizes of the areas involved in working memory, higher executive functioning, self awareness, and visual processing.
But the study authors caveated: 'It is possible that individuals who were predisposed to mental illnesses such as depression may already have an altered cortical morphology, and thus, they may become more prone to risky behavior.’
The practice of choking during sex is a relatively new phenomenon. Having progressed beyond hiding in niche corners of the internet on pornography sites – which have flourished – intimate choking is now a fixture in pop culture.
Beyond just Euphoria, musicians like Jack Harlow and comedians like Ali Wong have shared their preference for the practice.
The first episode of the Max show Euphoria shows a character, Cassie, engaging in intercourse with a partner who chokes her, assuming she would enjoy it. He did not ask her first.
Meanwhile, Jack Harlow sings in his song Lovin On Me, 'I'm vanilla, baby, I'll choke you, but I ain't no killer, baby.'
And comedian Ali Wong has said: 'I'm a bossy person, so you be the boss, okay? Just choke me enough that I can't talk. Because if I can talk, I'm gonna tell you what to do.'
A 2022 study reported that women who were choked at least once experienced loss of consciousness, indicating at least mild acquired brain injury, seizures, motor and speech disorders, and paralysis.
Sam Pybus, 32, from the UK killed his mistress Sophie Moss, 33, (pictured) by applying pressure to her neck during sex
Sam Pybus, 32, with his now ex-wife Louise Howitt, was jailed for four years and eight months after admitting the manslaughter of Sophie Moss, a vulnerable mother-of-two who he strangled to death in bed
Psychological outcomes included PTSD, depression, suicidality, and dissociation. Cognitive and behavioural symptoms were described less frequently, but included memory loss, increased aggression, compliance, and lack of help-seeking.
Dr Herbernick said: ‘I think parents are mostly just very shocked to hear about these changes in sexual behavior among teens and young adults, college students, and so on. Because these were not the mainstream behaviors, when people who are currently in their 40s 50s 60s were those ages. And so it's really hard for people to believe, to even accept that this could possibly be the case.’
On February 7, Sam Pybus from the UK applied pressure to his girlfriend Sophie Moss’ neck when they had sex at her home. She had previously asked for him to do it, making it technically consenual. Mr Pybus said he had been intoxicated when he fatally strangled the mother of two.
The case has been highlighted as the latest in a series of examples when a 'rough-sex defence' has been used by men accused of killing women.
It argues that the strangled person ‘asked for’ the partner to perform the act that led to the homicide, adding that the homicide was the result of sexual practices to which the victim consented and possibly demanded.
Mr Pybus was sentenced to just four years and eight months after pleading guilty to manslaughter, and not murder, as there was nothing to suggest he intended to kill her or cause serious harm