We’ve been seeing it everywhere, from movies to romance novels to social media. We’re talking about choking, also known as sexual strangulation. Once a fringe activity among practitioners of BDSM, choking has become more normalized thanks to internet porn and books like “Fifty Shades of Grey.” 

But is choking someone during sex safe? How about if you do it lightly, or only press on certain parts of the neck? And what do sexual strangulation and the head injuries suffered by football players have in common? Let’s find out. 

What is Sexual Strangulation, AKA Choking? 

Choking during sex involves putting one or both hands around the neck of a partner and squeezing. The pressure can vary from light to strong enough to cause unconsciousness. Common in porn, choking is most often performed by men or boys on their female partners but is not exclusive to heterosexual relationships. 

Why is Choking Popular?

As porn has become more extreme and “rough sex” more widespread particularly among young people, choking has become less taboo. In fact, choking is so common now that in a recent survey of 5,000 college students conducted by sex researcher Debby Herbenick, two thirds of the women said they’d been choked during sex.   

Learn more: BDSM Safety

Is Choking Pleasurable? 

While some people simply enjoy the power exchange dynamic of choking, others like the euphoria that can come from being briefly deprived of oxygen. This euphoria can feel particularly intense when combined with intercourse or other types of sex. 

Is Choking Safe?

Though studies are still limited, the news isn’t good when it comes to the physical dangers of choking. Why?

There’s no safe way to choke someone

Any squeezing of the neck reduces blood flow, which deprives the brain of oxygen. This includes even relatively “light” pressure that only lasts a few seconds at a time. Keep in mind that it takes less force to block blood flow to the brain by pressing on the jugular vein than it does to open a soda can.

The neck contains crucial arteries that carry blood to the brain and heart. These arteries aren’t designed to withstand pressure, ever, of any kind. 

Oxygen deprivation causes brain damage

The euphoria that can come from choking is a sign that your brain isn’t receiving enough oxygen. Lack of oxygen can result in symptoms like:

• Loss of coordination
• Headaches
• Incontinence
• Loss of consciousness
• Anxiety and depression
• Brain fog

These are only a few of the potential issues that can result from being choked — and they may be more than temporary. 

Learn more: BDSM Red Flags

Choking may cause permanent brain injury

The long-term impact of choking isn’t fully understood, but is concerning to neuroscientists like Keisuke Kawata, who studies the brains of athletes with CTE. CTE, or chronic traumatic encephalopathy, is a neurodegenerative disorder caused by repeated impacts to the head.

CTE can cause:

• Severe depression and other types of mental illness
• Memory loss
• Hallucinations
• Aggression
• Suicide and suicidal thoughts
• Dementia-like symptoms 

How does CTE relate to sexual strangulation? Dr. Kawata studied the brains of 40 young adult women, half of whom had never been choked, and half of whom had been choked at least 4 times in the previous 30 days. In the women who had been choked, MRI testing showed an imbalance in areas of the brain that control emotion, consciousness, and voluntary physical movement. 

These are early signs of oxygen deprivation and damage to the brain. While there are no studies on the long-term effects of choking, the early data suggests that it can cause harmful and potentially permanent changes to the brain. 

In another study, Dr. Kawata discovered ominous structural differences in the brains of the young women who reported being choked. The folds of their brains had changed in response to reduced bloodflow and oxygen deprivation. 

Learn more about the basics of BDSM: Dominant and Submissive Relationships

FAQs

How is being choked different from holding my breath?

When you hold your breath, oxygenated blood continues to flow to your brain. Choking prevents blood from reaching the brain altogether, depriving it of necessary oxygen and potentially causing damage.

Are there safer alternatives to choking?

Yes! Here are some options that can offer a similar feeling without the risk of brain damage.  

• Have your partner hold their hand over your mouth. You should be free to breathe through your nose
• Ask your partner to cup their hand around your throat without pressure. Remember that any pressure at all is not safe 
• Hold your breath for several seconds. Don't hold your breath more than feels comfortable to you 
• Try a collar! A collar can give you that sensation of a hug around the neck without constricting bloodflow and reducing oxygen to your brain