Wednesday, September 17, 2008

Holy Shit!

(WebMD) Sex triggered a life-threatening stroke in a healthy 35-year-old Illinois woman, her doctors report.

Sex- and orgasm-triggered strokes in relatively young women and men are rare, but not unheard of. They require a combination of factors and events not unusual in themselves, but which are highly unlikely to occur at the same time.

The 35-year-old woman's symptoms were typical of this unusual kind of "cryptogenic" stroke, says Jose Biller, MD, professor and chair of the neurology department at Loyola University, Chicago.

"This young woman ... while having intercourse had numbness on the left side of her face, slurred speech, and weakness in her left arm," Biller tells WebMD. "When she was transferred to our care six hours after onset, she was completely unable to move her left arm, her face was paralyzed, her speech was garbled, and she was in a state of panic."

It was too late to inject the woman with the clot-busting drug tPA, which must be given within three hours of a stroke. So Biller's team quickly ran a catheter from an artery in the woman's groin up into her brain to find the blood clot by angiography. Once it was found, they had only one option: to apply tPA directly to the clot.

It was a risky decision. "We did this with a lot of sweat," Biller says.

The woman's symptoms began to improve almost immediately; within an hour she was out of the woods and within 12 hours the symptoms were almost gone. Today she is well, with only an almost imperceptible fold in the skin under her nose and slight loss of dexterity in her left hand.

Stroke From Sex

Why did sex trigger this young woman's stroke? She shared one thing in common with six other young people who suffered sex-related strokes: a small opening in the wall between the two upper chambers of her heart.

One in four adults has this minor heart defect, called a patent foramen ovale or PFO. A PFO allows some blood to flow from the right side of the heart to the left side. This blood bypasses the lung and goes straight to the brain.

Most people with a PFO have no symptoms and don't know they have it. But 40% of people who suffer a cryptogenic stroke -- stroke of no known cause -- have a PFO.

Blood flow through a PFO increases when a person strains, such as bearing down during a bowel movement or breathing out with the mouth closed and nostrils pinched shut.

It also happens during sex, particularly during orgasm, says Brett L. Cucchiara, MD, director of the Penn Stroke Center at the University of Pennsylvania. Cucchiara was not involved in the Biller report, but studied two cases of sex-related stroke in 2006.

"In one of the cases we presented, it is a little embarrassing, one woman had stroke onset coincident with orgasm and having this sort of spontaneous guttural utterance or moan," Cucchiara tells WebMD.

But just having a PFO isn't enough to cause a stroke. A person also must have a blood clot, and that blood clot must break loose and enter the heart just in time to be sucked through the PFO during sex.

Normally a small blood clot would simply get stuck in the lungs and dissolve. But a blood clot that passes through a PFO can lodge in the brain and cause a stroke.

Biller's team did indeed find that their patient had a small blood clot in her leg, probably as a side effect of the oral contraceptives she used for birth control.

"This is a rare occurrence," Biller stresses.

"The vast, vast, vast majority of people with PFOs go through life and never have any problems," Cucchiara says. "You have to keep this risk of stroke during sex in perspective. The risk is very low.

"If you develop sudden neurological symptoms during sex, it could be a stroke and you need to seek help urgently and go to the emergency room," Cucchiara says.

"But you should not spend a lot of time worrying about this. Even if you have a PFO, of all the things to worr about in life, this ranks near the bottom in risk."

There are devices available for closing PFOs. But Biller and Cucchiara both note that doctors currently don't recommend this procedure -- even for most people who have already suffered a stroke.

That recommendation didn't convince Biller's young patient.

"She was scared to death, and she and her boyfriend and family were pushing us very hard to close the defect, so that is what we did," Biller says. "So she had the device implanted to close the PFO."

Biller's report appears in the September issue of the Journal of Stroke
and Cerebrovascular Diseases.

13 blew out from under the bed:

Annie Wan said...

how many like me will read this and agree with you - holy shit - and then forget about it and comfort themselves it only happens to other people and very rarely too.

hello - popped by via lady in red - *waves*

Indi said...

Bloody hell!! Scary stuff-thankfully for the young woman in question & the medical team knew exactly what to do...there must be a god after all...

Akelamalu said...

OMG that's scary.

Constance said...

I'd like to be having regular sex even if it did mean a slight risk... (pouts)

Laura said...

Every day I read of reasons convincing me that sex is a bad idea....

Riff Dog said...

Yeah, it figures that this report would be in a "Stroke" magazine! ;)

Ron said...

Oy Vey!?!?!?

Jeff B said...

Now I've had a stroke or two during sex, but that's only when I'm by myself!


sorry, couldn't help myself.

Rupert said...

Yeah, but if I was the dude that was with her, just think about the bragging rights! "Man, I fucked her so hard she had a stroke!"

Utter Basketcase said...

HECK! I'm never having sex again! :-P xx

Joanna Cake said...

Wow! Im wondering what that will do for sales of that particular birth control pill... Great post!

CrystalChick said...

So next time I'm pinching my face and repeating words over and over to make sure I'm saying them right and banging my left arm on the nightstand I'm gonna tell hubby this is why.
OMG what a crazy story. Who knew?

nitebyrd said...

Mei Del ~ Thanks for coming by. I'll drop over to your place soon. I think we all tend to think that way when we hear something that is awful. "It'll NEVER happen to me!" Let us pray.

Indigo ~ Thank the Gods for modern medicine and quick thinking people.

Akelamalu ~ Isn't it? Although, I can think of worse ways to die. I once got the mother of all migraines from masturbation. I seriously thought my brain was going to explode.

Loving Annie ~ I have no doubts that you will and without any negative effects.

Bunny ~ No matter what, sex is never a bad idea as long as you use common sense. This type of thing is rare but I thought it was post worthy. I like to keep my readers informed of the odd and weird news when I can. Thanks for coming to see me.

Riff ~ TA RUM DUM ... Ladies and gentlemen, he's here 'till Tuesday. Try the chicken! (I know it's veal but I don't eat veal and neither should any of you.)

Ron ~ Makes you want to plotz, doesn't it?

Jeff ~ Starting on Wednesday, THE RIFF AND JEFF SHOW! Don't miss them! :D

Rupert ~ I can always rely on you to see the bright side of any situation. You definitely are a glass half full guy!

Giggle ~ You will. It's too much fun. Although, once "the bean" comes you may forget what sex and sleep are like!

Cake ~ Thanks. Even with birth control pills, as with the majority of medications, you wonder it the side-effects are really worth the benefits.

Crystalchick ~ LOL! Yeah, it is crazy and scary. I console myself with the fact that some guy got shot in the head 19 times with a nail gun. He survived with no ill-effects. Not that you'll be using a nail-gun during sex, (at least, I HOPE not) but you get my drift, right?