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Love Death—A Retrospective and Prospective Follow-Up Mortality Study Over 45 Years

  • Lena Lange
    Correspondence
    Corresponding Author: Lena Lange, Institute of Legal Medicine, University Hospital, Goethe University of Frankfurt/Main, Kennedyallee 104, 60596 Frankfurt/Main, Germany. Tel: 0049-6301-83603; fax: 0049-6301-5882
    Affiliations
    Institute of Legal Medicine, University Hospital, Goethe-University of Frankfurt/Main, Frankfurt/Main, Germany
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  • Barbara Zedler
    Affiliations
    Institute of Legal Medicine, University Hospital, Goethe-University of Frankfurt/Main, Frankfurt/Main, Germany

    Institute of Legal Medicine, University Hospital, Justus Liebig University, Gießen/Marburg, Germany
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  • Marcel A. Verhoff
    Affiliations
    Institute of Legal Medicine, University Hospital, Goethe-University of Frankfurt/Main, Frankfurt/Main, Germany
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  • Markus Parzeller
    Affiliations
    Institute of Legal Medicine, University Hospital, Goethe-University of Frankfurt/Main, Frankfurt/Main, Germany
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Published:September 12, 2017DOI:https://doi.org/10.1016/j.jsxm.2017.08.007

      Abstract

      Background

      Although sexual activity can cause moderate stress, it can cause natural death in individuals with pre-existing illness. The aim of this study was to identify additional pre-existing health problems, sexual practices, and potential circumstances that may trigger fatal events.

      Methods

      This medicolegal postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine of the University hospital, Goethe-University, Frankfurt/Main, Germany.

      Outcomes

      Identification of pre-existing health problems, sexual practices, and potential circumstances than could trigger fatal events.

      Results

      From 1972 to 2016 (45 years) approximately 38,000 medicolegal autopsies were performed, of which 99 cases of natural death were connected to sexual activities (0.26%). Except for eight women, men represented most cases. The women’s mean age was 45 years (median = 45) and the men’s mean age was 57.2 years (median = 57). Causes of death were coronary heart disease (n = 28), myocardial infarction (n = 21) and reinfarction (n = 17), cerebral hemorrhage (n = 12), rupture of aortic aneurysms (n = 8), cardiomyopathy (n = 8), acute heart failure (n = 2), sudden cardiac arrest (n = 1), myocarditis (n = 1), and a combination of post myocardial infarction and cocaine intoxication (n = 1). Most cases showed increased heart weights and body mass indices. Death occurred mainly during the summer and spring and in the home of the deceased. If sexual partners were identified, 34 men died during or after sexual contact with a female prostitute, two cases at least two female prostitutes. Nine men died during or after sexual intercourse with their wife, in seven cases the sexual partner was a mistress, and in four cases the life partner. Five men died during homosexual contacts. Based on the situation 30 men were found in, death occurred during masturbation. Of the women, five died during intercourse with the life partner, two died during intercourse with a lover or friend, and in one case no information was provided.

      Clinical Translation

      Natural deaths connected with sexual activity appear to be associated with male sex and pre-existing cardiovascular disorders. Most cases recorded occurred with mistresses, prostitutes, or during masturbation. If death occurs, the spouse or life partner might need psychological support.

      Strength and Limitations

      To our knowledge, the present study contains the largest collection of postmortem data on natural deaths connected with sexual activities. However, the cases presented were of forensic interest; a larger number of undetected cases especially in the marital or stable relationship sector must be assumed.

      Conclusion

      Patients should be informed about the circumstances that could trigger the “love death.”
      Lange L, Zedler B, Verhoff MA, Parzeller M. Love Death—A Retrospective and Prospective Follow-Up Mortality Study Over 45 Years. J Sex Med 2017;14:1226–1231.

      Key Words

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