Sex should be a fun and pleasurable experience that leaves you in a state of post-coital bliss — not one that sends you to the emergency room.
Unfortunately, injuries from sex do happen from time to time. Minor ones can often be managed at home, but more serious injuries may require a visit to the ER.
“As an ER physician, I’ve seen a wide range of injuries, but some of the most surprising and delicate ones involve sex-related mishaps,” Dr. Jordan Wagner, known as Doctor ER on YouTube, told HuffPost. “These injuries can be both embarrassing and painful, but they’re more common than you’d think.”
Below, ER docs share how these injuries happen, how they’re treated, and offer some words of warning so you can (hopefully) avoid them in your own bedroom.
1. A penis fracture
Penile fractures, while uncommon, can occur during sexual activity due to direct trauma to an erect penis. The penis does not contain bones, so the “fracture” is actually the tearing of the tunica albuginea — the outer lining of the tubes (called the corpora cavernosa) that fill with blood to create an erection.
ER doctor Joe Whittington, who runs the Dr. Joe MD TikTok account, recalls a man in his early 20s who came into the ER with a suspected penile fracture.
“It was his first sexual encounter, and he recounted how during the intense activity, his penis slipped out and bent forcefully against his partner’s pelvic bone,” he told HuffPost.
“He immediately heard a popping sound, followed by sharp pain, swelling, and bruising. We quickly confirmed the diagnosis and scheduled him for emergency surgery to repair the ruptured tunica albuginea.”
After surgery, the man was advised to abstain from sexual activity and given pain medication, Whittington said.
“This incident underscores the importance of maintaining good communication and avoiding overly aggressive movements during intercourse to prevent such painful injuries.”
The urethra — the tube that allows urine to leave the body — can also be damaged during a penile fracture. According to former emergency medicine physician Jessica Singh, founder and CEO of Sukhayu Wellness, “It is critical to seek emergent medical evaluation and treatment” if you are experiencing the symptoms mentioned above.
2. An object stuck in the rectum
Between 2012 and 2021, there were an estimated 39,000 visits to U.S. emergency rooms for rectal foreign bodies — in other words, objects stuck in the rectum, the area between the end of the colon and the anal canal.
“Although there may be several reasons for rectal foreign body insertion, they are most commonly inserted during sexual activity,” Singh said.
Wagner said he’s seen everything from fruits to lightbulbs to water bottles get lodged in a patient’s rectum after being inserted for sexual pleasure.
“The body creates negative pressure, so once it goes too far, it can get sucked in,” he explained.
“If I had a nickel for every time a patient told me they ‘fell on something,’ I’d be retired on a private island by now,” he added.
Sometimes, doctors can remove these items manually with a gloved hand or a speculum, but more complicated situations require surgery.
Whittington recalled a case in which a middle-aged man came to the ER with severe abdominal pain and was unable to pass stool.
“He sheepishly admitted to inserting a light bulb into his rectum during anal play, which had now become lodged. Given the delicate and potentially dangerous nature of the situation, we took extra precautions to ensure the light bulb was removed safely without breaking,” he explained.
“After initial assessments, we carefully removed the object under sedation to prevent any further complications such as perforation or infection. Post-procedure, he was monitored for signs of infection and given antibiotics as a precaution.”
Rectal foreign bodies require medical evaluation and treatment, said Singh, noting that they must be removed immediately in order to avoid complications like infection or perforation of the intestinal wall.
That’s why it’s so important to stick to sex toys designed specifically for anal play. (Vibrators or dildos intended for vaginal use should not be inserted in the butt, nor should any household objects.)
“Ensure they have a flared base to prevent them from getting lost, and avoid overly forceful insertion,” Whittington said. “Using objects that are not meant for such activities can lead to serious injuries and complications.”
3. A prolonged erection
Priapism is the medical term for an “unwanted, prolonged, painful erection that lasts for hours beyond sexual stimulation or occurs without any sexual stimulation,” Wagner explained. When an erection lasts more than four hours, it becomes a medical emergency, he said.
“Blood can start to solidify, causing permanent damage and the inability to have future erections. In the business, we say: ‘time is penis,’” said Wagner.
In sex-related cases of priapism, the main culprits are medications used for erectile dysfunction, such as Viagra, or penile injection therapies. Prolonged erections are considered a rare side effect of oral ED medications like Viagra.
However, when the penis injections and oral medications are combined, the risk of priapism is elevated, urologist Dr. Drogo Montague told the Cleveland Clinic.
“So stay on the safe side and don’t pair them,” Montague advised.
When priapism occurs, the goal is to reduce the erection.
“This can involve injecting medications into the penis to help the blood flow out,” Wagner said. “If that doesn’t work, we use large bore needles to aspirate, or remove, the blood from the penis. If the process of blood solidification begins, a urologist might need to perform surgery to insert a penile shunt or, in severe cases, a penile prosthesis.”
4. Penis captivus
Penis captivus occurs when the penis gets stuck inside the vagina during intercourse. Essentially, the vaginal muscles contract more than usual, tightening the vaginal opening and making it difficult to remove an engorged penis. Once the muscle contractions or erection subside, partners should be able to separate.
It is thought to be a very rare occurrence in humans and most of the information we have about it is anecdotal in nature. Penis captivus might be related to a condition called vaginismus in which the “vagina involuntarily closes due to muscle spasms in the pelvic floor,” according to Medical News Today.
Whittington said he encountered a young couple who arrived at the ER “in a state of considerable embarrassment” after the female’s vaginal muscles had clamped down so firmly during sex that the two were “stuck together.”
“The couple explained that the situation arose during a particularly passionate moment,” he said. “To help them, we used muscle relaxants and cold compresses to gently relax the vaginal muscles. After a short while, they were able to separate without further issue.”
5. Genital infections caused by faeces
Penile or vaginal infections can occur if cuts on the genitals are exposed to faecal matter or other contaminants, said Wagner.
“This can happen during intercourse if proper hygiene is not maintained or if transitioning from anal to vaginal sex without cleaning,” he explained. “These infections are usually a result of bacteria entering the body through minor injuries, most commonly E. coli.”
Typically, these infections are treated with antibiotics and proper wound care, though some patients may need to be hospitalised and given IV antibiotics.
“Good hygiene is crucial,” said Wagner.
To prevent infections, you should change condoms if you’re transitioning between anal sex and vaginal sex. And any penis, finger or sex toy that’s been in the anus should be washed thoroughly using mild soap and water before it goes into the vagina.