Sex Strangulation Unsafe, But Doable

The kinky details of David Carradine’s death may leave you asking a seemingly forbidden question: Is there a safe way to engage in autoerotic asphyxiation? Most doctors say no, and strongly discourage self-strangulation during sex or masturbation. But there are ways to make it less dangerous, Christopher Beam writes in Slate.

The act, which involves tying the ends of a belt or rope around the neck and genitals, is best performed with a trusted partner and without drugs or alcohol, writes Beam. Having the belt fastened too tight will cause oxygen levels to drop, heightening the orgasm but also inhibiting blood flow. The practice kills 500 to 1,000 people annually, but studies show they do it "because of the risk of flirting with death—not just because orgasms without oxygen feel good." (More autoerotic asphyxiation stories.)