Author "John Curra" wrote, "The carotid arteries (on either side of the neck) carry oxygen-rich blood from the heart to the brain. When these are compressed, as in strangulation or hanging, the sudden loss of oxygen to the brain and the accumulation of carbon dioxide can increase feelings of giddiness, lightheadness, and pleasure, all of which will heighten masturbatory sensations."
Author "George Shuman" describes the effect this way, "When the brain is deprived of oxygen, it induces a lucid, semi-hallucinogenic state called Hypoxia. Combined with orgasm, the rush is said to be no less powerful than cocaine, and highly addictive."
On the subject of hallucinogenic states brought about by chronic hypoxia, "Dr. E L Lloyd" notes that they may be similar to the hallucinations experienced by climbers at altitude. He also comments that no such state occurs in hypoxia brought about by sudden aircraft decompression at altitude. These findings suggest to him that they do not arrive purely from a lack of oxygen. Upon examining the studies on hypoxia he found that "abnormalities in the cerebral neurochemistry involving one or more of the interconnected neurotransmitters, dopamine, Serotonin, and Beta-endorphin had been reported in all the conditions associated with hallucinations."
Historically, the practice of autoerotic asphyxiation has been documented since the early 17th century. It was first used as a treatment for erectile dysfunction. The idea for this most likely came from subjects who were executed by hanging. Observers at public hangings noted that male victims developed an erection.
Deaths have occurred from the loss of consciousness caused by partial asphyxia, resulting in continued asphyxia and death. While often asphyxiophilia is incorporated into sex with a partner, others enjoy this behaviour by themselves, making it potentially more difficult to get out of dangerous situations. Victims are often found to have rigged some sort of "rescue mechanism" that has not worked in the way they anticipated as they lost consciousness.
In some fatality cases, the body of the asphyxiophilic individual is discovered naked or with genitalia in hand, with pornographic material or sex toys present, or with evidence of having orgasmed prior to death. Bodies found at the scene of an accidental death often show evidence of other paraphilic activities, such as fetishistic cross-dressing and masochism. In cases involving teenagers at home, families may disturb the scene by "sanitizing" it, removing evidence of paraphilic activity. This can have the consequence of making the death appear to be a deliberate suicide, rather than an accident.
The great majority of known erotic asphyxial deaths are male; among all known cases in Ontario and Alberta from 1974 to 1987, only one out of 117 cases was female. Some individual cases of women with erotic asphyxia have been reported. The mean age of accidental death is mid-20s, but deaths have been reported in adolescents and in men in their 70s.
Autoerotic asphyxiation has at times been incorrectly diagnosed as murder and especially so when a partner is present. Some hospitals have teaching units specifically designed to educate doctors in the correct diagnosis of the condition.
Lawyers and insurance companies have brought cases to the attention of clinicians because some life insurance claims are payable in the event of accidental death, but not suicide.
It's not all fun and games, there has been some tragedies from playing these games, some famous examples below;-
- Peter Anthony Motteux, English author, playwright, translator, publisher and editor of The Gentleman's Journal, "the first English magazine," from 1692 to 1694, died from apparent autoerotic asphyxiation in 1718, which is probably the first recorded case.
- Frantisek Kotzwara, composer, lost his life from erotic asphyxiation in 1791.
- Sada Abe killed her lover, Kichizo Ishida, through erotic asphyxiation in 1936, and then went on to cut off his penis and testicles and carry them around with her in her handbag for a number of days. Most guys have dated someone crazy, but that's gotta be the classic.
- Stephen Milligan, a British politician and Conservative MP for Eastleigh, died from autoerotic asphyxiation combined with self-bondage in 1994. (We always thought politicians were a bit kinky)
- Michael Hutchence, Australian singer-songwriter and member of Rock band INXS. His death was ruled as suicide by the coroner but was believed by his family and partner to be the result of autoerotic asphyxia. Quite possibly the most classic "Rock n Roll" death ever.
- David Carradine died on June 4, 2009 from accidental asphyxiation, according to the medical examiner who performed a private autopsy on the actor. His body was found hanging by a rope in a closet in his room in Thailand, and there was evidence of a recent orgasm; two autopsies were conducted and concluded that his death was not suicide, and the Thai forensic pathologist who examined the body stated that his death may have been due to autoerotic asphyxiation. Two of Carradine's ex-wives, Gail Jensen and Marina Anderson, stated publicly that his sexual interests included the practice of self-bondage.