Coming and fainting: Is it possible to pass out from an orgasm?

Dear Alice,

I have a question. I just heard that a woman can faint while having an orgasm and if so, is this normal? What causes this?

Dear Reader,

It may "come" as a surprise to learn that some people unintentionally faint while orgasming! Though rare, it’s possible that when people become sexually aroused, their breath shortens and quickens so rapidly that they hyperventilate, disrupting their body’s balance of carbon dioxide and oxygen. As a result, they may experience dizziness, lightheadedness, and even fainting spells. To date, there isn’t sufficient research examining the cause of this, but it’s potentially due to some underlying medical conditions. There are also individuals who intentionally faint during sex to heighten their pleasure (be it partnered or solo sex), but it’s key to note that doing so carries with it some serious health risks and could potentially be fatal (more on that in a bit). If someone does experience unintentional fainting during sex, it’s best that they speak with their medical provider to determine appropriate treatment or management options.

Specific health conditions which may be related to unintentional fainting are:

  • Vasovagal syncope: When a person’s vagus nerve (the nerve running from the brain to the chest and abdomen) becomes overstimulated, their heart rate and blood pressure may suddenly drop, which can lead them to briefly lose consciousness. Common triggers include: getting up from a sitting or lying position too quickly, and drinking alcohol or caffeine. Typically, this condition is harmless and requires simple monitoring but no formal treatment.
  • Postural orthostatic tachycardia syndrome (POTS): POTS is a condition that happens when too little blood returns to the heart, sometimes causing fainting. During sex, this can happen if a person switches up positions too quickly. Other factors that may trigger POTS include low blood volume, heightened activation of the sympathetic (“fight or flight”) nervous system, and rapid increase in heart rate — especially when transitioning from laying down to standing up. There are a number of associated symptoms, such as blurred vision, fainting, heart palpitations, headache, poor concentration, tiredness, and other symptoms that resemble fatigue. While there isn’t a cure, POTS can be effectively managed with lifestyle changes and medications.
  • Abnormal heart rhythm: During daily activities, people with this serious health condition may feel fine. However, when they exert themselves during physical or sexual activity, their heart may not be able to maintain adequate blood pressure. When the exertion ends, their heart rate decreases, but the blood vessels from the muscles remain dilated, causing them to feel faint or pass out.

The good news is that all of these conditions can be monitored and treated. Because of the variety of factors at play with these conditions, exploring different treatment options may be in order to find what works best. These could range from lifestyle changes such as increasing salt intake, drinking more fluids, avoiding alcohol, and getting sufficient exercise to taking medications and closer monitoring. 

With all this said, it’s worth mentioning that some people may intentionally faint during orgasm, through a practice called auto-erotic asphyxiation (AEA). Through AEA, partners may choose to temporarily suffocate themselves or one another, in order to heighten their sexual pleasure. It’s crucial to note AEA can be dangerous, as it has sometimes resulted in brain damage or even death. 

If fainting during sex is a concern for you or someone you know, speaking with a health care provider can help determine the causes and appropriate treatments. 

Last updated Nov 24, 2017
Originally published May 03, 2002

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