Autoerotic asphyxiation, masturbatory self-strangulation, is said to be becoming a trend in South African schools. A number of cases have hit the headlines recently. What is this practice and why is it so dangerous?

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Asphyxiation means that the oxygen supply to the brain is cut off as a result of strangulation.

What is AEA?
Autoerotic asphyxiation (AEA) is a sexual practice in which people strangulate themselves during masturbation. Decreased blood flow to the brain results in the release of endorphines. People become euphoric and experience a heightened sexual experience and more intense orgasms. For many, AEA gradually becomes the only way in which they can reach orgasm.

In most cases, people strangulate themselves by using a ligature such as a rope with which they have made a noose or slip-knot around the neck. Most people have built-in safety or rescue methods. In nearly all fatal cases, people did indeed have safety mechanisms, but these had failed.

AEA is an extremely dangerous practice and results in several deaths each year. AEA shouldn't be confused with suicide. People who practice AEA die unintentionally, usually because they lose consciousness during partial asphyxia, and therefore lose control over the means of strangulation. It is particularly dangerous if people combine self-strangulation with self-bondage. Those who practice AEA are typically impulsive thrill-seekers who have a death fantasy, as opposed to a death wish. They’re basically playing Russian Roulette.

It is more common than is generally thought, especially among adolescent or young adult males. It has claimed the lives of many famous people, including novelist Jerzy Kosinski, the lead singer of INXS Michael Hutchence and the British Conservative MP Stephen Milligan.

Warning signs of AEA behaviour
It is difficult to identify people who practice AEA. They are usually happy, average, well-adjusted adolescents who have good relationships with family and friends.

If you are concerned that someone you know may be involved in AEA activities, look out for these signs:

• Unexplained marks on the neck
• Bloodshot eyes
• Ropes, knotted-up T-shirts or plastic bags
• Disorientation

- Ilse Pauw, Health24

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Learn more:
Paraphilias and fetishism
Glossary of sex terms
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