Erotic asphyxiation is also known as the "breathless orgasm" and it involves depriving the body of oxygen (hypoxia) during the moment of climax. This is rumored to make the orgasm more intense and is the main reason why people try it for the first time and, in some cases, become addicted to it. Because it is a very taboo behavior, many people do it alone (this is known as "autoerotic asphyxiation") and accidental deaths have resulted when someone is unable to stop the smothering mechanism (which may be a belt or other object used as a noose, or a plastic bag over the head). When a couple or larger group engages in it is known as "breath control play."

This practice is known as a form of paraphilia; that is, a form of sexual behavior which is seen as atypical or extreme, and which is not focused on mutual sexual gratification between two people. Many sexual fetishes fall under this category of paraphilia; this can include sexual arousal in response to non-sexual situations (such as driving a car) or to inanimate objects (such as shows) or to inappropriate things.

In the case of erotic asphyxiation, it is considered atypical and extreme because it can become dangerous so quickly. Depriving the brain or respiratory system of oxygen can cause cardiac arrest in as little as five seconds. It is also possible during solo or group activity to strangle oneself or another. Choking someone can break their windpipe or even their neck, and discerning the facial expressions that connote fear or ecstasy can be difficult. The decrease of oxygen and increase of carbon dioxide in the bloodstream that can occur during hypoxia can also cause cardiac arrest. Also the use of a "safe word" (traditionally used in BDSM play so that the activity can be stopped if it is too painful or otherwise uncomfortable) is impractical because, being unable to breathe, the person cannot speak. Accidental death is the most dangerous risk in this behavior, but there are others. First and foremost is a risk of brain damage. Injury to the vocal chords or abdomen can also occur, depending on the methods used. People can also fall and injure themselves if the lack of oxygen causes unconsciousness. So why would people do this? Probably for the same reason people engage in other high-risk behavior. Risk-takers do not believe that riding in a car without a seat belt, smoking 3 packs of cigarettes a day or shooting heroin will cause their death, but statistics prove otherwise.

Some people discover erotic asphyxiation by accident, during sex play or as a child when they do something like put a plastic bag over their heads. The lack of oxygen can produce a feeling of giddiness, and in tandem with orgasm this sensation is pleasing to some. In BDSM play, the "bottom" may enjoy the idea that they are helpless; the "top" may like the control of having another?s person life in their hands. But since it is so easy to cause unintentional death or injury, even among people experienced in non-traditional sex play, this behavior is rarely endorsed by anyone. (Even Lust Magazine, one source used in researching this article, says don't do it!)

Sources at the sexuality.org website mention that this behavior and the mystery surrounding it have a long history. In the 1700s, it was observed that men who had been hanged sometimes had erections just before they died. This led to a belief that hypoxia could be a cure for impotence! The writings of the Marquis de Sade also contain references to sexual gratification achieved by strangulation prior to orgasm. By the 1950s this paraphilia was recognized in Germany, a book on "bachelor machines", invented contraptions used for autoerotic pleasure? was published in France in 1954, and the term "sexual asphyxiation" was coined by clinicians in Great Britain in 1968. Performance artists in Europe and the United States portrayed autoerotic behavior including strangulation and smothering in their works during the 1970s and 1980s, and novelist William Burroughs celebrates autoerotic and erotic asphyxiation in many of his writings. Even mainstream authors like P.D. James deals with it in a crime novel called An Unsuitable Job for a Woman. During the late 1980s as BDSM activity become more mainstream, so did this dangerous behavior become more common.

The most common group to die through autoerotic asphyxiation is teenage boys, who have been found hanging and with pornographic materials nearby. The cause of death can only be speculated, as there is no one to corroborate it. But when there is some evidence that the cause may be autoerotic asphyxiation, this can cause embarrassment for families who may try to hide the cause of death. This can make it seem that a teenager comitted suicide when really he was only trying to have an orgasm in an admittedly dangerous way. It is believed that some teenage girls who commit suicide by hanging may also be after the sexual rush but since they are less likely to employ visual sexual aids, it is harder to determine if their deaths are accidental or intentional. There is a support group known as AeA Support Group which provides networking for those whose loved ones have died as a result of erotic asphyxiation, and numerous resources on the web to help people understand the danger behind this trend.