Sex is meant to be an enjoyable and fulfilling part of life, not a trip to the hospital. Yet, emergency departments across Canada see patients every week with injuries sustained during intimate moments. The common thread in these cases isn't necessarily risky behaviour, but the damaging delay in seeking medical help due to embarrassment.
The High Cost of Embarrassment: Why Waiting is Dangerous
Dr. Martina Ambardjieva, a urologist and emergency physician, emphasizes that the biggest issue is not the injury itself, but the hesitation to get care. "Most sex-related injuries are preventable, and none of them should be a source of shame," she states. "What does cause problems is waiting too long to seek care because of embarrassment. If something feels wrong — pain, bleeding, swelling, or an object that refuses to come out — just come in. Trust me, we've seen it all."
Doctors confirm these incidents are quite common, but stigma often prevents people from getting the timely help they need. Two emergency physicians shared details on the most frequent and serious injuries they encounter.
Penile Fractures: A True Urological Emergency
One of the most urgent cases is the penile fracture. "It's exactly as dramatic as it sounds — a loud 'crack,' immediate swelling, and a lot of panic," Dr. Ambardjieva explains. This typically occurs when the penis slips out during thrusting and forcefully strikes a partner's pelvis.
The injury involves a tear in the tunica albuginea, the tough fibrous sheath surrounding the erectile tissue. When erect, this tissue is thin and stretched, making it vulnerable to sudden bending or impact. Delaying treatment can lead to improper healing, resulting in permanent curvature, painful erections, or long-term erectile dysfunction. "This is the one sexual injury where time really matters," Ambardjieva stresses.
Foreign Objects and Vaginal Tears
Another routine part of ER and gynecology work involves retrieving objects that have become "lost" inside the body. Dr. Ambardjieva has removed items not designed for internal use, from vegetables to household objects, from various orifices. The risk is often due to using objects without a flared base or safety stop.
Anatomy matters greatly. While the vaginal canal is a closed space, the rectum has no anatomical stop and can create suction, pulling objects deeper. The urethra is narrow and delicate, making insertions there particularly dangerous. "It's important to normalize this. We remove lost objects every week... It's a common medical issue — not something to be ashamed of," she says.
Small vaginal tears, especially among postmenopausal women or those experiencing dryness, are another frequent ER visit cause. Friction, insufficient lubrication, or a tense pelvic floor can cause micro-tears that bleed more than expected. Bleeding that doesn't slow, is accompanied by large clots, severe pain, or lightheadedness requires immediate emergency care.
Testicular Torsion and Other Mishaps
Though less common, intercourse can sometimes trigger testicular torsion — a sudden, sharp pain caused by the twisting of the spermatic cord, which cuts off blood flow. This is a surgical emergency until proven otherwise. Without treatment within approximately four to six hours, the testicle can be permanently damaged or lost.
Other common issues include condom mishaps, such as breakage or a condom getting stuck inside, often due to incorrect sizing, expired products, or using oil-based lubricants that weaken latex. Even oral sex can lead to injuries, like bruising and swelling from overly enthusiastic suction. While often harmless, severe swelling or an unusual bend in the penis warrants a check-up.
When Curiosity Leads to Extreme Cases
Dr. Jared L. Ross, an assistant professor at the University of Missouri, has treated some extreme presentations. These have included patients with non-traditional objects lodged in the rectum, such as a pet gerbil or a full-sized LED lightbulb, often requiring surgical removal under anesthesia.
His advice is straightforward: "If you're into inserting things into your rectum, use devices designed for that so they don't get lost." More importantly, he echoes the sentiment that if an issue arises, seeking professional help is crucial.
The core message from medical professionals is clear. "Sexual injuries and accidents are far more common than people realize," concludes Dr. Ambardjieva. "Emergency clinicians truly aren't judging. We've seen it all." Pain, bleeding, swelling, or an object that won't come out are all valid reasons to seek care immediately. Bodies are vulnerable, sex is physical, and sometimes things go wrong. Getting help early is always the right and responsible choice.
