Love hurts, love scars, love wounds and mars -- these song lyrics were all too true for one New Zealand woman. An overly enthusiastic hickey from her partner landed her in the hospital with a minor stroke.
The 44-year-old Maori woman was brought to Middlemore Hospital in Aukland, New Zealand with a paralyzed left arm, doctors reported in a case study published in the New Zealand Medical Journal in November. Doctors were puzzled by her symptoms until they realized that there had been a clot in an artery on the right side of her neck beneath where she still showed the bruising of a hickey.
"Because it was a love bite, there would be a lot of suction. Because of the physical trauma, it had made a bit of bruising inside the vessel" causing a clot, Dr. Teddy Wu, who treated the patient, told the New Zealand press. The clot apparently resulted in a stroke.
This appears to be the only documented case of a hickey-related stroke, but in general, getting hurt in the heat of passion is not that uncommon, doctors say.
A 2010 U.K. poll found that a third of the British reported having had a sex-related injury, most often involving non-traditional settings for sex, such as on stairs, over kitchen tables, or in closets.
Americans aren't strangers to carnal catastrophe either, doctors say. Whether a simple muscle pull, a fractured penis, or a heart attack brought on by overzealous love-making, ER doctors "see just about everything, for better or for worse," said Dr. Corey Slovis, chair of the department of emergency medicine at Vanderbilt University.
One of the most notorious sexual boo-boos is "breaking" the penis through a penile fracture. This usually occurs when an erect penis is bent forcefully, causing the engorged tissue to tear. Victims will often hear a popping or cracking sound, followed by searing pain, said Slovis.
One patient, a man in his sixties, suffered a fracture when he fell down while masturbating. He attempted to rush to the door to lock it when he heard his mother trying to get in, Dr. Billy Goldberg, assistant professor of emergency medicine at the NYU School of Medicine told ABCnews.com.
More often than not, penile fractures occur during sexual intercourse, when the woman is on top, Slovis said. Julieanne Smolinski, 26, a New Yorker and blogger for Lemondrop.com, recounted her own such bedroom blunder to ABCnews.com:
"I did a kind of accidental back handspring off my boyfriend and cracked myself on the head," she said, but "my boyfriend got the worst of it and 'fractured' his penis. We didn't seek medical attention, [but] later I read that penile fractures can be really serious," she said, wondering in retrospect if they should have taken him to the hospital.
In the case of a true fracture, immediate medical attention is essential, Slovis said. The torn tissue often needs to be operated on and delaying treatment -- which men often do out of embarrassment -- only increases the chance of permanent damage.
And when emergency doctors say they see "any and everything" come into their ER, bizarre sexual injury is no exception.
"People do some strange stuff," Goldberg said, noting that he gets "a lot of rectal foreign bodies." One man had to be brought to the hospital by his mother after a screwdriver became lodged in his rectum during a sexual act.
Another tool-related injury involved a Maryland woman who landed in the ER after an incident with a saber saw. In an attempt at a do-it-yourself sex toy, her partner had attached a dildo over the blade of the power saw and used it on the woman, ultimately injuring her when the saw cut through the plastic of the toy, NBC news reported.
Clearly, carpentry tools and sexual play do not mix. Another bizarre accident left one woman with mild genital burns after her boyfriend performed oral sex on her too soon after eating a hot sauce-laden meal, Dr. Gabe Wilson, associate medical director of St. Luke's-Roosevelt Hospital in New York reported.
Not all sexual injuries involve ill-advised sex toys or sexual acrobatics like those Smolinski tried. Most often, a simple muscle pull or stumble is enough to leaving you throbbing in a less-than-pleasurable way.
In the U.K. poll, the most common sex injury was a pulled muscle, with back injuries, carpet burns, and cricked necks pulling in close behind. And perhaps surprisingly, the most dangerous spots for sex were also the most ordinary: the sofa, a chair, or the shower.
The most common issue Debby Herbenick, research scientist at Indiana University and author of "Because It Feels Good", hears about is small tears or cuts in the vagina, which can occur when sex is more vigorous and there isn't enough lubrication.
Women will often not feel any pain until after sex, because the arousal raises pain tolerance, Herbenick said, but if the cuts are sizable and bleeding doesn't stop on its own, a woman should seek medical attention to prevent infection.
Irritation or tearing from vigorous sex can be minimized by using a lubricant, she said, "but aside from that, there isn't much you can do. If you want to have rough sex, it's going to be rough."
While many sexual injuries are relatively mild, the exertion of coitus can be a trigger for life-threatening conditions.
The rush of ejaculation or orgasm has been known to trigger a subarachnoid hemorrhage when blood vessels in the brain burst. Patients are often symptomless until the rupture, but then experience sudden severe headache or loss of consciousness. This can be fatal if not treated immediately, Slovis said, and these symptoms should be taken seriously.
For those with known or yet-undiagnosed heart problems, the physical activity of sex can cause a heart attack. Viagra has only exacerbated this problem, Slovis noted, as many men who are not physically up to the exertion of intercourse go overboard. If chest pain is experienced during or after sex, seek medical help, he said.
These sexual hazards give new meaning to a desire for safe sex, but does this mean that protection has to take the form of knee pads and a helmet? Most of the safety tips are just common sense, says Dr. Mache Seibel, professor of obstetrics and gynecology at the University of Massachusetts Medical School. "If anything causes discomfort it should be discontinued," he says. "Just because something is supposed to be fun, doesn't mean it works for you."
Herbenick echoes this sentiment, noting that stretching isn't a bad idea if you're injury-prone, and it may be wise to clear the area of pointy objects and keep lit candles a good distance from you. Also, "keep pets out of the room," she said, citing a recent study she conducted on the subject. Cats have been known to jump on the bed and "scratch at genitals" when they see their owners getting frisky.
And if something seems disconcertingly out of the ordinary, such as sudden, unexplained pain, do not hesitate to seek medical help, Slovis emphasized. "There's nothing to be embarrassed about. ER doctors see it all, and it's better than risking permanent injury or even your life."
Ideally, however, with a little common sense, and maybe a warm-up, your romantic evening will stay between you and your loved one -- no medical intervention required.