I’ll admit it right up front. I fell for it.

I was standing in line at the drugstore when I noticed the cover of the March issue of Cosmo. The bottom right hand corner declared, “An Orgasm Almost Killed Her.” I’m a gynecologist, and I couldn’t think of what the mechanism might be for an orgasm to be fatal, but they included the subtitle “We Are Not Kidding” so it must be true. Medicine is constantly changing, and perhaps Cosmo might be the first to provide this important new information.

The article detailed the story of a young woman who had a stroke immediately following intercourse. Is it accurate to say that orgasm caused the stroke? It could have, but it is far from clear that there was a direct link between the orgasm and the stroke.

When the young woman who developed symptoms of a stroke shortly after sexual intercourse, her boyfriend rushed her to the hospital. Doctors found that a blood clot had blocked off part of her brain, causing the stroke symptoms. A review of her medical history revealed that she was at particular risk for blood clots because she was on the birth control pill. The Pill increases the risk of blood clots developing in the legs, and anyone who has other risk factors for blood clots should not take the Pill.

This patient had no contraindications to taking the Pill, and had she been like most other people, the blood clot in her leg should not have posed a threat of stroke. Unbeknownst to her, however, the young woman also had a small hole in her heart.

Everyone is born with a hole in the heart, called the foramen ovale (oval opening). The hole is there because the fetal circulation, when oxygen comes in through the umbilical cord instead of the lungs, is very different from the circulation after birth. In the first few moments after birth, the foramen ovale is supposed to be closed off by a flap of tissue. In this woman’s case, the flap did not cover the hole completely.

Because of this small hole within her heart, the blood clot that broke free of her leg vein traveled up to the heart, where it should have stopped, and crossed over to the other side of her heart and began the journey to her head. It lodged there, cutting off the circulation to a small part of her brain and causing the symptoms.

So the Pill caused the blood clot, and the hole in her heart allowed the blood clot to reach her brain, but is it true to say that an orgasm caused the clot to break free? It is possible, but then so are a lot of other things. Change in position like rising from a long period of sitting to standing can cause a clot to break free. Increased intra-abdominal pressure, like that caused by cough, could have also detached the clot. In fact, something as unglamorous as straining at a bowel movement, could also have caused the clot to be released into her bloodstream.

A blood clot is not the only way that you can die from sex. Anyone who has an abnormal blood vessel in the brain is at risk for bleeding into the brain if the blood pressure rises, and sex can cause a temporary rise in blood pressure. For those with heart problems, sexual activity can lead to a heart attack. For those with heart problems who are cheating on a spouse, the risk of a heart attack appears to be even higher. It must be the added effect of guilt on the blood pressure.

I feel a little embarrassed for being tricked by the headline into reading the magazine. However, on further reflection, I’ve decided that Cosmo has performed a public service, in the way that only Cosmo can. Blood clots in the leg are a rare side effect of the birth control pill. Patients receive written information about this side effect, but most probably pay no attention. After reading this story, it’s unlikely that anyone will forget the association between the Pill and blood clots.

That’s Cosmo for you: selflessly searching out stories of sex related medical problems in an effort to keep young women up to date with the latest health news. An orgasm almost killed that young woman. Don’t let it happen to you.