The “reverse cowgirl” position is one of the sexual positions most commonly associated with penile fracture.
What are the most common accidents during sex?
Penile fracture, microfissures and testicular injuries are among the most common accidents during sex. Learn more below.
Are penile fractures common during sexual intercourse?
Penile fracture — one of the most serious accidents
A penile fracture is the rupture of the tunica albuginea, a layer that supports and protects the testicles and the corpora cavernosa.
The first sign is a “cracking” sound caused by the rupture of the corpora cavernosa, the “spongy” tissues that fill with blood so the penis can become erect. After this sound, intense pain, bruising and immediate loss of erection usually appear.
An article on risk factors for penile fracture states that sexual intercourse is one of the main causes of male genital trauma.
The same study points out that the sexual positions with higher risk are “doggy style” and the man-on-top position.
According to the authors, about 74.5% of injuries during sex occur in these positions.
The study also concludes that taller patients and partners with a larger body size are factors that may increase the probability of these accidents.
Mild and moderate injuries
Other types of injuries include inflammation, genital irritation, microfissures, infections, injuries and testicular torsion. See more below.
- Penile inflammation: occurs during more aggressive sexual practices – including with sex toys – and may affect the skin that covers the glans.
- Genital irritation: penile sores may appear due to friction in intercourse with little lubrication.
- Microfissures: small cuts or cracks, often related to lack of lubrication.
- Testicular injuries: testicular torsion causes testicular pain and may affect fertility if the man delays seeking medical care.
Sex positions with higher risk of accidents during sex
Learn below which sexual positions may leave the penis more exposed to strong impacts and increase the chance of the most common accidents during sex.
Risky positions for men
First, the reverse cowgirl position. The “reverse cowgirl” position is cited in studies as one of the situations that may be associated with a higher risk of penile fracture.
In this position, the receptive partner stays on top, facing away from the man.
As the rhythm is determined by the person on top, sudden or misaligned movements are more likely to occur, increasing the risk of the penis bending.
Another position described as potentially risky is doggy style, or the “all fours” position. In this position, men tend to move more quickly and with deeper thrusts, which can lead to stronger impacts or penetration outside the ideal angle, increasing the risk of injury.
Infographic with the positions considered most risky for men
What to do in case of a sex-related accident
First aid after a sex-related accident is essential to help prevent complications. See what can be done below.
- Stop the activity immediately: interrupt any movement at the first sign of intense pain, cracking sound, loss of erection or swelling.
- Do not try to “force” the erection back: do not manipulate the penis to recover the erection, as this may worsen the injury.
- Apply cold compresses (without pressure): they may help reduce swelling and pain, but should be applied gently and never directly on the skin with ice.
- Seek a urologist immediately, even if the pain decreases: penile fracture is a serious urological emergency and requires medical evaluation.
How to prevent accidents during sex
Learn some practical measures that may help prevent accidents and protect male sexual health: 
Infographic on prevention of sex-related injuries
