Question: Hi there,

I have a few questions about sex, and I'm a little embarrassed to ask my in-person doctor, so I'm hoping to speak to someone well-versed in alternative sex who's also medically educated and can help me alleviate any concerns.

First off, I'm a healthy but sometimes prehypertensive male. My blood pressure is generally normal (120/80 or less) in the mornings and sometimes a little elevated later in the day, but not usually to 140/90 (very rarely, but not often). I'm eating healthy, exercising regularly, and trying to lose some extra weight, and I'm otherwise in good condition, including a healthy sex drive.

I'm into some alternative forms of sex, including some BDSM. This includes edging (getting close to orgasm repeatedly without achieving it), prolonged orgasm denial, electrostimulation (use of TENS like units for pleasure/pain and eventually forced orgasm, always done safely and below the waist), and some degree of pain and overstimulation, but always done carefully and usually not constant (the arousal and stimulation is, but the pain and overintensity usually has breaks). I generally keep any sessions of alternative play (edging, electro, intense stimulation, forced orgasms) to 4 hours or less, but there is generally a good degree of arousal and stimulation for most of that time (followed by rest after of course).

So, my question is:
I know regular sex is much like other forms of exercise and beneficial/fairly safe. Is there any concern that this type of BDSM stimulation, with some pain, overstimulation, surprise/shock, and forced orgasms will negatively effect my blood pressure, or as with things like exercise, is this fairly healthy if done in moderation and the body adapts to it? I've checked my pulse during this type of play, and while slightly elevated, it's not nearly as fast as, say, when I'm working out on the treadmill or hiking. I don't think there'd be any point in trying to check blood pressure during this type of play since home monitors aren't built for that and I would have no idea how to interpret the results even if they were (as resting BP is usually used).

I'm mostly concerned about avoiding excess heart attack/stroke risk and spikes in blood pressure that could contribute to those factors, but I know some spikes in blood pressure are normal and healthy in everyday activity (for example, exercise or fight or flight responses). I know from everything I've read that, while sex raises BP slightly, it's nowhere near intense exercise normally and considered very safe, even for people with high BP (which I don't currently even have), and even recommended for a healthy lifestyle. I'm just hopeful that these BDSM practices are also safe (in moderation of course) and not that significantly different from "regular" sex. I also know from what I've read that the body adapts to chronic pain and it doesn't generally increase blood pressure, and while acute pain can result in an immediate spike, it usually lessens. Please provide any insights you may have, and thank you for addressing my concerns!

Thanks for any input, and sorry for the embarrassing question! =oP

Thanks so much for the excellent response!

It's wonderful to be able to discuss this with someone without worrying about what they think, and I appreciate your patience and non-hesitancy to help with my questions. =)

My father died fairly young (52) of a heart attack while exercising, so I am perhaps overly paranoid about heart health and blood pressure. I do monitor my BP several times the week before a doctor's appointment, since I sometimes have a high reading in the office due to anxiety and want something more reliable over a bit of time, but as you suggest, I don't take my BP the rest of the time and actually don't keep the monitor in the house. I only retrieve it before a doctor's appointment so I can get some readings the week right before.

I'll stop worrying and treat BDSM like any other exercise like hiking...take breaks if needed, hydrate, and otherwise just enjoy it.

I appreciate your help! Thanks again!