One study looked at deaths from bdsm v other forms of activities, and deaths from bdsm itself.

First thing to note is the 88% of the reported deaths from bdsm arose as a result of *strangling* a person.

Minus out the strangling and then, the rate of death from bdsm falls to 12% of the previous rate.

Next, even with the bdsm strangling included . . . deaths from bdsm are rarer than deaths from natural, vanilla sex!

https://link.springer.com/article/10.1007/s00414-021-02674-0

long and extensive study here.

A recently published case collection described three cases of fatal incidents related to consensual BDSM activity [6]. These non-natural deaths associated with BDSM activity raised several questions concerning the topic: How frequent is a fatal outcome in BDSM play? What are the risks of BDSM play? How well are participants informed about safety issues and medical aspects in those potentially dangerous activities? Is fatal BDSM play a consequence of a lack of knowledge or education of private and professional practitioners? . .

In 13 cases, a toxicology report for the deceased was mentioned, of which in eight cases (61.5%) toxicology analysis was positive. . .

The most common cause of death in the course of erotic asphyxiation is *strangulation* (n?=?15 [out of 17]).

Wiseman [1], a prominent BDSM community author, explains in his BDSM beginner’s book SM 101: A Realistic Introduction the risk of breath control play and clarifies that practitioners can be taught how to participate in such activities safely.

Breath control play is very controversial in the BDSM scene, and some BDSM communities ban members from engaging in breath control play [17].

The fatal outcome in BDSM play seems to be very rare. There are 14 published case reports and one organized study on non-natural death associated with sexual activity. The study by Bunzel et al. showed that of 16,437 autopsies from 1993 to 2017, 0.018% (3 cases) were non-natural deaths related to sexual activity involving BDSM. . .

As for natural death related to sexual activities, a 45-year mortality study conducted in Germany showed a rate of 0.26%. . .

The most common cause of death [during ordinary, vanilla sex] was coronary heart disease, followed by myocardial infarction [heart attack] and reinfarction [22]. . .

Causes of death
The most prominent cause of death in BDSM fatalities emerging from the 17 reported cases was strangulation (88.2%). It can be differentiated between ligature and manual strangulation and hanging; ligature strangulation was documented as the most frequent cause of death. In one case, the cause of death was severe hemorrhage [bled to death] caused by the vaginal insertion of foreign objects [8].

These results show that fatalities correlate with the usage of alcohol and drugs. . . Drugs and alcohol can affect the practitioner’s ability to participate in a BDSM play with the needed safety precautions [17]. Wiseman states that performing BDSM activities while being drunk or on drugs is unsafe and irresponsible [1].

https://pmc.ncbi.nlm.nih.gov/articles/PMC9548576/

Another study . . .

This paper reviews how [vanilla] sexual activity can lead to an increase in cardiac arrhythmias and sudden cardiac arrest [heart attacks] in patients that are not medically optimized or are unaware of their underlying cardiac condition. The most common cardiovascular diseases associated with sexually induced arrhythmias and arrest are discussed regarding their potential risk and the psychosocial impact of this risk on these patients. . .

Sexual activity is considered to require a low to moderate metabolic equivalent of task (MET), but even mild physical activity in a de-conditioned patient with cardiovascular disease while trying to achieve an orgasm during coitus can precipitate arrhythmias or sudden cardiac death (Figure 1).

"...deaths from bdsm are rarer than deaths from natural, vanilla sex!"

Did you know that about 1/3 of all fatal car accidents are caused by drunk drivers?
Meaning the real danger are the sober drivers, they cause 2/3 of all accidents.
Alcohol reduces the risk of causing a fatal accident by half!

“you know, to be really safe you should always carry a bomb on an airplane. Because the chances of there being one bomb on a plane are pretty small. But the chances of two bombs are almost minuscule. So by carrying a bomb on a plane, the odds of your becoming a hostage or of getting blown up are astronomically reduced” - Laurie Anderson

I heard half of all car accidents occur within a mile of your house, so I moved.

Ahh, I could keep going but I won’t. Lol

LOL

There are various studies by the psych and the med doctors, because, allegedly, young people have learned and copied strangling as a form of erotic play and they are doing this even in vanilla sex.

Anyway, vanilla sex with strangling might kill some but I do not know if we have any numbers. Bdsm with strangling has resulted in 15 deaths reported enough to be included in the study published in medical literature.

As for deaths due to sex due to the exertion from either sex itself or from running or being a police officer who confronts irritating, aggressive criminals, I do not think we know the numbers! Oh, to the extent that we know the numbers, they are more numerous than deaths from bdsm . . . but then, bdsm is less common than vanilla sex, so . . . !

If you exclude strangling people or hanging them from a rope, which account for nearly all the bdsm deaths . . . then, anything and everything can kill you: bdsm, running and vanilla sex.

The case of bdsm leading to manslaughter charge in Massachusetts 10 or 20 years ago . . . was apparently due to a heart attack from stress!