The “Most Dangerous” Sex Position, According to a TikTok Doctor

Cowgirls, broken penises, and sex paranoia, oh my.

Christopher Kokoski
Heart Affairs
Published in
5 min readAug 21, 2023

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Cute digital woman with large eyes — The “Most Dangerous” Sex Position, According to a TikTok Doctor
Image created by the Author via DALL-E and Canva

TikTok is known for its short and snappy videos that are often packed with intriguing, informative, or entertaining content.

One such piece of content, shared by a TikTok-famous NHS doctor, has been making waves for revealing the “most dangerous” sex position.

The Most “Dangerous” Position Revealed

Dr. Karan Rajan, a surgical physician boasting a following of 5.2 million on TikTok, recently stirred up quite the discussion with a viral video in which he revealed the sexual position most commonly associated with penile fractures.

Dr. Karan named the reverse cowgirl position as the most dangerous, explaining that it can lead to trauma and subsequent fracture if not done with care.

As usual, the TikTok comments did not disappoint:

  • Kadeem said: “Why am I scared of this happening to me, I don’t even get any play 💀”
  • M went dark comedy with: “Now I know what position to do when my man wanna act up 😌”
  • Malthe Munch asked the perfect question: “But will The danger noodle heal at some point?”

Despite the term “fracture” being used, it’s important to note that there’s no actual bone in the penis.

Rather, the term “penile fracture” actually describes a rupture in the tunica albuginea, a tough, fibrous layer of tissue that surrounds the testes and enables the penis to expand when becoming erect.

We should all agree to call it “danger noodle” from here forth.

The Risk of Penile Fracture

According to the Mayo Clinic, penile fractures are indeed rare but can occur due to trauma to an erect penis.

While engaging in the reverse cowgirl position, erratic movements or lack of synchronization between partners could result in the penis accidentally slipping out, and possibly getting compressed against the partner’s pubic bone, which might cause a fracture.

Yikes! Thanks, Mayo Clinic, for that visual. 😟

Signs of a penile fracture:

  • Sudden pain in the penis
  • An audible snap or crackling noise ( I could have lived without that knowledge)
  • Rapid loss of erection
  • Swelling
  • Discoloration due to bleeding beneath the skin

In other words, you will know if it occurs because you will hurt like hell.

These injuries require urgent medical attention and often prompt surgical repair to prevent long-term consequences, including impotence, scar tissue, and a lasting bend in the penis.

Other Dangerous Positions

Some positions are riskier than others.

As mentioned earlier, the reverse cowgirl position is one such example, as shared by Dr. Karan Rajan.

However, a 2017 study in the International Journal of Impotence Research, titled “Relationship between sexual position and severity of penile fracture,” suggests that the doggy style position is actually the riskiest. According to the study, this position accounted for a whopping 41% of penile fracture cases.

The research study said:

The sexual position at the time of injury varied, with 23 cases (25.5%) occurring in the ‘man-on-top’, 37cases (41%) in the ‘doggy style’ and 9 cases (10%) in the ‘woman-on-top’. We do not observe differences between the severity of the PF between the ‘doggy style’ and ‘man-on-top’ (P=0.9595), but the ‘doggy style’ had more severity of PF when compared with ‘woman-on-top’ (P=0.0396) and penile manipulation (P=0.0026).

Other positions that involve intense or sudden thrusting can also pose risks, particularly if partners aren’t in sync or if there is a possibility of slippage.

Great, I’m Terrified, Now What?

It’s completely understandable if, after reading about the potential risks of certain sex positions, you’re feeling a bit wary about your next amorous encounter.

But there’s no need to swear off sex forever or invest in a protective sex suit.

Yes, that’s a real product concept.

Life is full of risks. Every time you cross the street or eat a particularly challenging taco, you’re exposing yourself to potential dangers.

Just like you wouldn’t give up crossing streets or enjoying tacos, there’s no need to give up on intimacy because of the small risk of penile fractures. Keep the communication channels open with your partner, go slow, and try not to overthink it.

Being present and connected during those moments can make all the difference. So, let’s not let the fear of a rare injury ruin the beautiful and enjoyable act of intimacy.

As they say, the best defense is a good offense.

How to Avoid Penile Fractures

Penile fractures can be painful and can cause long-term health issues if not treated properly.

Here are some precautions that can help avoid these injuries:

  1. Proper Positioning — Ensure that both partners are well-aligned during intercourse to minimize the risk of the penis slipping out and potentially getting injured.
  2. Clear Communication — Open communication is key. Discuss comfort, boundaries, and preferences with your partner before and during sex so that both parties can adjust movements and positions accordingly.
  3. Take It Slow — Avoid overly aggressive or erratic movements, especially in positions that are known to be riskier. Gradually increasing intensity can help prevent sudden injuries.
  4. Lubrication — Using appropriate lubrication can help reduce friction and the risk of injury during intercourse. However, it’s essential to ensure that the chosen lubricant is compatible with any barrier methods of contraception being used.
  5. Mindfulness Being mindful and present during sex can help you and your partner stay attuned to each other’s movements and responses. This mutual awareness can help prevent accidental injuries.
  6. Flexibility and Variety — Incorporating different positions and techniques can help reduce the risk of injury by avoiding repetitive movements that could put a strain on specific areas.
  7. Know Your Limits — If you’re tired, intoxicated, or not in the right mindset, it might be best to postpone sexual activity. Being in control of your actions reduces the risk of accidents.

Final Thoughts

The reverse cowgirl is a fun position to try but it’s not one to engage in all willy-nilly.

Always keep the safety of your “danger noodle” in mind. :)

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Disclaimer: This article is for educational purposes only and should not be considered as a substitute for professional medical advice. If you have concerns about your health or experience any symptoms, consult a healthcare professional.

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Christopher Kokoski
Heart Affairs

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