Coughing/Gagging connected to sexual intercourse

Posted by Elaine Strain on May 12, 1999 at 13:51:39
Dear Doctors:
Thank you so much for allowing me the opportunity to ask your opinions about something.
I'm writing concerning my husband of 17 years.  He is 40 years old, a non-smoker, non drinker, slightly overweight, active and strong.  He works as a mechanic for United Parcel Service, usually putting in 8 to 10 hour days.  He eats normally, but because he is responsible for a fleet of trucks, his job postion is very stressful.
We've been trying to pinpoint how long this problem has been going on, but we've only been able to dicern that it's been close to a year--maybe a bit less.
About a year ago, he began experiencing heartburn.  He began taking Zantac, as the heartburn was only occasional, usually upon eating a meal high in fat content. Eventually, the heartburn began showing up every night, and the Zantac became a regular routine...taken before bed, assuming the heartburn would show up a few hours after he drifted off.  It always did.
A bit after that, another thing started up.  During sex, within a few SECONDS after orgasm, he is overwhelmed by one massive cough.  Many times this is followed by more coughs, just as intense, culminating in gagging.  As far as I know, though, he has not thrown up.  
We've gone to several doctors about this.  They run tests and tell him his heart is fine.  They've even laughed about it.  But it scares my husband.  He feels that, no matter what the doctors tell him, it's his heart. That's because he has always had an uncomfortable "weird" feeling in his chest. A pressure with NO PAIN. So he's associating the two. This DOES NOT occur upon other physical activity.  Running after the kids, etc. Just sex.
So far, we've only been able to come to one conclusion:  He MUST have acid reflux desease, as the Zantac stops working halfway through the night, and he can get heartburn at various times of the day--no matter what he's eaten or not eaten.  But the massive cough and gagging, we feel began way back before the reflux desease set in...back when his discomfort was probably simple heartburn.
We would simply like to know if there is a correlation between some kind of stressful change in the body taking place only with sex, this terrible cough and gag thing, and the acid reflux desease.
Thanks for any help.  We're at our wits end.  Oh...and this doesn't help our sex life!

Posted by CCF CARDIO MD - CRC on May 12, 1999 at 15:53:53
Dear Elaine,
This is a very interesting and unique question.  I have an idea as to what may be causing this.  There is a very complex balance between the parasympathetic (relaxing system) and sympathetic (stress system) nervous systems during sex.  During arousal the parasympathetic system is predominant and during orgasm the sympathetic nervous system is dominant.  There is a strong relationship between the vagal nerve, which is the primary nerve for the parasympathetic system and coughing.  What happens in your husbands case is a strong resurgance of the parasympathetic system following orgasm leading to coughing.  This could also cause slowing of the heart rate and an odd sensation in the chest.
As to the cure I don't have any brillant ideas.  Atropine blocks the parasympathetic system but this would not be very practical.  Perhaps extending the foreplay or trying different positions (i.e. woman on top)  I would be curious to know if anyone else has had this experience and what they did to resolve it.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Mike1251]

A related discussion, Coughing during sex was started.

[Godsent55]

I also have been having this same problem after sex once he pulls out rather i *** or not i just start gagging. till i have to run to the bathroom because i think i might throw up.....this is not funny this started happening like almost two years ago i dont like this its not sexy it makes me uncomfortable ...i dont know what to do ....????!?!help me!!

[Godsent55]

hi im 19 and i also have been having this same problem after sex once he pulls out rather i *** or not i just start gagging. till i have to run to the bathroom because i think i might throw up.....this is not funny this started happening like almost two years ago i dont like this its not sexy it makes me uncomfortable ...i dont know what to do ....???

[afghani]

A related discussion, Coughing during sex intercourse was started.