Sex-related amnesia

by Charles Downey

At one time or another, you've probably miffed your sweetie by forgetting an anniversary or a birthday. But to blank out on a passionate night of sex? Or to forget where you are because of making love? Although it's notcommon, it could actually happen. A few cases reported in England and at Johns Hopkins University Medical Center in Baltimore have been recently making the news.

British physician Russell Lane of the West London Neurosciences Centre at Charing Cross Hospital in London, England, came across a case in which a wife complained about five occasions from 1977 to 1995 when her now 64-year-old husband suffered memory loss after making love.

"The wife told me her husband would repeatedly ask questions like 'What are we doing?' 'What time of year is it?' and 'What time of day is it?'" says Dr. Lane from his London office. "On those occasions, the man could recognize his wife and others, was aware of his confusion, and did not lapse into unconsciousness."

The amnesic episodes lasted half an hour to sixty minutes, whereupon the man would completely regain his bearings, except that he had no memory whatever of having sex and had only a very hazy recollection of foreplay.

Dr. Lane's diagnosis? Transient global amnesia (TGA). But because of the way it strikes, he refers to it as "Recurrent coital amnesia."

"TGA is well-defined, happens to many people right out of the blue and is most often associated with some form of environmental or emotional stress," Dr. Lane says. "A sudden change in very hot to very cold weather, for instance, can bring on an attack of TGA, but very often the attacks occur without any obvious reason at all."

When Dr. Lane took down the patient's medical history, the physician found the man also had a two-decade history of migraine headache. Moreover, the amnesia happened over 22 years but only in connection with sexual intercourse. While in the hospital, doctors did a CT scan on the patient's brain, wired him for an EEG test and did a cranial ultrasound test to boot. But all were normal.

"The man reported having some severe headaches during intercourse many years ago, although he said he had no headaches during the amnesic love-making sessions," Dr. Lane says. "I think the episodes of forgotten intercourse are more than likely linked to the migraine. But we are not exactly sure how it all ties together."

Dr. Lane also recalled seeing another case years ago when a patient reported suffering memory loss following a single episode of intercourse.

With typical British understatement, Dr. Lane wrote a letter to the British medical magazine, Journal of Neurology, Neurosurgery and Psychiatry. "The fact that a person can repeatedly experience selective amnesia for sexual intercourse...raises interesting social and medico-legal considerations."

Adds Dr. Lane: "Frankly, I was expecting a call from the White House because of the interesting legal ramifications presented by selective sexual amnesia."

Two Johns Hopkins physicians, Drs. Chi Van Dang and Lawrence B. Gardner, came across two men who had used a sexual technique known as the "Valsalva maneuver" and lost their memories right after sexual intercourse.

"Both wives were terrified," Dr. Dang says. "After sex, both men were babbling and confused about where they were, so the wives feared for the worst and thought the men were having a stroke or a heart attack."

The Valsalva maneuver is supposed to enhance sexual relations by delaying a man's climax. To perform it, he squeezes the muscles that would stop a stream of urine in mid-flow and then bears down hard on the same muscles that move the bowels. Some practitioners report being able to have multiple orgasms.

However, memory loss wasn't something the men counted on.

According to Drs. Dang and Gardner, bearing down on sexual muscles along with the typical activation of the sympathetic nervous system during sex created intense pressure in the brain's blood vessels, resulting in temporary lack of blood flow to the center part of the brain. That, in turn, resulted in amnesia.

Says Dr. Dang: "That type of amnesia results in a complete inability to recall what happened during the period of confusion. So not only did the men forget the sexual encounters, our patients could not recall the name of the current U.S. president (Clinton) and replied after we asked, 'Jimmy Carter.'" The other typical orientation questions physicians routinely ask confused patients are, "What is today's date?" "What year is it?" and "Where are you?"

One patient recovered and was able to answer these questions within two hours while the other remained disoriented for about five hours. That patient, a retired physician, did not remember anything within six hours of the love making session that caused it all.

There was no history of migraine in either of the Johns Hopkins patients.

The cases came to light because Johns Hopkins medical students are taught to take extremely thorough medical and social histories from patients. The two men went to the doctor's office because of complaints unrelated to the sexual amnesia.

"The theory is not proven, but we're pretty sure the amnesia resulted from back pressure put on the brain during the sexual maneuvers," says Dr. Dang who is a professor of medicine and director of hematology at Johns Hopkins University Medical Center.

Quips Dr. Dang: "A presidential Valsava maneuver during some of his encounters may have allowed him to not recall specific events when questioned."

Moral of the story? Keep your wits about you and don't try any fancy maneuvers. After all, what good is steamy sex if you can't remember a thing about it?