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Viagra falls: Is there a relationship between sex and nosebleeds?

In previous blogs I have covered a number of different topics relating to various human behaviours involving blood including haematophagia (the eating and/or drinking of blood products), haemolacria (the crying of blood), clinical vampirism as a sexual paraphilia, and menophilia (sexual arousal from women menstruating). Today’s blog adds to the list by taking a brief look at sex and nosebleeds (medically known as epistaxis).

There are many causes of nosebleeds. The two most common are nose picking and being exposed to dry air for long periods. Other reasons include having high blood pressure, having a cold or flu, allergic rhinitis (nose allergies), acute sinusitis, heavy alcohol use, being exposed to chemical irritants, being on certain medications (such as blood thinners and non-steroidal anti-inflammatory drugs), nose trauma, cocaine use, and haemophilia. Added to this, there is plenty of anecdotal evidence of people claiming to get nosebleeds during vigorous sex.

However, an article in Culture Smash by Brian Ashcroft quoted an otolaryngologist, Dr. Kouichirou Kanaya (an ear, nose, and throat specialist) who was quoted as saying:

“The notion that sexual arousal causes the heart rate and blood pressure to rise is something that’s a well documented fact; however, in actuality, sexual arousal and bloody noses have no direct connection”

However, while researching this article I came across a number of medical papers showing that there is one area where nosebleeds have been related to sexual activity. More specifically, there have been a number of cases in the literature where men taking sildenafil (Viagra) and/or tadalafil (Cialis) have had nosebleeds during sex. For instance, Dr. L.A. Hicklin and colleagues reported two cases in a 2002 issue of the Journal of the Royal Society of Medicine. These are reported verbatim below followed by a 2006 case by Dr. G. Pomara and colleagues in the International Journal of Impotence Research, and a 2005 case by Dr. H. Ismail and Dr. P.G. Harries in the journal Acta oto-laryngologica:

Case 1: “A man in his late 50s was admitted from the emergency department with heavy prolonged epistaxis…During the admission the patient volunteered that, in the hours before his first nose-bleed, he had been engaging in energetic sexual activity. To enhance his sexual performance he had taken 50 mg sildenafil. Over the subsequent few days he had had several short but heavy epistaxes, and on the day of admission bleeding had continued for 6 hours without stopping. With packing and bed rest the bleeding gradually settled and he was discharged after six days”.
Case 2: “A man in his early 70s was admitted from the emergency department after 5 hours of epistaxis. He had taken sildenafil to enhance his sexual performance in the morning before his epistaxis…This was his first nose-bleed requiring medical attention…[After] two days and he was discharged home with no further epistaxis”.
Case 3: “A 32-year-old male presented to our department for recurrent epistaxis during sexual intercourses…During the consultation, he volunteered that the trigger for the epistaxis appeared to have been misuse of phosphodiesterase (PDE)-5 inhibitors, Viagra and Cialis. This first report of epistaxis after PDE-5 inhibitors in a young patient underline the possibility that in the next years the number of similar cases might increase due to the diffusion of PDE-5 inhibitor misuse in recreational settings”.
Case 4: “A 66-year-old male presented to our department with recurrent epistaxis. On examination it was not possible to identify the source of the bleeding, despite various measures…During a consultation the patient volunteered that the trigger for the epistaxis appeared to have been energetic sexual activity. To enhance his sexual performance he had taken Viagra; however, on stopping the Viagra and changing to the newer drug Cialis, the episodes of epistaxis continued. We document what we believe to be the first case of epistaxis caused by Cialis”.

So why would Viagra and Cialis cause nosebleeds? Given that these medications help engorge erectile tissue, the nose also contains erectile tissue and the authors of these case reports believe that nasal engorgement also took place and lead to the nosebleeds. The phenomenon may be under-reported because individuals that use Viagra to enhance their sex lives may be too embarrassed to discuss this with doctors if it relates to sexual dysfunction. (I also came across a case report in a 2009 issue of the Indian Journal of Chest Diseases and Allied Sciences by Dr. R. Dixit and colleagues of a 38-year old man persistently coughing up of blood [haemoptysis] whenever he used Viagra during sex).

Another interesting angle on sexual nosebleeds comes from Japanese cartoon animation (and more specifically Manga comics). In an online article entitled ‘Nosebleeds: Manga just wouldn’t be the same without them’, the author argues that Manga cartoons contain a number of specific tropes (i.e., a significant or recurrent theme). These tropes (amongst others) included nosebleeds, sweat drops, snot bubbles, and popping veins. Sexual nosebleeds were the number one trope in the article. The article noted that:

“A nosebleed, in the wonderful world of manga, equates to sexual arousal. I saw this trope for the first time in Dragonball, when Bulma lifts her dress and the lecherous Master Roshi spurts blood from his nose. Although Bulma was commando at the time, nosebleeds can be triggered by seeing something as mild as a pair of panties. In the case of the boy in the following image, it seems his bloody nose was triggered more by a fetish for swimsuits rather than the girl wearing them: Clearly, horn dogs don’t spontaneously get nosebleeds in real life. So why is it so in manga? I think it’s generally accepted that a rush of blood to the head and the resulting nosebleed is a visual metaphor for blood rushing to, er, somewhere else – which probably explains why I’ve only ever seen guys get nosebleeds, although I could be wrong about that”.

I’ve never watched a full Manga cartoon in my life but from everything I’ve read, male nosebleeds are common cliché in anime cartoons and are known as ‘hanaji’. According to the online Urban Dictionary, hanaji is “when you see a boy get a nosebleed in anime, [and] usually means his blood pressure has suddenly severely increased from seeing a really cute girl”. In an article by Brian Ashcroft for Culture Smash, he also noted the nosebleed trope in Manga cartoons:

“A character, male or female, gets excited—often sexually excited. Blood dribbles, or squirts, out of the character’s nose. The notion that arousal or excitement induces bloody noses…isn’t just part of anime or manga iconography. It’s also become an old wives’ tale of sorts…The trope is very much a Japanese one, appearing throughout the country’s popular culture and with various nuances in anime and manga. It is not a new trope and has existed for years…Manga artist Yasuji Tanioka is believed to be the first one to introduce the motif with his early 1970s manga Yasuji no Mettameta Gaki Dou Kouza. Other manga artists liked the expression and began replicating it in their own work”.

In relation to the nosebleed trope in anime cartoons, Dr. Kouichirou Kanaya (the ear, nose, and throat specialist quoted above) speculated that:

“Bloody noses are probably used to show in a powerful way just how excessively large the change induced by sexual arousal is. It’s a climax, and in manga, it often seems to be code for ejaculation”.

There are also anecdotal cases of nosebleed fetishes (called epistaxiophilia). However, the love of nosebleeds appears to have been created by using the name of nosebleed phobia (epistaxiophobia) and changing the suffix ‘phobia’ for ‘philia’. To my knowledge, there has never been an academic paper or clinical case study published on epistaxiophilia. However, I did come across a number of online confessions of individuals that admitted (if they are true) that they were sexually aroused by nosebleeds. Here are some extracts that I found in various online forums:

Extract 1: “Was just reading a thread on r/Askmen about men who get nosebleeds during sex. My brain processed SEX and NOSEBLEEDS and I immediately imagined myself riding a guy home when he suddenly got a nose bleed. I was strangely turned on by that idea. I don’t think I’d be comfortable sharing this newly discovered turn on with any of my friends because I feel like it’s so damn weird” (Female, Reddit, AskWomen forum)
Extract 2: “Nosebleed fetish? Does anyone have it? I normally don’t like blood but I find nosebleeds really hot. I wouldn’t ever hurt my loved one, but I have to admit that I’m quite aggressive towards normal people because of it” (Inwealorwoe [Male], Yahoo! Answers)
Extract 3: “I’ll completely understand and I won’t take offense if you run from this post flailing and gagging…For the longest time, I’ve had a nosebleed Maybe that links to the fact that I’ve also got haematophilia and a vampire fetish. But you know what I really like? When someone sneezes while they have a nosebleed” (Proclaimer, Female, 21 years old)
Extract 4: “I think it’s incredibly sexy when a guy has a nosebleed. Sneezing while having a nosebleed. I would agree that nosebleeds are probably a turn-on for me because of the whole vulnerability/loss of control factor. Same as with sneezing and colds and things like that” (Helter Skelter, female, 19 years old)
Extract 5: “I actually do have a blood/vampire fetish. I often find myself getting very thirsty as well as aroused when watching vampires feed in movies. However I don’t really find nosebleeds all that appealing. I’m not disgusted by it or anything, but it just wouldn’t really do anything for me. I guess it’s just not the type of bleeding that I’m attracted to. I can see how it might be appealing to others though” (Shayla, female 31 years)

Obviously I cannot vouch for the veracity of these claims but I have no reason to doubt them (and the final extract liked other blood fetishes but not a nosebleed fetish). There is no detail in any of these extracts to speculate as to why anyone develops a fetish to nosebleeds. However I’ll leave you with a reply to the person in Extract 2 above:

“[Nose bleed fetishes] makes sense. A sexual therapist said that our sexual fantasies are derived from non-sexual things in our life. So your fetish for nosebleeds could actually stem from something non-sexual in your life. For example, it probably turns you on because it makes you feel empowered and aggressive, since if the person you are with has a nosebleed it means you must have been rough with them. So I would say that your fetish is probably normal, because many people are turned on by feeling empowered and aggressive. Sounds normal to me” (The Way It Is, Yahoo! Answers)”.

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Ashcroft, B. (2012). Sexual arousal doesn’t cause bloody noses, says medical science! Culture Smash, October 19. Located at: http://kotaku.com/5953124/sexual-arousal-doesnt-cause-bloody-noses-says-medical-science

Dixit, R., Jakhmola, P., Sharma, S., Arya, M., & Parmej, A. R. (2009). Recurrent haemoptysis following sildenafil administration. Indian Journal of Chest Diseases and Allied Sciences, 15, 119-120.

Hicklin, L.A., Ryan, C., Wong, D.K.K., & Hinton, A.E. (2002). Nose-bleeds after sildenafil (Viagra). Journal of the Royal Society of Medicine, 95(8), 402-403.

Ismail, H., & Harries, P. G. (2005). Recurrent epistaxis after treatment with tadalafil (Cialis). Acta oto-laryngologica, 125(3), 334-335.

Pomara, G., Morelli, G., Menchini-Fabris, F., Dinelli, N., Campo, G., LiGuori, G., & Selli, C. (2006). Epistaxis after PDE-5 inhibitors misuse. International Journal of Impotence Research, 18(2), 213-214.

Posted in Case Studies, Compulsion, Obsession, Pain, Paraphilia, Psychology, Sex, Sex addiction

Blood pressures: Interview with a [female] vampire

Nov 24

Posted by drmarkgriffiths

In a previous blog I briefly examined clinical vampirism as a sexual paraphilia. In that blog I noted that there had been very little empirical research on clinical vampirism and that most of what is known comes from clinical case studies. Furthermore, vampirism (i) is rarely a single clinical condition, (ii) may or may not be associated with other psychiatric and/or psychological disorders (e.g., severe psychopathy, schizophrenia, hysteria, mental retardation), and (iii) may or may not necessarily include sexual arousal. Other related conditions include odaxelagnia (deriving sexual pleasure from biting), haematolagnia (deriving sexual satisfaction from the drinking of blood), and haematophilia (deriving sexual satisfaction from blood in general), and auto-haemofetishism (i.e., deriving sexual pleasure from sight of blood drawn into a syringe during intravenous drug practice).

More recently I was contacted by a female ‘vampire’ (I use the term lightly in this instance) who has read my original article wanted to share her story with me. She gave me permission to disseminate her story with my blog readers on the understanding that I guaranteed her anonymity, confidentiality, and used her preferred name of ‘Countess Maria’ (CM) throughout the article. (She also signed herself as ‘The Young Madam’ but I will use CM for the remainder of this article). Obviously, I have no way of verifying anything that CM communicated to me, but on a personal level I have no reason to doubt the veracity of her claims. All of our communication was via email under her real name (which I then checked out online on a specific social networking site and I am 100% sure that she is who she says she is). She also said she “would be honored to have you feature my story. I have answered your questions…as I honor your intellect and respect…being a professor is indeed a respectable, hardy, and challenging profession which is why I greatly respect an honor such profession”. More specifically, she added:

CM: “Whom I share this information must take it to the grave with them; except for you. You may share my story if and only if you use my name I have used for years ‘Countess Marie’. I do indeed consider myself a Countess due to what I have endured through humanitarian efforts as well as my ever strong want, need, and desire to help humanity – even if humanity shuns me for who I am”.

I asked CM for some socio-demographic information and she told me that she was 23 years of age, described herself as an African American and was currently employed as a Pharmacy Technician. Based on what she told me, she was well educated with various medical qualifications including Pharmacy Technician and Animal Care Certification. I also asked her about her religious beliefs and she responded: “Christian with great noble intent (‘I will gladly share my last piece of bread with my fellow man’). I live by that statement and I intend to follow through”. She also went ion to say: “I am finally in my studied job, as a Pharmacy Technician. I have always had a thing for helping people…this is just one if the many ways I can help. My dream in life is to be a great humanitarian and grow to greatness in helping those around me…I love who I am, and I am always wanting to follow my path.

In her account, CM didn’t really label herself a vampire but admitted that she liked drinking blood, and that many of the acts she engaged in would be labelled as vampire-like by others. She also talked about her first experiences of blood-sucking:

CM: “It is my understanding that you wish to hear about my further expansion on my clinical vampirism. Truthfully, I don’t really put a label on what it is I do. I have been consuming blood since I was young. The first cut I ever got was from a tree branch. I sucked my arm for several hours because the taste was delicious”.

At that point, CM didn’t really view her activity as in any way wrong but over time she began to realize that blood sucking was not considered normal behaviour and that she was socially ostracized by those who knew about her love of blood:

CM: “As I furthered in age through the years I noticed that I was considered different and odd, but I kept to myself about it. My love, my best friends, and you are the only people to know I consume blood…I would also like to add I have been called everything in the book for consuming blood; Monster, Demon, Grim’s Helper, and all the names in the middle…[Even] my friends called me [these things] at first because they did not understand what it mean for me”

However, CM went to great lengths to tell me that her love of blood did not involve the sucking of blood from other humans:

CM: “Make no mistake…I have never consumed blood from any human being – [only] myself. I consume pork blood, beef blood, and if that cannot be obtained I buy steaks and cook them very rare just enough for blood to spill out of it. I enjoy eating food, but it’s not really fun if it lacks in my nutrition. I add blood to juice, tea, desserts, cakes, salads, and disguise it in all sorts of ways”.

CM claimed she would never do anything that impacted on other humans and that morally it would be wrong to enforce her own beliefs and desires on others. She also believes that blood consumption is what keeps her alive:

“I never feed anyone else my blood food. I cook human food properly for guests for I know I am the only one who enjoys the taste of blood. To many, it is bitter and irony-metallic tasting. I cannot relate, due to the fact that for me, it tastes like fine wine. Without blood, I know that I would surely die. I need blood to live. I have always felt that way. Nothing on Earth will ever change my thoughts on the matter. I love blood…To me blood is life or death”.

CM also told me she had been diagnosed with anemia and I asked her whether believed that her love of blood may be because she has anemia:

“I will always love blood. I know that as far as my health goes, it actually favors blood consumption. I was told I almost died by slowly falling into a coma from sleeping for almost 4 straight days. The entire time I was asleep it only felt like seconds, but when I awoke, everyone was worried…I was diagnosed with being anemic, as well as hyperthyroidism. My hyperthyroidism is such [that] I will be on Levothyroxin until the day I die. My blood naturally lacks the iron (due to being anemic) so consuming blood helps me in many ways…I feel that my anemia further shows me that when I feel dizzy or “off centered” that I should consume blood. I only consume pig or beef blood…NEVER human blood”.

As she had read my article clinical vampirism as a sexual paraphilia I also asked CM if her consuming of blood was in any way sexually motivate. She responded by saying:

“The sight of blood is a turn on for me, but only inside of a container. If someone is bleeding of course I would help aid them and stop the pain. If I see frozen blood in the grocery store or walk in the meat section at the market for too long, all I can smell is the blood, which causes arousal for me. I don’t stay in butcher shops long for that reason”.

This suggests that blood for CM (in some circumstances) is sexually arousing and that there may be paraphilic elements in her reason for liking blood. Whether CM is typical of other ‘vampires’ is not clear. But given the little we know about people that love drinking blood, I am grateful to CM for her time in answering my questions and her honesty in relation to the development and motivations underpinning her hobby.

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Benezech, M., Bourgeois, M., Boukhabza, D. & Yesavage, J. (1981). Cannibalism and vampirism in paranoid schizophrenia. Journal of Clinical Psychiatry, 42(7), 290.

Gubb, K., Segal, J., Khota1, A, Dicks, A. (2006). Clinical Vampirism: a review and illustrative case report. South African Psychiatry Review, 9, 163-168.

Halevy, A., Levi, Y., Ahnaker, A. & Orda, R. (1989). Auto-vampirism: An unusual cause of anaemia. Journal of the Royal Society of Medicine, 82, 630-631.

Hemphill R.E. & Zabow T. (1983) Clinical vampirism. A presentation of 3 cases and a re-evaluation of Haigh, the ‘acid-bath murderer’. South African Medical Journal, 63(8), 278-81.

Kelly, B.D., Abood, Z. & Shanley, D. (1999). Vampirism and schizophrenia. Irish Journal of Psychological Medicine, 16, 114-117.

Jaffe, P., & DiCataldo, F. (1994). Clinical vampirism: Blending myth and reality. Bulletin of the American Academy of Psychiatry and the Law, 22, 533-544.

Miller, T.W., Veltkamp, L.J., Kraus, R.F., Lane T. & Heister, T. (1999). An adolescent vampire cult in rural America: clinical issues and case study. Child Psychiatry and Human Development 29, 209-19.

Milner, J.S. Dopke, C.A. & Crouch, J.L. (2008). Paraphilia not otherwise specified: Psychopathology and Theory In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 384-418). New York: Guildford Press.

Noll, R. (1992). Vampires, Werewolves and Demons: Twentieth Century Reports in the Psychiatric Literature. New York: Brunner/Mazel.

Prins, H. (1985). Vampirism: A clinical condition. British Journal of Psychiatry, 146, 666-668.

Vanden Bergh, R. L., & Kelly, J. F. (1964). Vampirism: A review with new observations. Archives of General Psychiatry, 11, 543-547.

Wilson N. (2000) A psychoanalytic contribution to psychic vampirism: a case vignette. American Journal of Psychoanalysis, 60, 177-86.

Yates, P.M., Hucker, S.J. & Kingston, W.A. (2008). Sexual sadism: Psychopathology and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment. pp.213-230. New York: Guildford Press.

Posted in Case Studies, Compulsion, Eating disorders, Paraphilia, Psychology, Sex

1 Comment

Tags: Auto-haemofetishism, Autovampirism, Clinical vampirism, Drinking blood, Haematolagnia, Haematophilia, Menophilia, Odaxelagnia, Sexual paraphilia, Sexual vampirism, Vampirism

Bad blood: A brief look at zoophagia

Sep 8

Posted by drmarkgriffiths

In previous blogs on vampirism as a sexual paraphilia and tampon fetishes, I briefly mentioned zoophagia. In his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, Dr Anil Aggrawal defines zoophagia as eating live animals for erotic arousal. The online Wiktionary provides the same definition but also adds that it is another name for Renfield’s Syndrome (which I also covered in my blog on vampirism as a sexual paraphilia). Renfield’s Syndrome (as yet) does not appear in the Diagnostic and Statistical Manual of Mental Disorders but has been described as consisting of three stages (of which only one stage comprises zoophagia). More specifically:

Stage 1 – Autovampirism (autohemophagia): In the first stage, RS sufferers drink their own blood and often bite or cut themselves to do so (although some pay just pick at their own scabs).
Stage 2 – Zoophagia: In the second stage, RS sufferers eat live animals and/or drink their blood. The sources animal blood may come from butchers and abbatoirs if they have no direct access.
Stage 3 – True vampirism: In the final stage, RS sufferers drink blood from other human beings. The sources of blood may be stolen from blood banks or hospitals or may be direct from other people. In the most extreme cases, RS sufferers may commit violent crimes including murder to feed their craving.

What is clear from the description of zoophagia as part of Renfield’s Syndrome is that sexual pleasure and sexual arousal do not appear to be part of the motivation to engage in the behaviour. Of all the sexual paraphlias I have ever written about, zoophagia is one of the few that I find it hard to imagine what the etiology of the behaviour involves. How does anybody end up developing sexual pleasure from eating animals while they are still alive?

There is very little written about zoophagia from an academic perspective. Most references to the behaviour are found in the forensic crime literature in relation to sexual homicides or as a behaviour associated with specific events such as satanic rituals (although this is more to do with haematophagy – the drinking of animal blood – than zoopahgia). As Dr. Eric Hickey notes in his 2010 book Serial Murderers and Their Victims, in most countries, drinking blood is not a crime. Zoophagia is arguably a sub-type of haematophilia (i.e., a sexual paraphilia in which individuals derive sexual pleasure and arousal from the tasting or drinking blood). Dr. Hickey also noted the relationship between zoophagia and haematophilia:

“[Haematophilia] is usually done in the presence of others. Most persons engaging in this form of paraphilia also have participated in or have co-occurring paraphilia often harmful to others. In addition, a ‘true hematolagniac’ is a fantasy-driven psychopath and to be considered very dangerous. According to Noll (1992), such desires are founded in severe childhood abuse. The child may engage in auto-vampirism in tasting his own blood and during puberty. These acts are eventually sexualized and reinforced through masturbation. A progressive paraphilic stage during adolescence is the sexual arousal of eating animals and drinking their blood (zoophagia) while masturbating. The compulsive, fantasy driven, sexual nature of this paraphilia creates a very dangerous adult”.

One of the most infamous serial killers that engaged in zoophagic activity was the German Peter Kurten (1883-1931), a mass murderer nicknamed the ‘Vampire of Dusseldorf’ (a case study also written about by Dr. Louis Schlesinger in his 2004 book Sexual Murder). Citing the work of criminologist Herschel Prins published in a 1985 issue of the British Journal of Psychiatry, Dr. Hickey recalled that:

“Kurten was raised in a very physically and sexually abusive home where he witnessed his alcoholic father raping his mother and sisters. He also engaged in sexually abusing his sisters…At age 11 he was taught by the local dog catcher how to torture dogs and sheep while masturbating. He developed multiple paraphilia including vampirism, hematolagnia, necrophilia, erotophonophilia, and zoophagia and was known to drink directly from the severed jugular of his victims. He raped, tortured, and killed at least nine known victims although he was believed to have murdered several others. He used hammers, knives, and scissors to kill both young girls and women and admitted that he was sexually aroused by the blood and violence. Some victims incurred many more stab wounds than others, and when asked about this variation he explained that with some victims his orgasm was achieved more quickly…Before his beheading he asked if he would be able to hear the blood gushing from his neck stump because “that would be the pleasure to end all pleasures”.

Most of the literature on the drinking of blood for sexual pleasure concerns humans and is found in the studies on clinical vampirism (that I reviewed in a previous blog). From the few case studies I have read where zoophagia was mentioned in passing, all of the people written about engage in other sexually paraphilic behaviours (similar to that of Kurten outlined above). There may also be links between zoophagia and sexual cannibalism (which I also covered in a previous blog). For instance, some zoophagic activity might be viewed as omophagic activity in which the act is a form of symbolic ritual where the person consuming the blood and/or flesh of a live animal believes they are incorporating the ‘life force’ of the animal in question. For instance, an entry in Murderpedia claims:

“Some killers have adopted a form of omophagia, which is called zoophagia, as a means of possessing their victims. Zoophagia is the consumption of life forms, as seen in the character of Renfield in Dracula, who progresses from spiders to flies to birds to cats. The idea is to ingest increasingly sophisticated life forms as a way to improve one’s own”

An online article on vampires and the fetish scene by the Occult and Violent Ritual Crime Research Center notes that some of the behaviours that vampires engage in are similar to behaviours engaged in by fetishists. In a section on ‘blood rituals and blood play’, the article notes that throughout history and across cultures, people have attributed sacred and magical qualities to blood, and that blood rituals include drinking and/or pouring blood on the body. It also noted that:

“In some cultures it was believed that drinking the blood of a victim would endow you with the victim’s strength. Similarly by drinking the blood of an animal you would acquire its qualities…The use of blood is commonly referred to as blood sports, blood play, blood lust and blood fetishism”.

Any information that we currently have on zoophagia comes from clinical and/or forensic case studies. It would appear that zoophagia is incredibly rare, usually occurs among males, often coincides with other sexually paraphilic behaviour, and is most likely to occur among those with psychopathic and/or serial killing tendencies (unless the behaviour is part of a satanic and/or other ritualistic event).

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Benezech, M., Bourgeois, M., Boukhabza, D. & Yesavage, J. (1981). Cannibalism and vampirism in paranoid schizophrenia. Journal of Clinical Psychiatry, 42(7), 290.

Gubb, K., Segal, J., Khota1, A, Dicks, A. (2006). Clinical Vampirism: a review and illustrative case report. South African Psychiatry Review, 9, 163-168.

Halevy, A., Levi, Y., Ahnaker, A. & Orda, R. (1989). Auto-vampirism: An unusual cause of anaemia. Journal of the Royal Society of Medicine, 82, 630-631.

Jaffe, P., & DiCataldo, F. (1994). Clinical vampirism: Blending myth and reality. Bulletin of the American Academy of Psychiatry and the Law, 22, 533-544.

Noll, R. (1992). Vampires, Werewolves and Demons: Twentieth Century Reports in the Psychiatric Literature. New York: Brunner/Mazel.

Occult and Violent Ritual Crime Research Center (2012). Renfield’s Syndrome. Located at: http://www.athenaresearchgroup.org/renfieldsyndrome.htm

Perlmutter, D. (2004). Investigating Religious Terrorism and Ritualistic Crimes. Boca Raton, Florida: CRC Press LLC.

Prins, H. (1985). Vampirism: A clinical condition. British Journal of Psychiatry, 146, 666-668.

Wilson N. (2000) A psychoanalytic contribution to psychic vampirism: a case vignette. American Journal of Psychoanalysis, 60, 177-86.

Posted in Addiction, Case Studies, Compulsion, Eating disorders, Mania, Obsession, Obsessive-Compulsive Disorder, Paraphilia, Psychology, Sex

1 Comment

Tags: Autohemophagia, Blood fetishism, Blood sports, Compulsion, Erotophonophilia, Haematophilia, Necrophagia, Necrophilia, Necrozoophilia, Satanic rituals, Sexual necrophagy, Sexual paraphilia, Vampirism, Zoophagia, Zoophilia

Period drama: A brief look at haematophilia and sexualized tampon use

Jan 4

Posted by drmarkgriffiths

I apologize in advance if today’s blog is a little more unpalatable than usual. If you are in any way prudish or squeamish, then stop reading now. The topic of today’s blog is the haematophilia and sexualized use of tampons. It was while researching my previous blogs on paraphilic vampirism and menophilia (i.e., a sexual paraphilia in which individuals derive sexual arousal from menstruating females) that I came across various references to tampons as a source of sexual arousal and pleasure.

Both menophilia and paraphilic vampirism are arguably sub-categories of haematophilia (i.e., a sexual paraphilia in which individuals derive sexual pleasure and arousal from the tasting or drinking blood). As Dr. Eric Hickey notes in his 2010 book Serial Murderers and Their Victims, in most countries, drinking blood is not a crime. He also notes that in reference to haematophilia:

“The activity is usually done in the presence of others. Most persons engaging in this form of paraphilia also have participated in or have co-occurring paraphilia often harmful to others. In addition, a ‘true hematolagniac’ is a fantasy-driven psychopath and to be considered very dangerous. According to Noll (1992), such desires are founded in severe childhood abuse. The child may engage in auto-vampirism in tasting his own blood and during puberty. These acts are eventually sexualized and reinforced through masturbation. A progressive paraphilic stage during adolescence is the sexual arousal of eating animals and drinking their blood (zoophagia) while masturbating. The compulsive, fantasy driven, sexual nature of this paraphilia creates a very dangerous adult”.

Dr. Hickey’s book also includes a case study of Peter Kürten (1883-1931), a mass murderer nicknamed the ‘Vampire of Dusseldorf’, who terrified the inhabitants of his home town in Germany (a case study also written about by Dr. Louis Schlesinger in his 2004 book Sexual Murder). Citing the work of criminologist Herschel Prins published in a 1985 issue of the British Journal of Psychiatry, Dr. Hickey recalled that:

This brief overview shows that Kurten had multiple paraphilias (including necrophilia) and was a genuine haematophile. I picked out necrophilia as one of the co-occurring paraphilias because Dr. Anil Aggrawal has written extensively on necrophilia and noted in both his 2009 paper in the Journal of Forensic and Legal Medicine and his 2011 book Necrophilia: Forensic and Medico-legal Aspects that: “some [necrophiles] remove clothes, especially panties or even tampons from corpses to keep as fetish objects…and their paraphilia is known as necrofetishism”. This was the first-ever academic reference I had read that related to the sexualized and fetishistic use of tampons.

Not only has sexualized tampon use been associated with haematophilia, menophilia, and necrophilia, it is also associated with mysophilia (in which individuals derive sexual pleasure and arousal from filth, and which I examined in a previous blog along with salirophilia). If you want some (non-academic) proof, a number of internet websites cater for tampon-loving mysophiles including Charlotte’s Panties site that sells used tampons and sanitary pads for sexual pleasure. Another avenue to check out is the Men in Menstruation website (that perhaps more accurately should be named ‘Men Into Menstruation’). Another unusual way in which tampon use has been sexualized is in their use in urethral stimulation. A number of medical papers have made reference to the fact that tampons have got stuck in the urethra during self-inflicted sexual stimulation (such as a paper by Dr. W. Kochakarn and Dr. Pummanagura in a 2008 issue of the Asian Journal of Surgery).

While researching this blog I came across dozens and dozens of ‘tampon fetish’ sites (type ‘tampon fetish video’ into Google and you’ll see what I mean – be warned, almost all of them are very sexually explicit such as Bloody Trixie’s Red Fetish Blog). I also came across quite a few men who confessed to their tampon fetish online:

Extract 1: “I have a fetish for tampons. Lots of people think it’s disgusting, and lots of girls especially. But since I was in Junior High I’ve been fascinated by girls’ periods, and began sneaking into toilets at an early age to look. There are cool spy cam videos of girls changing tampons. I love them. I found a good unisex bathroom in our building, and can go there and find fresh tampons. The idea that it was just in a girl’s vagina, and that she was sitting there slipping it out, and a new one in, turns me on, and I’ll often masturbate. Sometimes there is blood on the bottom of the seat. I love pictures of girls with the tampon string showing, and having sex during my girlfriend’s period. I found a site where girls discuss their periods often in detail, day by day, and I like to read it” (“String Lover”)
Extract 2: “Recently when my girlfriend stayed over she said we couldn’t have sex because it was her period and after she left I saw a used tampon in the trash. I found it gross at first but then it kind of turned me on, without thinking I licked it I KNOW, I kind of liked it and now 2 months later I’m still eating her tampon blood, does this mean I’m a vampire? (“Sir Valentine”)
Extract 3: “I am a 37 year-old male that has a tampon fetish. I love to insert tampons into my rectum. When I insert it I get turned on and sometimes blow my load. It feels so good inside my rectum that I do it daily. It helps hold my poop in to my bowel movement is so full backed up that it pushes the tampon out and my poop goes into my diaper that usually is already soaked full of warm, most pee. The feel of the pee and BM is so great. Any women that would like me to do this to them would be awesome. While you are inserting the tampon into my rectum I’ll insert one into your rectum (“Unpottytrainedfireman”)
Extract 4: “I have been a cross dresser for years, and just in the last few years I started wearing tampons and Kotexs. I wear the tampons when I am dressed as a girl, and they give me a greater feeling of being a girl. I wear the kotexs the rest of the time when I am wearing panties and panty hose under my male clothes (“Marry”)
Extract 5: “I am a cross dresser and I fully dress as ‘Tami’ every day and when I am always dressed I use tampons and a Kotex because I love the feeling of them and they make me feel more feminine. Right from the start of my cross dressing I started just using Kotex to hide my manhood then I thought it might feel good to put a tampon in my rear and it felt so good so now I wear them every day while I am dressed (“Tami”)

The first three extracts are all variants of what I would term the archetypal ‘tampon fetish’ (where the tampon itself is sexualized) in some way. In Extract 1 it appears to be linked to voyeurism, in Extract 2 it appears to be linked to menophilia, and in Extract 3 there are associations with both coprophilia and urophilia. The final two extracts are where the tampon is sexualized but only as an adjunct or accessory to the primary paraphilic interest of transvestism (something that I have never seen mentioned in the academic or forensic psychiatry literature). However, there are numerous examples of the practice online, and even an online article on the Blurt It website entitled ‘Is It Okay For Men To Wear Panties and Kotex Maxi Pads?’ There are also websites that cater for tampon fetishes that do not appear to have anything to do with blood. For instance, there are some sites dedicated to those individuals (presumably men) who are sexually aroused by the sight of tampon strings hanging from female genitalia (such as at the Peachy Forum – be warned, this is sexually explicit site) as noted in Extract 1 (above).

Although there have been academic and clinical writings on various ‘blood paraphilias’ (most notably paraphilic vampirism), there is nothing (to my knowledge) specifically on tampon fetishes. Whether empirical research is needed is debatable, but even a quick perusal of the online fetish sites suggest that while it be an understandable niche sexual market, there are definitely admirers and adherents out there.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Aggrawal, A. (2009). A new classification of necrophilia. Journal of Forensic and Legal Medicine, 16, 316-320.

Aggrawal A. (2011). Necrophilia: Forensic and Medico-legal Aspects. Boca Raton: CRC Press.

Benezech, M., Bourgeois, M., Boukhabza, D. & Yesavage, J. (1981). Cannibalism and vampirism in paranoid schizophrenia. Journal of Clinical Psychiatry, 42(7), 290.

Hickey, E. (2010). Serial Murderers and Their Victims. Belmont, CA; Wadsworth Cengage Learning.

Jaffe, P., & DiCataldo, F. (1994). Clinical vampirism: Blending myth and reality. Bulletin of the American Academy of Psychiatry and the Law, 22, 533-544.

Kochakarn, W. & Pummanagura, W. (2008). Foreign bodies in the female urinary bladder: 20-year experience in Ramathibodi hospital. Asian Journal of Surgery, 31, 130–133.

Noll, R. (1992). Vampires, Werewolves and Demons: Twentieth Century Reports in the Psychiatric Literature. New York: Brunner/Mazel.

Prins, H. (1985). Vampirism: A clinical condition. British Journal of Psychiatry, 146, 666-668.

Schlesinger, L. (2004). Sexual Murder. New York: CRC Press.

Posted in Case Studies, Compulsion, Obsession, Psychology, Sex, Sex addiction

3 Comments

Tags: Blood fetishes, Blood paraphilias, Clinical vampirism, Coprophilia, Haematophilia, Menophilia, Mysophilia, Necrofetishism, Necrophilia, Salirophilia, Sexual fetish, Sexual paraphilia, Tampon fetishes, Urethral stimulation, Urophilia, Vampirism, Zoophagia

The bite of passion: Vampirism as a sexual paraphilia

Mar 22

Posted by drmarkgriffiths

Although vampirism as a sexual paraphilia has been noted in the academic literature for many years (in fact there are references to it in Richard van Krafft-Ebing’s 1886 text Psychopathia Sexualis), there has been very little empirical research and most of what is known comes from clinical case studies. To complicate things further, vampirism (i) is rarely a single clinical condition, (ii) may or may not be associated with other psychiatric and/or psychological disorders (e.g., severe psychopathy, schizophrenia, hysteria, mental retardation), and (iii) may or may not necessarily include sexual arousal. Other related conditions have been documented such as odaxelagnia (deriving sexual pleasure from biting), haematolagnia (deriving sexual satisfaction from the drinking of blood), and haematophilia (deriving sexual satisfaction from blood in general), and auto-haemofetishism (i.e., deriving sexual pleasure from sight of blood drawn into a syringe during intravenous drug practice).

In 1964, Vandenbergh and Kelly defined vampirism as “the act of drawing blood from an object, (usually a love object) and receiving resultant sexual excitement and pleasure”. In 1983, Bourguignon described vampirism as a clinical phenomenon in which myth, fantasy, and reality converge and that other paraphilic behaviour may be involved including necrophagia, necrophilia, and sadism. Also in 1983, noted that “vampirism is a rare compulsive disorder with an irresistible urge for blood ingestion, a ritual necessary to bring mental relief; like other compulsions, its meaning is not understood by the participant”.

In 1985, Herschel Prins published what is arguably the most cited paper in the field (in the British Journal of Psychiatry), and proposed that there were four types of vampirism (although confusingly, one of these sub-types is not actually vampiric as no blood ingestion takes place and some of the satisfaction gained may not necessarily be sexual). These four types were:

Necrosadistic vampirism (i.e., deriving satisfaction from the ingestion of blood from a dead person);
Necrophilia (i.e., deriving satisfaction from sexual activity with a dead person without the ingestion of blood)
Vampirism (i.e., deriving satisfaction from the ingestion of blood from a living person)
Autovampirism (deriving satisfaction from the ingestion of one’s own blood).

In Prins’ typology above, vampirism evidently overlaps with that of necrophilia. However, earlier papers (such as Vandenbergh and Kelly’s in 1964) clearly differentiated between necrophilia and vampirism, arguing that vampirism shouldn’t be mixed with necrophilia given that vampirism is often focused on the living. Vandenbergh and Kelly also differentiate vampirism from sexual sadism (due to the fact that vampirism doesn’t always include pain and suffering). In fact, in a literature review of sexual sadism, Yates and colleagues (2008) included the “rare phenomenon” of vampirism in their review. Drawing on the work of Jaffe and DiCataldo (1994), they described those people who get sexual arousal from bloodletting (either through cutting or biting), and for which a small minority enjoy sucking and/or drinking the blood too. Vanden Bergh and Kelly (1964) noted that the sucking or drinking of the blood from the wound is often an important part of the act but not necessarily essential.

Using the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), Dr Joel Milner, Dr Cynthia Dopke, and Dr Julie Crouch (2008) argue that if the individual’s vampirism causes pain and suffering in their victims it should be classed as a sexually sadistic paraphilia. However, if the victim does not suffer in any way, the vampirism should be classed as a paraphilia not otherwise specified (P-NOS). Milner and colleagues argue this approach is consistent with other P-NOS classifications involving other body fluids/substances (other than blood) such as urophilia (urine) and coprophilia (faeces).

Any discussion of vampirism wouldn’t be complete without at least a mention of Renfield’s Syndrome (RS) although it has yet to be included in the DSM. Renfield was a fictional mental patient in Bram Stoker’s novel Dracula (1887) who ate living things (flies, spiders, birds) believing that this would bring him greater ‘life force’ powers. The RS disorder, named in 1992 by clinical psychologist Dr Richard Noll (DeSales University, Pennsylvania, USA), is a rare psychiatric compulsion (not necessarily sexual and often linked with schizophrenia) – in which sufferers feel compelled to drink blood. As with some of the papers written on vampirism as a sexual paraphilia, this has also been called ‘clinical vampirism’. Like the character Renfield, RS sufferers believe that they can obtain increased power or strength (i.e., the ‘life force’) through the imbibing of blood.

RS sufferers are predominantly male (although there are known female vampirists), and like many paraphilias, the disorder often originates from a childhood event in which the affected individual associates the sight or taste of blood with psychological and/or physical excitement. It is during adolescence that the attraction to blood can become sexual in nature. Clinical evidence suggests female RS sufferers are unlikely to assault others for blood, but male RS sufferers are potentially more dangerous. It has been noted that RS usually comprises three stages:

Stage 1 – Autovampirism (autohemophagia): In the first stage, RS sufferers drink their own blood and often bite or cut themselves to do so (although some pay just pick at their own scabs).
Stage 2 – Zoophagia: In the second stage, RS sufferers eat live animals and/or drink their blood. The sources animal blood may come from butchers and abbatoirs if they have no direct access.
Stage 3 – True vampirism: In the final stage, RS sufferers drink blood from other human beings. The sources of blood may be stolen from blood banks or hospitals or may be direct from other people. In the most extreme cases, RS sufferers may commit violent crimes including murder to feed their craving.

In a 1981 issue of the Journal of Clinical Psychiatry, Dr M. Benezech and colleagues reported a case study of cannibalism and vampirism in a French paranoid and psychotic schizophrenic. After trying to kill a number of people (mainly neighbours) between 1969 (when he was aged 29 years) and 1978, he attempted a vampiric rape on a child in 1979. Although he was stopped he went on later that day to murder an elderly man and successfully ate large pieces of the victim’s thigh, and attempted to suck his blood. Here, the vampirism was seen as secondary to the schizophrenia. A similar type case report of a 21-year old eastern European schizophrenic vampirist was published in 1999 by Dr Brendan Kelly (St James Hospital Dublin, Ireland) and colleagues in the Irish Journal of Psychological Medicine. However, the patient didn’t attempt to suck blood from himself or others but instead frequented a hospital accident and emergency department in search of their supply of blood for transfusion.

In a 1989 issue of the Journal of the Royal Society of Medicine, Dr A. Halevy and his colleagues reported the case of a 21-year old man (who had been in prison since he was 16 years old) who had anaemia and gastrointestinal bleeding as a result of self-inflicted injuries and blood ingestion on multiple occasions (for instance, one incident involved him cutting his arm with a razor blade, draining the blood into a glass, and then drinking it). He was classed by the authors as an ‘autovampirist’ in Prins’ typology although the authors were unable to determine if there was any sexual motivation involved.

In one of the few papers to examine more than one case study, Dr R.E. Hemphill and Dr. T. Zabow (1983, at the University of Cape Town) examined four vampirists in depth, including John Haigh (the English ‘acid-bath murderer’ who killed six people during the 1940s and drunk the blood of his victims), along with reference to other criminal vampirists. Hemphill and Zabow noted that since childhood all four cases had cut themselves, and that to relieve a craving they had drank their own, and others’ (human and/or animal) blood. All four cases were said to be intelligent with no mental instability or psychopathology in any of their family histories.

Most recently Dr K Gubb and his colleagues at the Tara Hospital Johannesburg (South Africa) published a case study of a 25-year old African man suffering from ‘psychic vampirism’ in the South African Psychiatry Review. In this paper, they argued that this particular type of clinical vampirism had never been reported in the literature before. The man was brought in for psychiatric treatment by his mother after he had become withdrawn, stopped socializing, was undressing in public, and started talking to himself. He claimed to hear the voice of ‘Sasha’, a “flame vampire from the scriptures of Geeta”. The man himself beleived he was “Vasever – lord of the vampires”. He claimed to have survived by hunting as a vampire by hurting more than 1000 humans “zooming in and out of them” (rather than biting them). Schizophrenia was diagnosed. The authors claimed that the vampirism was only of academic interest “because of its relative scarcity” but did not influence the diagnosis or treatment in any particular way.

They concluded that vampirism may be representative of some pathology other than schizophrenia (or simply represent an alternative belief system). Unlike other vampirism cases in the clinical literature, there was an absence of a fully developed psychopathic personality, along with a complete absence of sexual and gender identity disorders. This, they speculated, “may have protected the man from developing the homicidal, cannibalistic, libidinal and sexual features of vampirism seen in the other cases”.