Masturbation kills up to 100 Germans a year, according to a study which has also uncovered the bizarre ways people have died pleasuring themselves.
One man - wearing pantyhose, a raincoat and a diving suit as well as a plastic bag over his head - died in Hamburg after sitting next to a heater and trying to melt slices of cheese on his body.
Another man in Halle was found dead with Christmas tree lights clamped to his nipples having apparently tried to stimulate himself by electrocution.
Forensic examiner Harald Voss said the most common reason for autoerotic deaths was the desire for the ultimate orgasm through depriving oneself of oxygen.
Between 80 and 100 people across the country accidentally die every year due to risky masturbation practices, his study found.
This was based on findings that for every one million German citizens there are "one or two" cases of deaths a year in which a prop or device was used to boost stimulation during sexual activity.
In one example, a man was found suffocated in the cellar of his home in Hesse having apparently tied chains around his body and neck.
According to Bild, porn was present and investigators made the assumption that he had suffered an autoerotic death.
The Local reports Voss as saying the number of similar cases going unreported was 'extremely high' but that he had only personally dealt with five cases over the last three decades.
Cases sometimes go unreported because families of victims feel ashamed, he added.
The Department of Legal Medicine in Hamburg alone recorded 40 accidental autoerotic deaths between 1983 and 2003 with all victims aged between 13 and 79, The Local reports.
Victims are usually men, Voß said, since women were 'more cautious and don't incorporate so many intricacies'.
He said the risks involved in autoerotic activity were underestimated, adding: 'Losing consciousness can happen quicker than people think.'