From the potential for unwanted pregnancy in a post-Roe world to accidentally hooking up with someone who says stuff like, “Just playing devil’s advocate,” sex can be, shall we say, risky business. But while you may be familiar with some of the more common risks and how to mitigate them (condoms, regular STI testing, birth control, etc.), there’s one possible sex hazard that may not be top of mind when you’re prepping for your next sesh: a broken penis.
Yep. Unfortunately, you can, in fact, break a penis (yours or a partner’s) during sex. Which is why TikTok-famous doctor Karan Rajan, MD, an NHS surgeon, has declared reverse cowgirl the world’s most dangerous sex position in a viral video, claiming that riding in reverse is responsible for 50 percent of penile fractures.
While broken boners may sound like fake news, you really can fracture a penis—it just means something a little different than, say, a broken arm. (Because, ICYMI, there are no actual bones in a boner.)
"'Penis fracture’ happens when an erect penis is subjected to forceful bending or trauma," explains Elizabeth Swenson, MD, an OB/GYN at Wisp. “This can rupture the tunica albuginea, a thick membrane surrounding the erectile tissues. Immediate symptoms can include a cracking sound, severe pain, bruising, and swelling.”
You read that right: a “cracking sound.” (*Shudders*)
Doctors agree that the reverse cowgirl position (where the receiving partner is on top, facing away from the penetrating partner) is indeed more likely than others to fracture a penis. While it’s rare (Dr. Swenson says penile fractures occur in roughly 1 in 175,000 encounters), it does happen.
"Certain positions, like reverse cowgirl, can pose risks if not performed with care. The danger lies in the potential for abrupt or awkward movements, which can lead to penile fracture," says Laurence Levine, MD, board-certified urologist and Chief Medical Officer at Promescent. Basically, because the person on top can’t see what they’re doing in this position, it’s easier for partners to get out of sync. The penis can then slip out without the riding partner noticing and get crushed. (Ouch.)
Such harsh movements can not only tear the tunica albuginea but, according to Dr. Levine, can trigger Peyronie's disease, a disorder of wound healing that can cause deformity to the penis, which may consist of curvature, indentation, and/or shortening.
Clearly none of this is ideal, and if you have a penis, you're likely protectively holding your junk as you read this. But fear not! There’s no need to strike reverse cowgirl from your sexual repertoire. There are ways to play in this position safely and minimize your risk of winding up in a Sex Sent Me to the ER-coded nightmare. Read on for our must-know, expert-approved tips to enjoy the wild ride that is reverse cowgirl, without breaking any dicks.
First of all, why is reverse cowgirl so hot?
In addition to the whole risk-of-breaking-a-penis thing, it’s no secret that reverse cowgirl can be one of the more physically demanding sex positions—particularly for the partner on top. But while getting a leg workout while enjoying a view of your partner’s feet may not sound super sexy to some, there are plenty of reasons people are into throwing it back in reverse. (And, ahem, there are also plenty of ways to modify this position to make it more comfortable/pleasurable for everyone involved.)
“This position can be enjoyable for the partner with a vulva due to the angle of penetration and ease of clitoral stimulation (with hands, a toy, or even by leaning forward),” says sex coach Sophia Murphy, director of wellness at TBD Health.
And, JFYI, you don’t have to have a vag to ride in reverse cowgirl. There’s always reverse anal, which, per Murphy, is “essentially the same, except the insertion occurs in the anus as opposed to the vulva.” Regardless of who’s getting it on with what body parts (and/or strap-ons), reverse cowgirl allows for easy access with hands (or sex toys) to amplify an already intense position.
Get into the groove (and grab the lube)
Reminder that trying to have sex based on what you see in porn can be like trying to drive based on what you see in action movies. If you’re the receiving partner in reverse cowgirl, it may be tempting to hop on and start showing off like your fave porn performer. But not only is fast and furious not always the ticket to great sex, but that aggressive and show-off-y mentality can put your partner’s precious cargo at risk of fracture.
“Slow, controlled movements are safer, and the penetrating partner should guide the penetration to prevent bending or forceful impact,” Dr. Levine says, adding that using ample lubrication can also reduce the risk of injury.
And speaking of lube, from the best water-based lubes, to those ideal for anal play, we’ve got you covered with our favorite, award-winning picks. YW!
Communicate!
Because the person on top is facing away from their partner in reverse cowgirl, it can be more difficult to keep a steady rhythm, see what they’re doing, and gauge the penetrating partner’s response. All of which is to say: communication is crucial in this position. If you really want to enjoy hot and minimally risky reverse cowgirl, you're going to have to talk.
“Whether you're playing anally or vaginally in this position, it's important for both partners to communicate that they feel comfortable,” stresses Chris Bustamante, DNP, founder of LGBTQ and BIPOC-owned Lushful Aesthetics.
Check in regularly to make sure the speed, angle, and rhythm is working for both partners. Of course, speaking up in bed—especially with a newer partner—can be intimidating. When in doubt, try integrating direction into dirty talk with a positive spin. For instance, the penetrating partner could say something like: “It's so hot watching you ride me. Your hips turn me on so much. I love it when you gyrate slowly so I can savor every inch of you.”
Relax and enjoy
If this whole thing has you feeling a little freaked out, don’t stress. Yes, fractured penises happen, but as Dr. Swenson stresses, only in about 1 in 175,000 sexual encounters. So while we’ll take any excuse to remind you of the importance of moving at your own pace (literally and figuratively), and practicing informed, risk-aware, consensual sex, trust that the chances of actually winding up with a broken boner due to reverse cowgirl gone awry are relatively low.
“In my practice, I have encountered cases of penile fracture, although they are not common,” says Dr. Levine. “These injuries are treatable, typically requiring prompt surgical intervention. The prognosis is generally good if treated early,” he adds, noting that delaying treatment can lead to complications like erectile dysfunction or penile curvature.
The TL;DR of it all is: Yes, penile fracture is a thing that can happen and yes, it’s more likely to happen in reverse cowgirl. But! The chances of ending up in the ER with a broken penis due to getting it on, even in “the world’s most dangerous sex position,” is fairly minimal—especially if you remember to go slow and communicate with your partner. No sex is guaranteed to be 100 percent safe, but as long as everyone involved is aware of the risks and best practices to mitigate them, then feel free to relax and enjoy the ride.
