Four previously unpublished cases of female asphyxiophilia are presented. All women were found immobilised by obviously self-tied
ropes, string or handcuffs. The women, who were alone at the time of death, died of a lethal paraphilia. The autopsies revealed
asphyxiation as the cause of death, caused in two cases by suffocation as a result of hanging and strangulation and in the
other two cases by plastic bags placed over the individuals head. In one case there was additional evidence at the scene that
the deceased had inhaled ether. In none of the four cases was there any indication that the asphyxiation was due to homicide
or suicide. Thus they can be described as accidental autoerotic deaths (AAD). The four cases closely mirror findings from
scenes of male AADs, although autoerotic practices are generally believed to be rarer among females than in males.
Keywords Female accidental autoerotic death - Lethal paraphiliac syndrome - Non-lethal paraphilia - Paraphiliac pattern
Received: 8 March 2001 / Accepted: 9 October 2001