Sex lands people in the emergency room more often than most people would ever imagine. Some of the injuries are just terrible luck. Others require a more involved explanation. Either way, the doctors say the real problem usually isn’t the injury itself. It’s the time people waste being too embarrassed to come in.

“Most sex-related injuries are preventable, and none of them should be a source of shame,” Dr. Martina Ambardjieva, a urologist and ER physician, told HuffPost. “What does cause problems is waiting too long to seek care because of embarrassment. If something feels wrong—pain, bleeding, swelling, or an object that refuses to come out—just come in. Trust me, we’ve seen it all.”

Here’s a sampling of what that actually looks like.

1. Yes, It Can Actually Break

Ambardjieva calls this one of the most urgent sex-related emergencies she sees. “It’s exactly as dramatic as it sounds—a loud ‘crack,’ immediate swelling, and a lot of panic,” she told HuffPost. It happens when the penis slips out during thrusting and hits a partner’s pelvis with force, tearing the fibrous sheath surrounding the erectile tissue. Delay care, and you’re looking at permanent curvature, painful erections, or long-term erectile dysfunction. “This is the one sexual injury where time really matters,” she said.

2. What Goes In Doesn’t Always Come Out

Ambardjieva removes foreign objects from bodies on a regular basis—cucumbers, carrots, a pencil in a urethra—and says the embarrassment people feel is wildly disproportionate to how routine the situation is for her team. The anatomy is important here. The vaginal canal is a closed space. The rectum creates suction and has no anatomical stop, meaning things can travel further in. “It’s important to normalize this,” she said. “We remove lost objects every week. It’s a common medical issue, not something to be ashamed of.”

3. The Injury Nobody Talks About

Friction-related vaginal tears send a lot of people to the ER, especially postmenopausal women, and the bleeding tends to scare people more than the injury itself warrants. Ambardjieva points out that water-based lubricants dry out quickly, which increases friction over time, while silicone-based ones stay effective longer. Bleeding that won’t stop, severe pain, clots, or lightheadedness all mean it’s time to go in.

4. Sharp Pain Down There Is Never a Good Sign

Less common but not rare, torsion during sex happens when the spermatic cord twists and cuts off blood flow. “It’s sudden, sharp testicular pain—and it’s an emergency until proven otherwise,” Ambardjieva said. The window for saving the testicle is roughly four to six hours.

5. When Things Get Really Out of Hand

Dr. Jared L. Ross, an assistant professor at the University of Missouri, has seen the extreme end of this spectrum. A few years ago in St. Louis, he treated a patient who had inserted his pet gerbil into his rectum (yes, cue Richard Gere jokes). “He ended up in the ER with rectal bleeding. We were able to get the gerbil out, but unfortunately, the gerbil wasn’t so lucky; he had already suffocated,” Ross told HuffPost.

Then there was Christmas 2024. Two patients, same shift, both with wives out of town. One had inserted a full-sized LED lightbulb rectally and required anesthesia and surgery to remove it. The second arrived shortly after with a vibrator lodged inside. “Both myself and the other ER doc on shift tried again, but no luck; we had to call the surgeon back,” Ross said. “I remember he remarked it was a pretty fancy one, rechargeable batteries. I can’t imagine how those conversations went when their wives got back in town.”

Both doctors agree on this much. Shame is what turns a manageable situation into a serious one. Come in early, tell the truth, and let the professionals do their jobs. They’ve already seen worse. Much worse.