New GP guidance highlights the serious health risks of non-fatal strangulation
16 Oct 2026
Non-fatal strangulation (NFS) can cause serious physical harm, yet it may go unnoticed in healthcare settings. Experts are calling for greater awareness and better conversations between doctors and patients about this often overlooked issue.
The University of Melbourne’s Centre for Excellence in Rural Sexual Health (CERSH) has developed a position statement and clinical resource covering the medical and psychological effects of strangulation, along with advice on how healthcare professionals can discuss the issue with patients.
Associate Professor Siobhan Bourke, a sexual health physician and CERSH Clinical Lead, said the resource explains how strangulation can lead to immediate and longer-term health complications. It also outlines its links to intimate partner violence and the potential for escalating harm.
Associate Professor Bourke raised concerns about strangulation becoming more common or normalised in sexual settings, including through pornography. She stressed that consent must be ongoing and can be withdrawn at any time. When a person's throat is compressed, they may be unable to communicate that they want an activity to stop.
Why GPs need to recognise the warning signs
Dr Wei-May Su, a GP and Chair of RACGP Specific Interests Abuse and Violence in Families, said non-fatal strangulation can remain hidden because healthcare professionals may not routinely ask about it.
She cautioned that it can damage blood vessels, restrict blood flow to the brain, cause acquired brain injury and lead to life-threatening complications.
Dr Su also highlighted the connection between non-fatal strangulation and the risk of homicide in situations involving domestic and family violence.
Repeated strangulation may lead to repeated brain injuries, potentially affecting a person's long-term cognitive function. Dr Su said GPs need to recognise these risks and understand how they can respond, even when they feel less confident addressing the broader issues of family violence.
The CERSH resource notes that around 25–50% of non-fatal strangulation cases may have no visible external injuries. As there is no single sign that confirms strangulation, clinicians need to consider the patient's history, symptoms and the circumstances of the incident when deciding whether further medical assessment is needed.
Starting sensitive conversations with patients
Associate Professor Bourke said non-fatal strangulation may be missed because it is not discussed openly enough. She encouraged healthcare professionals to make conversations about consent, sexual activity and strangulation a more routine part of appropriate patient care.
The CERSH resource suggests questions GPs can use to explore a patient's experiences, including whether they have experienced unwanted sexual activity, had their breathing restricted during sex, or had someone place pressure around their neck.
Questions should be asked sensitively, with attention to the patient's safety, privacy and comfort.
Dr Su said GPs do not need to screen every patient for non-fatal strangulation. However, discussions about sexual health, mental health or possible domestic violence may provide opportunities to ask relevant questions.
She acknowledged that these conversations can be challenging for both patients and practitioners. Access to clear guidance and professional resources can help GPs feel more confident responding to disclosures and recognising physical harm.
Further training and clinical resources
CERSH is working to improve sexual health education for medical students and qualified healthcare professionals. Its resources aim to support more effective, trauma-informed discussions about sexual violence, coercion and non-fatal strangulation.
Additional resources for GPs include:
- Free, RACGP-accredited online training through CERSH, with a new module on non-consensual sex, coercion and non-fatal strangulation in development.
- An Australian Journal of General Practice article covering the management of non-fatal strangulation in general practice.
- An on-demand webinar featuring Dr Su, with clinical case studies and examples of how healthcare professionals can respond.
Experts say improving awareness and communication can help GPs identify potential harm and provide appropriate care and support.
New GP guidance highlights the serious health risks of non-fatal strangulation
Source: RACGP newsGP, reporting on the University of Melbourne’s Centre for Excellence in Rural Sexual Health resources on non-fatal strangulation.