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Anal sex or anal intercourse principally means the insertion and thrusting of the erect
penis A penis (; : penises or penes) is a sex organ through which male and hermaphrodite animals expel semen during copulation (zoology), copulation, and through which male placental mammals and marsupials also Urination, urinate. The term ''pen ...
into a person's
anus In mammals, invertebrates and most fish, the anus (: anuses or ani; from Latin, 'ring' or 'circle') is the external body orifice at the ''exit'' end of the digestive tract (bowel), i.e. the opposite end from the mouth. Its function is to facil ...
, or anus and
rectum The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...
, for sexual pleasure.Se
pages 270–271
for anal sex information, an
page 118
for information about the
clitoris In amniotes, the clitoris ( or ; : clitorises or clitorides) is a female sex organ. In humans, it is the vulva's most erogenous zone, erogenous area and generally the primary anatomical source of female Human sexuality, sexual pleasure. Th ...
.
Other forms of anal sex include anal fingering, the use of sex toys, anilingus, and pegging. Although ''anal sex'' most commonly means penileanal penetration, sources sometimes use ''anal intercourse'' to exclusively denote penileanal penetration, and ''anal sex'' to denote any form of anal
sexual activity Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) t ...
, especially between pairings as opposed to anal masturbation. While anal sex is commonly associated with male homosexuality, research shows that not all homosexual men engage in anal sex and that it is not uncommon in heterosexual relationships. Types of anal sex can also be part of lesbian sexual practices. People may experience pleasure from anal sex by stimulation of the anal
nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerv ...
endings, and
orgasm Orgasm (from Greek , ; "excitement, swelling"), sexual climax, or simply climax, is the sudden release of accumulated sexual excitement during the sexual response cycle, characterized by intense sexual pleasure resulting in rhythmic, involu ...
may be achieved through anal penetration – by indirect stimulation of the
prostate The prostate is an male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemica ...
in men, indirect stimulation of the
clitoris In amniotes, the clitoris ( or ; : clitorises or clitorides) is a female sex organ. In humans, it is the vulva's most erogenous zone, erogenous area and generally the primary anatomical source of female Human sexuality, sexual pleasure. Th ...
or an area in the
vagina In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular sex organ, reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The #Vag ...
(sometimes called ''the G-spot'') in women, and other
sensory nerve A sensory nerve, or afferent nerve, is a nerve that contains exclusively afferent nerve fibers. Nerves containing also motor fibers are called mixed nerve, mixed. Afferent nerve fibers in a sensory nerve carry sensory system, sensory information ...
s (especially the
pudendal nerve The pudendal nerve is the main nerve of the perineum. It is a Mixed nerve, mixed (motor and sensory) nerve and also conveys Sympathetic nervous system, sympathetic Autonomic nervous system, autonomic fibers. It carries sensation from the exter ...
). However, people may also find anal sex painful, sometimes extremely so, which may be due to psychological factors in some cases. As with most forms of sexual activity, anal sex can facilitate the spread of
sexually transmitted infections A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, or ...
(STIs). Anal sex is considered a high-risk sexual practice because of the vulnerability of the anus and rectum. The anal and rectal tissue are delicate and do not, unlike the vagina, provide lubrication. They can easily tear and permit disease transmission, especially if a
personal lubricant Personal lubricants (colloquially termed lube) are specialized lubricants used during sexual acts, such as intercourse and masturbation, to reduce friction to or between the penis and vagina, anus or other body parts, or applied to sex toys to ...
is not used. Anal sex without protection of a
condom A condom is a sheath-shaped Barrier contraception, barrier device used during sexual intercourse to reduce the probability of pregnancy or a Sexually transmitted disease, sexually transmitted infection (STI). There are both external condo ...
is considered the riskiest form of sexual activity, and therefore health authorities such as the
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
(WHO) recommend
safe sex Safe sex is sexual activity using methods or contraceptive devices (such as condoms) to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer ...
practices for anal sex.World Health Organization, Department of Reproductive Health and Researc
Global strategy for the prevention and control of sexually transmitted infections: 2006–2015. Breaking the chain of transmission
, 2007,
Strong views are often expressed about anal sex. It is controversial in various cultures, often because of religious prohibitions against anal sex among males or teachings about the procreative purpose of sexual activity. It may be considered
taboo A taboo is a social group's ban, prohibition or avoidance of something (usually an utterance or behavior) based on the group's sense that it is excessively repulsive, offensive, sacred or allowed only for certain people.''Encyclopædia Britannica ...
or unnatural, and is a criminal offense in some countries, punishable by
corporal Corporal is a military rank in use by the armed forces of many countries. It is also a police rank in some police services. The rank is usually the lowest ranking non-commissioned officer. In some militaries, the rank of corporal nominally corr ...
or
capital punishment Capital punishment, also known as the death penalty and formerly called judicial homicide, is the state-sanctioned killing of a person as punishment for actual or supposed misconduct. The sentence (law), sentence ordering that an offender b ...
. By contrast, anal sex may also be considered a natural and valid form of sexual activity as fulfilling as other desired sexual expressions, and can be an enhancing or primary element of a person's
sex life In human sexuality, a sex life is a sector of a person's day-to-day existence which may involve sexual activity or represent the absence of sexual activity. In general parlance, the term can have many sub-meanings and social layers, but generall ...
.


Anatomy and stimulation

The abundance of nerve endings in the anal region and
rectum The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...
can make anal sex pleasurable for men and women. The internal and external
sphincter A sphincter is a circular muscle that normally maintains constriction of a natural body passage or orifice and relaxes as required by normal physiological functioning. Sphincters are found in many animals. There are over 60 types in the human bo ...
muscles control the opening and closing of the anus; these muscles, which are sensitive membranes made up of many nerve endings, facilitate pleasure or pain during anal sex. ''Human Sexuality: An Encyclopedia'' states that "the inner third of the anal canal is less sensitive to touch than the outer two-thirds, but is more sensitive to pressure" and that "the rectum is a curved tube about long and has the capacity, like the anus, to expand". Research indicates that anal sex occurs significantly less frequently than other sexual behaviors, but its association with dominance and submission, as well as
taboo A taboo is a social group's ban, prohibition or avoidance of something (usually an utterance or behavior) based on the group's sense that it is excessively repulsive, offensive, sacred or allowed only for certain people.''Encyclopædia Britannica ...
, makes it an appealing stimulus to people of all
sexual orientation Sexual orientation is an enduring personal pattern of romantic attraction or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender. Patterns ar ...
s. In addition to
sexual penetration Sexual penetration is the insertion of a body part or other object into a body orifice, such as the mouth, vagina or anus, as part of human sexual activity or sexual behavior in non-human animals. The term is most commonly used in statute la ...
by the penis, people may use
sex toys A sex toy is an object or device that is primarily used to facilitate Sexual stimulation, sexual pleasure, such as a dildo, artificial vagina or Vibrator (sex toy), vibrator. Many popular sex toys are designed to resemble human genitals, and ma ...
such as a dildo, a butt plug or anal beads, engage in anal fingering, anilingus, pegging, anal masturbation, figging or fisting for anal sexual activity, and different sex positions may also be included. Fisting is one of the least practiced of the activities, partly because it is uncommon that people can relax enough to accommodate an object as big as a fist being inserted into the anus. In a male receptive partner, being anally penetrated can produce a pleasurable sensation due to the object of insertion rubbing or brushing against the
prostate The prostate is an male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemica ...
through the anal wall. This can result in pleasurable sensations and can lead to an
orgasm Orgasm (from Greek , ; "excitement, swelling"), sexual climax, or simply climax, is the sudden release of accumulated sexual excitement during the sexual response cycle, characterized by intense sexual pleasure resulting in rhythmic, involu ...
in some cases. Prostate stimulation can produce a deeper orgasm, sometimes described by men as more widespread and intense, longer-lasting, and allowing for greater feelings of ecstasy than orgasm elicited by penile stimulation only. The prostate is located next to the rectum and is the larger, more developed male homologue (variation) to the female Skene's glands. It is also typical for a man to not reach orgasm as a receptive partner solely from anal sex. General statistics indicate that 70–80% of women require direct clitoral stimulation to achieve orgasm. The
vagina In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular sex organ, reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The #Vag ...
l walls contain significantly fewer nerve endings than the clitoris (which has many nerve endings specifically intended for orgasm), and therefore intense sexual pleasure, including orgasm, from vaginal sexual stimulation is less likely to occur than from direct clitoral stimulation in the majority of women. The clitoris is composed of more than the externally visible glans (head). The vagina, for example, is flanked on each side by the
clitoral crura The clitoral crura (: clitoral crus) are two erectile tissue structures, which together form a "V" shape. ''Crus'' is a Latin word that means "leg". Each "leg" of the ''V'' converges on the clitoral body. At each divergent point is a corpus ca ...
, the internal legs of the clitoris, which are highly sensitive and become engorged with blood when sexually aroused. * Indirect stimulation of the clitoris through anal penetration may be caused by the shared
sensory nerve A sensory nerve, or afferent nerve, is a nerve that contains exclusively afferent nerve fibers. Nerves containing also motor fibers are called mixed nerve, mixed. Afferent nerve fibers in a sensory nerve carry sensory system, sensory information ...
s, especially the
pudendal nerve The pudendal nerve is the main nerve of the perineum. It is a Mixed nerve, mixed (motor and sensory) nerve and also conveys Sympathetic nervous system, sympathetic Autonomic nervous system, autonomic fibers. It carries sensation from the exter ...
, which gives off the inferior anal nerves and divides into the perineal nerve and the dorsal nerve of the clitoris. Although the anus has many nerve endings, their purpose is not specifically for inducing orgasm, and so a woman achieving orgasm solely by anal stimulation is rare. Stimulation from anal sex can additionally be affected by popular perception or portrayals of the activity, such as
erotica Erotica is art, literature or photography that deals substantively with subject matter that is erotic, sexually stimulating or sexually arousing. Some critics regard pornography as a type of erotica, but many consider it to be different. Erot ...
or
pornography Pornography (colloquially called porn or porno) is Sexual suggestiveness, sexually suggestive material, such as a picture, video, text, or audio, intended for sexual arousal. Made for consumption by adults, pornographic depictions have evolv ...
. In pornography, anal sex is commonly portrayed as a desirable, painless routine that does not require
personal lubricant Personal lubricants (colloquially termed lube) are specialized lubricants used during sexual acts, such as intercourse and masturbation, to reduce friction to or between the penis and vagina, anus or other body parts, or applied to sex toys to ...
; this can result in couples performing anal sex without care, and men and women believing that it is unusual for women, as receptive partners, to find discomfort or pain instead of pleasure from the activity.Se
page 560
for effects of viewing pornography with regard to anal sex, an
pages 286–289
for anal sex as a birth control method.
Pdf.Preview.
By contrast, each person's sphincter muscles react to penetration differently, the anal sphincters have tissues that are more prone to tearing, and the anus and rectum, unlike the vagina, do not provide lubrication for sexual penetration. Researchers say adequate application of a personal lubricant, relaxation, and communication between sexual partners are crucial to avoid pain or damage to the anus or rectum. Additionally, ensuring that the anal area is clean and the
bowel The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system. T ...
is empty, for both aesthetics and practicality, may be desired by participants.


Male to female


Behaviors and views

The anal sphincters are usually tighter than the pelvic muscles of the vagina, which can enhance the sexual pleasure for the inserting male during male-to-female anal intercourse because of the pressure applied to the penis.Se
page 3
for women preferring anal sex to vaginal sex, an
page 15
for reaching orgasm through indirect stimulation of the G-spot.
Men may also enjoy the penetrative role during anal sex because of its association with dominance, because it is made more alluring by a female partner or society in general insisting that it is forbidden, or because it presents an additional option for penetration. While some women find being a receptive partner during anal intercourse painful or uncomfortable, or only engage in the act to please a male sexual partner, other women find the activity pleasurable or prefer it to vaginal intercourse. In a 2010 clinical review article of heterosexual anal sex, ''anal intercourse'' is used to specifically denote penile-anal penetration, and ''anal sex'' is used to denote any form of anal sexual activity. The review suggests that anal sex is exotic among the sexual practices of some heterosexuals and that "for a certain number of heterosexuals, anal intercourse is pleasurable, exciting, and perhaps considered more intimate than vaginal sex". Anal intercourse is sometimes used as a substitute for vaginal intercourse during
menstruation Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and Mucous membrane, mucosal tissue from the endometrium, inner lining of the uterus through the vagina. The menstrual cycle is characterized ...
. The likelihood of
pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
occurring during anal sex is greatly reduced, as anal sex alone cannot lead to pregnancy unless sperm is somehow transported to the vaginal opening. Because of this, some couples practice anal intercourse as a form of
contraception Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only be ...
, often in the absence of a condom. Some couples may practice anal sex as a way of preserving female
virginity Virginity is a social construct that denotes the state of a person who has never engaged in sexual intercourse. As it is not an objective term with an operational definition, social definitions of what constitutes virginity, or the lack thereo ...
because it is non-procreative and does not tear the hymen; this has been reported in Christian communities in the United States. A person, especially a teenage girl or woman, who engages in anal sex or other sexual activity with no history of having engaged in vaginal intercourse may be regarded as not having yet experienced virginity loss. This is sometimes called as '' technical virginity.''Se
here
an
pages 48–49
for the majority of researchers and heterosexuals defining virginity loss/"technical virginity" by whether or not a person has engaged in vaginal sex.
Heterosexuals may view anal sex as "fooling around" or as foreplay; scholar Laura M. Carpenter stated that this view "dates to the late 1600s, with explicit 'rules' appearing around the turn of the twentieth century, as in marriage manuals defining petting as 'literally every caress known to married couples but does not include complete sexual intercourse." One study found US teens who pledged to not have sex until marriage were more likely to engage in anal sex without vaginal sex than teens who had not made a sexual abstinence pledge, and found pledge-takers were just as likely to test positive for an STI five years after taking the pledge as those who had not pledged to abstinence.


Prevalence

Because most research on anal intercourse addresses
men who have sex with men Men who have sex with men (MSM) are men who engage in sexual activity with other men, regardless of their sexual orientation or sexual identity. The term was created by epidemiologists in the 1990s, to better study and communicate the spre ...
, little data exists on the prevalence of anal intercourse among heterosexual couples. In Kimberly R. McBride's 2010 clinical review on heterosexual anal intercourse and other forms of anal sexual activity, it is suggested that changing norms may affect the frequency of heterosexual anal sex. McBride and her colleagues investigated the prevalence of non-intercourse anal sex behaviors among a sample of men (n=1,299) and women (n=1,919) compared to anal intercourse experience and found that 51% of men and 43% of women had participated in at least one act of oral–anal sex, manual–anal sex, or anal sex toy use. The report states the majority of men (n=631) and women (n=856) who reported heterosexual anal intercourse in the past 12 months were in exclusive, monogamous relationships: 69% and 73%, respectively. The review added that because "relatively little attention sgiven to anal intercourse and other anal sexual behaviors between heterosexual partners", this means that it is "quite rare" to have research "that specifically differentiates the anus as a sexual organ or addresses anal sexual function or dysfunction as legitimate topics. As a result, we do not know the extent to which anal intercourse differs qualitatively from coitus." According to a 2010 study from the National Survey of Sexual Health and Behavior (NSSHB) that was authored by Debby Herbenick et al., although anal intercourse is reported by fewer women than other partnered sex behaviors, partnered women in the age groups between 18 and 49 are significantly more likely to report having anal sex in the past 90 days. Women engaged in anal intercourse less commonly than men. Vaginal intercourse was practiced more than insertive anal intercourse among men, but 13% to 15% of men aged 25 to 49 practiced insertive anal intercourse. With regard to adolescents, limited data also exists. This may be because of the taboo nature of anal sex and that teenagers and caregivers subsequently avoid talking to one another about the topic. It is also common for subject review panels and schools to avoid the subject. A 2000 study found that 22.9% of college students who self-identified as non-virgins had anal sex. They used condoms during anal sex 20.9% of the time as compared with 42.9% of the time with vaginal intercourse. Anal sex being more common among heterosexuals today than it was previously has been linked to the increase in consumption of anal pornography among men, especially among those who view it on a regular basis. Seidman et al. argued that "cheap, accessible and, especially, interactive media have enabled many more people to produce as well as consume pornography," and that this modern way of producing pornography, in addition to the buttocks and anus having become more eroticized, has led to a significant interest in or obsession with anal sex among men.


Male to male


Behaviors and views

Anal sex has been commonly associated with male homosexuality. However, not all homosexual men engage in anal sex. Oral sex and mutual masturbation are more common than anal stimulation among men in sexual relationships with other men. Among men who have anal sex with other men, the insertive partner may be referred to as the ''
top Top most commonly refers to: * Top, a basic term of orientation, distinguished from bottom, front, back, and sides * Spinning top, a ubiquitous traditional toy * Top (clothing), clothing designed to be worn over the torso * Mountain top, a moun ...
'' and the one being penetrated may be referred to as the '' bottom''. Those who enjoy either role may be referred to as '' versatile''. Though some
men who have sex with men Men who have sex with men (MSM) are men who engage in sexual activity with other men, regardless of their sexual orientation or sexual identity. The term was created by epidemiologists in the 1990s, to better study and communicate the spre ...
may find that being a receptive partner during anal sex makes them question their
masculinity Masculinity (also called manhood or manliness) is a set of attributes, behaviors, and roles generally associated with men and boys. Masculinity can be theoretically understood as Social construction of gender, socially constructed, and there i ...
, playing bottom in sexual intercourse is at least as common as playing top among western gay and bisexual men and, among committed male couples, anal intercourse is rated as providing the most satisfying orgasms.


Prevalence

Reports regarding the prevalence of anal sex among men who have sex with men vary. According to 2011 research from the Journal of Sexual Medicine, in the most recent sexual intercourse between homosexual men, the most common behavior was kissing the partner on the mouth, followed by oral sex, and mutual masturbation. Anal sex occurred in less than half of the sexual relationships between homosexual men. A survey publish by '' The Advocate'' in 1994 indicated that 46% of homosexual men who have anal sex, preferred to penetrate their partners, while 43% preferred to be the receptive partner. Other sources suggest that roughly three-fourths of homosexual men have had anal sex at least one time, with an equal percentage participating as tops and bottoms. In a 2012 sex survey conducted by the NSSHB in the U.S., among homosexual men who have anal sex, 83.3% report ever having anal sex in the insertive position, and 90% in the receptive position. According to Weiten et al., anal intercourse is more popular among homosexual male couples than among heterosexual couples, but "it ranks behind oral sex and mutual masturbation" among both sexual orientations in prevalence. Wellings et al. reported that "the equation of 'homosexual' with 'anal' sex among men is common among lay and health professionals alike" and that "yet an Internet survey of 180,000 MSM across Europe (EMIS, 2011) showed that oral sex was most commonly practised, followed by mutual masturbation, with anal intercourse in third place". Though anal sex is less common than oral sex and handjobs among committed male couples, they rate orgasms derived from anal intercourse as more satisfying than that of any other sexual practice.


Female to male

Women may sexually stimulate a man's anus by fingering the exterior or interior areas of the anus; they may also stimulate the
perineum The perineum (: perineums or perinea) in placentalia, placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is ...
(which, for males, is between the base of the
scrotum In most terrestrial mammals, the scrotum (: scrotums or scrota; possibly from Latin ''scortum'', meaning "hide" or "skin") or scrotal sac is a part of the external male genitalia located at the base of the penis. It consists of a sac of skin ...
and the anus), massage the prostate or engage in anilingus. Sex toys, such as a dildo, may also be used. The practice of a woman penetrating a man's anus with a strap-on dildo for sexual activity is called pegging. Reece et al. reported in 2010 that receptive anal intercourse is infrequent among men overall, stating that "an estimated 7% of men 14 to 94 years old reported being a receptive partner during anal intercourse". ''
The BMJ ''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...
'' stated in 1999:


Female to female

With regard to lesbian sexual practices, anal sex includes anal fingering, use of a dildo or other sex toys, or anilingus. There is less research on anal sexual activity among women who have sex with women compared to couples of other sexual orientations. In 1987, a non-scientific study (Munson) was conducted of more than 100 members of a lesbian social organization in Colorado. When asked what techniques they used in their last ten sexual encounters, lesbians in their 30s were twice as likely as other age groups to engage in anal stimulation (with a finger or dildo). A 2014 study of partnered lesbian women in Canada and the U.S. found that 7% engaged in anal stimulation or penetration at least once a week; about 10% did so monthly and 70% did not at all. Anilingus is also less often practiced among female same-sex couples.


Health risks


General risks

Anal sex can expose its participants to two principal dangers which are infections due to the high number of infectious
microorganism A microorganism, or microbe, is an organism of microscopic scale, microscopic size, which may exist in its unicellular organism, single-celled form or as a Colony (biology)#Microbial colonies, colony of cells. The possible existence of unseen ...
s not found elsewhere on the body, and physical damage to the anus and rectum due to their fragility. Unprotected penile-anal penetration, colloquially known as '' barebacking'', carries a higher risk of passing on
sexually transmitted infections A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, or ...
(STIs) because the anal sphincter is a delicate, easily torn tissue that can provide an entry for
pathogens In biology, a pathogen (, "suffering", "passion" and , "producer of"), in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ. The term ...
. Use of
condom A condom is a sheath-shaped Barrier contraception, barrier device used during sexual intercourse to reduce the probability of pregnancy or a Sexually transmitted disease, sexually transmitted infection (STI). There are both external condo ...
s, ample lubrication to reduce the risk of tearing, and safer sex practices in general, reduce the risk of STIs. However, a condom can break or otherwise come off during anal sex, and this is more likely to happen with anal sex than with other sex acts because of the tightness of the anal sphincters during friction. Unprotected receptive anal sex (with an HIV positive partner) is the sex act most likely to result in HIV transmission. As with other sexual practices, people without sound knowledge about the sexual risks involved are susceptible to STIs. Because of the view that anal sex is not "real sex" and therefore does not result in virginity loss, or pregnancy, teenagers and other young people who are unaware of the risks of the anal sex may consider vaginal intercourse riskier than anal intercourse, and they also may believe that an STI can only result from vaginal intercourse. It may be because of these views that condom use with anal sex is often reported to be low and inconsistent across all groups in various countries. Although anal sex alone does not lead to pregnancy, pregnancy can still occur with anal sex or other forms of sexual activity if the penis is near the vagina (such as during intercrural sex or other genital-genital rubbing) and its sperm is deposited near the vagina's entrance and travels along the vagina's lubricating fluids; the risk of pregnancy can also occur without the penis being near the vagina because sperm may be transported to the vaginal opening by the vagina coming in contact with fingers or other non-genital body parts that have come in contact with semen. There are a variety of factors that make male-to-female anal intercourse riskier than vaginal intercourse for women, including the risk of HIV transmission being higher for anal intercourse than for vaginal intercourse. The risk of injury to the woman during anal intercourse is also significantly higher than the risk of injury to her during vaginal intercourse because of the durability of the vaginal tissues compared to the anal tissues. Additionally, if a man abruptly changes from anal intercourse to vaginal intercourse without a condom or without changing it, infections can arise in the vagina or urinary tract due to bacteria present within the anus; these infections can also result from switching between vaginal sex and anal sex by the use of fingers or sex toys. Pain during receptive anal sex is formally known as ''anodyspareunia.''Handbook of affirmative psychotherapy with lesbians and gay men
By Kathleen Ritter, Anthony I. Terndrup; p350
Factors predictive of pain during anal sex include inadequate lubrication, feeling tense or anxious, lack of stimulation, as well as lack of social ease with being gay and being
closeted ''Closeted'' and ''in the closet'' are metaphors for LGBTQ people who have not disclosed their sexual orientation or gender identity and aspects thereof, including sexual identity and sexual behavior. This metaphor is associated and sometime ...
. Research has found that psychological factors can in fact be the primary contributors to the experience of pain during anal intercourse and that adequate communication between sexual partners can prevent it, countering the notion that pain is always inevitable during anal sex. The prevalence of anodyspareunia is difficult to measure; in two population studies of men receiving anal sex, 18% and 14% reported experiencing anodyspareunia. In a study of 2002 women, 8.7% of those who had engaged in anal sex reported experiencing severe pain.


Damage

Anal sex can exacerbate hemorrhoids and therefore result in bleeding; in other cases, the formation of a hemorrhoid is attributed to anal sex. If bleeding occurs as a result of anal sex, it may also be because of a tear in the anal or rectal tissues (an anal fissure) or perforation (a hole) in the colon, the latter of which being a serious medical issue that should be remedied by immediate medical attention. Because of the rectum's lack of elasticity, the anal
mucous membrane A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It ...
being thin, and small
blood vessel Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...
s being present directly beneath the mucous membrane, tiny tears and bleeding in the rectum usually result from penetrative anal sex, though the bleeding is usually minor and therefore usually not visible. By contrast to other anal sexual behaviors, anal fisting poses a more serious danger of damage due to the deliberate stretching of the anal and rectal tissues; anal fisting injuries include anal sphincter lacerations and rectal and sigmoid colon (rectosigmoid) perforation, which might result in death. Repetitive penetrative anal sex may result in the anal sphincters becoming weakened, which may cause rectal prolapse or affect the ability to hold in feces (a condition known as
fecal incontinence Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents—including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom ...
). Rectal prolapse is very uncommon, and its causes are not well understood. Kegel exercises have been used to strengthen the anal sphincters and overall
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
, and may help prevent or remedy fecal incontinence.


Cancer

Most cases of anal cancer are related to infection with the human papilloma virus (HPV). The risk of anal cancer through anal sex is attributed to HPV infection, which is often contracted through unprotected anal sex.* * Anal cancer is significantly less common than cancer of the colon or rectum (
colorectal cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the Colon (anatomy), colon or rectum (parts of the large intestine). Signs and symptoms may include Lower gastrointestinal ...
); the American Cancer Society estimates that in 2023 there were approximately 9,760 new cases (6,580 in women and 3,180 in men) and approximately 1,870 deaths (860 women and 1,010 men) in the United States, and that, though anal cancer has been on the rise for many years, it is mainly diagnosed in adults, "with an average age being in the early 60s" and it "affects women somewhat more often than men."


Cultural views


General

Different cultures have had different views on anal sex throughout human history, with some cultures more positive about the activity than others. Historically, anal sex has been restricted or condemned, especially with regard to religious beliefs; it has also commonly been used as a form of domination, usually with the active partner (the one who is penetrating) representing
masculinity Masculinity (also called manhood or manliness) is a set of attributes, behaviors, and roles generally associated with men and boys. Masculinity can be theoretically understood as Social construction of gender, socially constructed, and there i ...
and the passive partner (the one who is being penetrated) representing
femininity Femininity (also called womanliness) is a set of attributes, behaviors, and Gender roles, roles generally associated with women and girls. Femininity can be understood as Social construction of gender, socially constructed, and there is also s ...
. A number of cultures have especially recorded the practice of anal sex between males, and anal sex between males has been especially stigmatized or punished. In some societies, if discovered to have engaged in the practice, the individuals involved were put to death, such as by
decapitation Decapitation is the total separation of the head from the body. Such an injury is invariably fatal to humans and all vertebrate animals, since it deprives the brain of oxygenated blood by way of severing through the jugular vein and common c ...
, burning, or even
mutilation Mutilation or maiming (from the ) is Bodily harm, severe damage to the body that has a subsequent harmful effect on an individual's quality of life. In the modern era, the term has an overwhelmingly negative connotation, referring to alteratio ...
. Anal sex has been more accepted in modern times; it is often considered a natural, pleasurable form of sexual expression. The buttocks and anus have become more eroticized in modern culture, including via
pornography Pornography (colloquially called porn or porno) is Sexual suggestiveness, sexually suggestive material, such as a picture, video, text, or audio, intended for sexual arousal. Made for consumption by adults, pornographic depictions have evolv ...
. Engaging in anal sex is still, however, punished in some societies. For example, regarding LGBT rights in Iran,
Iran Iran, officially the Islamic Republic of Iran (IRI) and also known as Persia, is a country in West Asia. It borders Iraq to the west, Turkey, Azerbaijan, and Armenia to the northwest, the Caspian Sea to the north, Turkmenistan to the nort ...
's Penal Code states in Article 109 that "both men involved in same-sex penetrative (anal) or non-penetrative sex will be punished" and "Article 110 states that those convicted of engaging in anal sex will be executed and that the manner of execution is at the discretion of the judge".


Ancient and non-Western cultures

From the earliest records, the ancient
Sumer Sumer () is the earliest known civilization, located in the historical region of southern Mesopotamia (now south-central Iraq), emerging during the Chalcolithic and Early Bronze Age, early Bronze Ages between the sixth and fifth millennium BC. ...
ians had very relaxed attitudes toward sex and did not regard anal sex as
taboo A taboo is a social group's ban, prohibition or avoidance of something (usually an utterance or behavior) based on the group's sense that it is excessively repulsive, offensive, sacred or allowed only for certain people.''Encyclopædia Britannica ...
. priestesses were forbidden from producing offspring and frequently engaged in anal sex as a method of birth control. Anal sex is also obliquely alluded to by a description of an
omen An omen (also called ''portent'') is a phenomenon that is believed to foretell the future, often signifying the advent of change. It was commonly believed in ancient history, and still believed by some today, that omens bring divine messages ...
in which a man "keeps saying to his wife: 'Bring your backside. Other Sumerian texts refer to homosexual anal intercourse. The , a set of priests who worked in the temples of the goddess
Inanna Inanna is the List of Mesopotamian deities, ancient Mesopotamian goddess of war, love, and fertility. She is also associated with political power, divine law, sensuality, and procreation. Originally worshipped in Sumer, she was known by the Akk ...
, where they performed elegies and lamentations, were especially known for their homosexual proclivities. The Sumerian sign for was a ligature of the signs for 'penis' and 'anus'. One Sumerian proverb reads: "When the wiped off his ass e said 'I must not arouse that which belongs to my mistress .e., Inanna'" The term '' Greek love'' has long been used to refer to anal intercourse, and in modern times, "doing it the Greek way" is sometimes used as slang for anal sex. Male-male anal sex was not a universally accepted practice in
Ancient Greece Ancient Greece () was a northeastern Mediterranean civilization, existing from the Greek Dark Ages of the 12th–9th centuries BC to the end of classical antiquity (), that comprised a loose collection of culturally and linguistically r ...
; it was the target of jokes in some Athenian comedies.
Aristophanes Aristophanes (; ; ) was an Ancient Greece, Ancient Greek Ancient Greek comedy, comic playwright from Classical Athens, Athens. He wrote in total forty plays, of which eleven survive virtually complete today. The majority of his surviving play ...
, for instance, mockingly alludes to the practice, claiming, "Most citizens are ('wide-arsed') now." The terms , , and were used by Greek residents to categorize men who chronically practiced passive anal intercourse. Pederastic practices in ancient Greece (sexual activity between men and adolescent boys), at least in
Athens Athens ( ) is the Capital city, capital and List of cities and towns in Greece, largest city of Greece. A significant coastal urban area in the Mediterranean, Athens is also the capital of the Attica (region), Attica region and is the southe ...
and
Sparta Sparta was a prominent city-state in Laconia in ancient Greece. In antiquity, the city-state was known as Lacedaemon (), while the name Sparta referred to its main settlement in the Evrotas Valley, valley of Evrotas (river), Evrotas rive ...
, were expected to avoid penetrative sex of any kind. Greek artwork of sexual interaction between men and boys usually depicted fondling or intercrural sex, which was not condemned for violating or feminizing boys, while male-male anal intercourse was usually depicted between males of the same age-group. Intercrural sex was not considered penetrative and two males engaging in it was considered a "clean" act. Some sources explicitly state that anal sex between men and boys was criticized as shameful and seen as a form of hubris. Evidence suggests, however, that the younger partner in pederastic relationships (i.e., the ) did engage in receptive anal intercourse so long as no one accused him of being 'feminine'. In later Roman-era Greek poetry, anal sex became a common literary convention, represented as taking place with "eligible" youths: those who had attained the proper age but had not yet become adults. Seducing those not of proper age (for example, non-adolescent children) into the practice was considered very shameful for the adult, and having such relations with a male who was no longer adolescent was considered more shameful for the young male than for the one mounting him. Greek courtesans, or hetaerae, are said to have frequently practiced male-female anal intercourse as a means of preventing pregnancy. A male citizen taking the passive (or receptive) role in anal intercourse ( in
Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...
) was condemned in Rome as an act of ('immodesty' or 'un
chastity Chastity, also known as purity, is a virtue related to temperance. Someone who is ''chaste'' refrains from sexual activity that is considered immoral or from any sexual activity, according to their state of life. In some contexts, for exampl ...
'); free men, however, could take the active role with a young male slave, known as a or . The latter was allowed because anal intercourse was considered equivalent to vaginal intercourse in this way; men were said to "take it like a woman" ( 'to undergo womanly things') when they were anally penetrated, but when a man performed anal sex on a woman, she was thought of as playing the boy's role. Likewise, women were believed to only be capable of anal sex or other sex acts with women if they possessed an exceptionally large clitoris or a dildo. The passive partner in any of these cases was always considered a woman or a boy because being the one who penetrates was characterized as the only appropriate way for an adult male citizen to engage in sexual activity, and he was therefore considered unmanly if he was the one who was penetrated; slaves could be considered "non-citizen". Although Roman men often availed themselves of their own slaves or others for anal intercourse, Roman comedies and plays presented Greek settings and characters for explicit acts of anal intercourse, and this may be indicative that the Romans thought of anal sex as something specifically "Greek". In Japan, records (including detailed shunga) show that some males engaged in penetrative anal intercourse with males. Evidence suggestive of widespread male-female anal intercourse in a pre-modern culture can be found in the erotic vases, or stirrup-spout pots, made by the Moche people of Peru; in a survey, of a collection of these pots, it was found that 31 percent of them depicted male-female anal intercourse significantly more than any other sex act. Moche pottery of this type belonged to the world of the dead, which was believed to be a reversal of life. Therefore, the reverse of common practices was often portrayed. The Larco Museum houses an erotic gallery in which this pottery is showcased.


Religion


Judaism

The ''
Mishneh Torah The ''Mishneh Torah'' (), also known as ''Sefer Yad ha-Hazaka'' (), is a code of Rabbinic Jewish religious law (''halakha'') authored by Maimonides (Rabbi Moshe ben Maimon/Rambam). The ''Mishneh Torah'' was compiled between 1170 and 1180 CE ( ...
'', a text considered authoritative by Orthodox Jewish sects, states "since a man's wife is permitted to him, he may act with her in any manner whatsoever. He may have intercourse with her whenever he so desires and kiss any organ of her body he wishes, and he may have intercourse with her naturally or unnaturally raditionally, ''unnaturally'' refers to anal and oral sex provided that he does not expend semen to no purpose. Nevertheless, it is an attribute of piety that a man should not act in this matter with levity and that he should sanctify himself at the time of intercourse."


Christianity

Christian texts may sometimes euphemistically refer to anal sex as the ('the sin against nature', after
Thomas Aquinas Thomas Aquinas ( ; ; – 7 March 1274) was an Italian Dominican Order, Dominican friar and Catholic priest, priest, the foremost Scholasticism, Scholastic thinker, as well as one of the most influential philosophers and theologians in the W ...
) or ('sodomitical lusts', in one of
Charlemagne Charlemagne ( ; 2 April 748 – 28 January 814) was List of Frankish kings, King of the Franks from 768, List of kings of the Lombards, King of the Lombards from 774, and Holy Roman Emperor, Emperor of what is now known as the Carolingian ...
's ordinances), or ('that horrible sin that among Christians is not to be named').


Islam

, or the sin of Lot's people, which has come to be interpreted as referring generally to same-sex sexual activity, is commonly officially prohibited by Islamic sects; there are parts of the
Quran The Quran, also Romanization, romanized Qur'an or Koran, is the central religious text of Islam, believed by Muslims to be a Waḥy, revelation directly from God in Islam, God (''Allah, Allāh''). It is organized in 114 chapters (, ) which ...
which talk about smiting on Sodom and Gomorrah, and this is thought to be a reference to "unnatural" sex, and so there are
hadith Hadith is the Arabic word for a 'report' or an 'account f an event and refers to the Islamic oral tradition of anecdotes containing the purported words, actions, and the silent approvals of the Islamic prophet Muhammad or his immediate circle ...
and Islamic laws which prohibit it. Same-sex male practitioners of anal sex are called ''luti'' or ''lutiyin'' in plural and are seen as criminals in the same way that a thief is a criminal.


Other animals

As a form of non-reproductive sexual behavior in animals, anal sex has been observed in a few other
primate Primates is an order (biology), order of mammals, which is further divided into the Strepsirrhini, strepsirrhines, which include lemurs, galagos, and Lorisidae, lorisids; and the Haplorhini, haplorhines, which include Tarsiiformes, tarsiers a ...
s, both in captivity and in the wild.


See also

* Anal eroticism * Ass to mouth * Autosodomy * Coprophilia * Creampie (sexual act) * Felching * Gay bowel syndrome * Klismaphilia * Sodomy law


References


Further reading

* Brent, Bill ''Ultimate Guide to Anal Sex for Men'', Cleis Press, 2002. * DeCitore, David ''Arouse Her Anal Ecstasy'' (2008) * Houser, Ward ''Anal Sex'', Encyclopedia of Homosexuality Dynes, Wayne R. (ed.), Garland Publishing, 1990. pp. 48–50. * Morin, Jack ''Anal Pleasure & Health: A Guide for Men and Women'', Down There Press, 1998. * Sanderson, Terry ''The Gay Man's Kama Sutra'', Thomas Dunne Books, 2004. * Tristan Taormino '' The Ultimate Guide to Anal Sex for Women'', Cleis Press, 1997, 2006. * Underwood, Steven G. ''Gay Men and Anal Eroticism: Tops, Bottoms, and Versatiles'', Harrington Park Press, 2003


External links

{{DEFAULTSORT:Anal Sex Anal eroticism Sexology Sexual acts