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Wikipedia

Anal sex

April 16, 2023

Anal sex or anal intercourse is generally the insertion and thrusting of the erect penis into a person's anus, or anus and rectum, for sexual pleasure.[1][2][3] Other forms of anal sex include fingering, the use of sex toys for anal penetration, oral sex performed on the anus (anilingus), and pegging.[4][5] Although anal sex most commonly means penile–anal penetration,[3][4][6] sources sometimes use anal intercourse to exclusively denote penile–anal penetration, and anal sex to denote any form of anal sexual activity, especially between pairings as opposed to anal masturbation.[6][7]

An illustration of anal sex

While anal sex is commonly associated with male homosexuality, research shows that not all gay men engage in anal sex and that it is not uncommon in heterosexual relationships.[2][8][9] Types of anal sex can also be a part of lesbian sexual practices.[10] People may experience pleasure from anal sex by stimulation of the anal nerve endings, and orgasm may be achieved through anal penetration – by indirect stimulation of the prostate in men, indirect stimulation of the clitoris or an area of the vagina (sometimes called the G-spot) in women, and other sensory nerves (especially the pudendal nerve).[2][4][11] However, people may also find anal sex painful, sometimes extremely so,[12][13] which may be due to psychological factors in some cases.[13]

As with most forms of sexual activity, anal sex participants risk contracting sexually transmitted infections (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 provide lubrication like the vagina does, so they can easily tear and permit disease transmission, especially if a personal lubricant is not used.[3][2][14] Anal sex without protection of a condom is considered the riskiest form of sexual activity,[14][15][16] and therefore health authorities such as the World Health Organization (WHO) recommend safe sex practices for anal sex.[17]

Strong views are often expressed about anal sex. It is controversial in various cultures, especially with regard to religious prohibitions. This is commonly due to prohibitions against anal sex among males or teachings about the procreative purpose of sexual activity.[5][7] It may be considered taboo or unnatural, and is a criminal offense in some countries, punishable by corporal or capital punishment.[5][7] 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.[5][7]

Anatomy and stimulation

See also: Prostate massage
 
Male genital anatomy, showing the location of the prostate with respect to the rectum

The abundance of nerve endings in the anal region and rectum can make anal sex pleasurable for men or women.[4][2][5] The internal and external sphincter 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.[2][5] 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 eight or nine inches long and has the capacity, like the anus, to expand".[5]

Research indicates that anal sex occurs significantly less frequently than other sexual behaviors,[1] but its association with dominance and submission, as well as taboo, makes it an appealing stimulus to people of all sexual orientations.[5][18][19] In addition to sexual penetration by the penis, people may use sex toys such as a dildo, a butt plug or anal beads, engage in fingering, anilingus, pegging, anal masturbation or fisting for anal sexual activity, and different sex positions may also be included.[5][20] Fisting is the least practiced of the activities,[21] partly because it is uncommon that people can relax enough to accommodate an object as big as a fist being inserted into the anus.[5]

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 through the anal wall.[4][11] This can result in pleasurable sensations and can lead to an orgasm in some cases.[4][11] 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.[4][11] The prostate is located next to the rectum and is the larger, more developed male homologue (variation) to the female Skene's glands.[22] It is also typical for a man to not reach orgasm as a receptive partner solely from anal sex.[23][24]

General statistics indicate that 70–80% of women require direct clitoral stimulation to achieve orgasm.[11][25][26] The vaginal 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.[27][28][29] The clitoris is composed of more than the externally visible glans (head).[2][30] The vagina, for example, is flanked on each side by the clitoral crura, the internal legs of the clitoris, which are highly sensitive and become engorged with blood when sexually aroused.[31][32][33] Indirect stimulation of the clitoris through anal penetration may be caused by the shared sensory nerves, especially the pudendal nerve, which gives off the inferior anal nerves and divides into the perineal nerve and the dorsal nerve of the clitoris.[4] 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.[34][35]

The Gräfenberg spot, or G-spot, is a debated area of female anatomy, particularly among doctors and researchers,[27][36][28] but it is typically described as being located behind the female pubic bone surrounding the urethra and accessible through the anterior wall of the vagina; it and other areas of the vagina are considered to have tissue and nerves that are related to the clitoris.[31][27][28] Direct stimulation of the clitoris, a G-spot area, or both, while engaging in anal sex can help some women enjoy the activity and reach orgasm during it.[2][37]

Stimulation from anal sex can additionally be affected by popular perception or portrayals of the activity, such as erotica or pornography. In pornography, anal sex is commonly portrayed as a desirable, painless routine that does not require personal lubricant; 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.[6][38][39][40] 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 do not provide lubrication for sexual penetration like the vagina does. 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.[2][13][41] Additionally, ensuring that the anal area is clean and the bowel is empty, for both aesthetics and practicality, may be desired by participants.[21]

Male to female

Behaviors and views

 
1892 lithograph by Paul Avril depicting male-to-female anal sex.

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.[3][37][18] 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.[5][18]

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.[6][37][42][43]

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".[6]

Anal intercourse is sometimes used as a substitute for vaginal intercourse during menstruation.[5] The likelihood of pregnancy 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, often in the absence of a condom.[5][38][44]

Male-to-female anal sex is commonly viewed as a way of preserving female virginity because it is non-procreative and does not tear the hymen; 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 is often regarded among heterosexuals and researchers as not having yet experienced virginity loss. This is sometimes called technical virginity.[45][46][47][48] 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.'"[45]

Prevalence

Because most research on anal intercourse addresses men who have sex with men, little data exists on the prevalence of anal intercourse among heterosexual couples.[6][49] 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.[6] 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.[6] The review added that because "relatively little attention [is] given 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."[6]

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.[50][51]

With regard to adolescents, limited data also exists.[49] 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.[49] 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.[49]

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.[39][40][52] 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.[52]

Male to male

Behaviors and views

 
19th-century erotic interpretation of Hadrian and Antinous (detail), by Paul Avril.

Historically, anal sex has been commonly associated with male homosexuality. However, many gay men and men who have sex with men in general (those who identify as gay, bisexual, heterosexual or have not identified their sexual identity) do not engage in anal sex.[8][9][53][54] Among men who have anal sex with other men, the insertive partner may be referred to as the top and the one being penetrated may be referred to as the bottom. Those who enjoy either role may be referred to as versatile.[55][56]

Gay men who prefer anal sex may view it as their version of intercourse and a natural expression of intimacy that is capable of providing pleasure.[19][53][57] The notion that it might resonate with gay men with the same emotional significance that vaginal sex resonates with heterosexuals has also been considered.[57][58] Some men who have sex with men, however, believe that being a receptive partner during anal sex questions their masculinity.[59][60]

Men who have sex with men may also prefer to engage in frot or other forms of mutual masturbation because they find it more pleasurable or more affectionate, to preserve technical virginity, or as safe sex alternatives to anal sex,[53][55][61] while other frot advocates denounce anal sex as degrading to the receptive partner and unnecessarily risky.[58][62]

Prevalence

Reports regarding the prevalence of anal sex among gay men and other men who have sex with men vary. A survey in The Advocate in 1994 indicated that 46% of gay men preferred to penetrate their partners, while 43% preferred to be the receptive partner.[55] Other sources suggest that roughly three-fourths of gay men have had anal sex at one time or another, with an equal percentage participating as tops and bottoms.[55] A 2012 NSSHB sex survey in the U.S. suggests high lifetime participation in anal sex among gay men: 83.3% report ever taking part in anal sex in the insertive position and 90% in the receptive position, even if only between a third and a quarter self-report very recent engagement in the practice, defined as 30 days or less.[63]

Oral sex and mutual masturbation are more common than anal stimulation among men in sexual relationships with other men.[1][53][64] According to Weiten et al., anal intercourse is generally more popular among gay male couples than among heterosexual couples, but "it ranks behind oral sex and mutual masturbation" among both sexual orientations in prevalence.[1] 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".[9]

Female to male

 
A woman wearing a strap-on dildo about to engage in anal sex with a man (pegging).

Women may sexually stimulate a man's anus by fingering the exterior or interior areas of the anus; they may also stimulate the perineum (which, for males, is between the base of the scrotum and the anus), massage the prostate or engage in anilingus.[5][21][65] Sex toys, such as a dildo, may also be used.[5][21] The practice of a woman penetrating a man's anus with a strap-on dildo for sexual activity is called pegging.[20][66]

It is common for heterosexual men to reject being receptive partners during anal sex because they believe it is a feminine act, can make them vulnerable, or contradicts their sexual orientation; they may believe being a receptive partner is indicative that they are gay.[21][67] 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".[68]

The BMJ stated in 1999:

There are little published data on how many heterosexual men would like their anus to be sexually stimulated in a heterosexual relationship. Anecdotally, it is a substantial number. What data we do have almost all relate to penetrative sexual acts, and the superficial contact of the anal ring with fingers or the tongue is even less well documented but may be assumed to be a common sexual activity for men of all sexual orientations.[69]

Female to female

 
A woman performing anilingus (anal–oral sex) on another woman.

With regard to lesbian sexual practices, anal sex includes fingering, use of a dildo or other sex toys, or anilingus.[10][70]

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).[2] 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.[71] Anilingus is also less often practiced among female same-sex couples.[72][73]

Health risks

General risks

 
Mucous membranes of the rectum

Anal sex can expose its participants to two principal dangers: infections due to the high number of infectious microorganisms not found elsewhere on the body, and physical damage to the anus and rectum due to their fragility.[14][16] Unprotected penile-anal penetration, colloquially known as barebacking,[74] carries a higher risk of passing on sexually transmitted infections (STIs) because the anal sphincter is a delicate, easily torn tissue that can provide an entry for pathogens.[14][16] Use of condoms, ample lubrication to reduce the risk of tearing,[2][41] and safer sex practices in general, reduce the risk of STIs.[16][75] 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.[16]

Unprotected receptive anal sex (with an HIV positive partner) is the sex act most likely to result in HIV transmission.[14][15][16] Other infections that can be transmitted by unprotected anal sex are human papillomavirus (HPV) (which can increase risk of anal cancer[76]); typhoid fever;[77] amoebiasis; chlamydia;[15] cryptosporidiosis; E. coli infections; giardiasis; gonorrhea;[15] hepatitis A; hepatitis B; hepatitis C; herpes simplex;[15] Kaposi's sarcoma-associated herpesvirus (HHV-8);[78] lymphogranuloma venereum; Mycoplasma hominis; Mycoplasma genitalium; pubic lice;[15] salmonellosis; shigella; syphilis;[15] tuberculosis; and Ureaplasma urealyticum.[79]

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 may consider vaginal intercourse riskier than anal intercourse and believe that a STI can only result from vaginal intercourse.[80][81][82] 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.[80]

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.[83][84]

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.[3][85][86] 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.[3][87][88] Additionally, if a man moves from anal intercourse immediately 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.[2][3][89]

Pain during receptive anal sex among gay men (or men who have sex with men) is formally known as anodyspareunia.[13] In one study, 61% of gay or bisexual men said they experienced painful receptive anal sex and that it was the most frequent sexual difficulty they had experienced. By contrast, 24% of gay or bisexual men stated that they always experienced some degree of pain during anal sex,[13] and about 12% of gay men find it too painful to pursue receptive anal sex; it was concluded that the perception of anal sex as painful is as likely to be psychologically or emotionally based as it is to be physically based.[13][90] 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. 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.[13][90]

Unprotected anal sex is a risk factor for formation of antisperm antibodies (ASA) in the recipient. In some people, ASA may cause autoimmune infertility.[91] Antisperm antibodies impair fertilization, negatively affect the implantation process and impair growth and development of the embryo.[92][91]

Physical damage: hemorrhoids and rectal prolapse

Anal sex can exacerbate hemorrhoids and therefore result in bleeding; in other cases, the formation of a hemorrhoid is attributed to anal sex.[3][93] 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.[3][93] Because of the rectum's lack of elasticity, the anal mucous membrane being thin, and small blood vessels 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.[16]

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.[5][94]

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).[3][93] Rectal prolapse is relatively uncommon, however, especially in men, and its causes are not well understood.[95][96] Kegel exercises have been used to strengthen the anal sphincters and overall pelvic floor, and may help prevent or remedy fecal incontinence.[3][97]

Cancer

Most cases of anal cancer are related to infection with the human papilloma virus (HPV). Anal sex alone does not cause anal cancer; the risk of anal cancer through anal sex is attributed to HPV infection, which is often contracted through unprotected anal sex.[76] Anal cancer is relatively rare, and significantly less common than cancer of the colon or rectum (colorectal cancer); the American Cancer Society states that it affects approximately 7,060 people (4,430 in women and 2,630 in men) and results in approximately 880 deaths (550 in women and 330 in 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."[76]

Though anal cancer is serious, treatment for it is "often very effective" and most anal cancer patients can be cured of the disease; the American Cancer Society adds that "receptive anal intercourse also increases the risk of anal cancer in both men and women, particularly in those younger than the age of 30. Because of this, men who have sex with men have a high risk of this cancer."[76]

Cultural views

General

 
Depiction of anal sex on 510 BCE Attic red-figure kylix
 
Suzuki Harunobu, A shunga print depicting an older and a younger man

Different cultures have had different views on anal sex throughout human history, with some cultures more positive about the activity than others.[5][52][98] 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 and the passive partner (the one who is being penetrated) representing femininity.[5][7][52] 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.[7][57][99] In some societies, if discovered to have engaged in the practice, the individuals involved were put to death, such as by decapitation, burning, or even mutilation.[5]

Anal sex has been more accepted in modern times; it is often considered a natural, pleasurable form of sexual expression.[5][7][98] Some people, men in particular, are only interested in anal sex for sexual satisfaction, which has been partly attributed to the buttocks and anus being more eroticized in modern culture, including via pornography.[52] Engaging in anal sex is still, however, punished in some societies.[7][100] For example, regarding LGBT rights in Iran, Iran'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".[100]

Ancient and non-Western cultures

See also: Homosexuality in ancient Greece, Homosexuality in ancient Rome, and Sexuality in ancient Rome § Anal sex

From the earliest records, the ancient Sumerians had very relaxed attitudes toward sex[101] and did not regard anal sex as taboo.[101] Entu priestesses were forbidden from producing offspring[102][103] and frequently engaged in anal sex as a method of birth control.[102][101][103] Anal sex is also obliquely alluded to by a description of an omen in which a man "keeps saying to his wife: 'Bring your backside.'"[103] Other Sumerian texts refer to homosexual anal intercourse.[101] The gala, a set of priests who worked in the temples of the goddess Inanna, where they performed elegies and lamentations, were especially known for their homosexual proclivities.[104] The Sumerian sign for gala was a ligature of the signs for 'penis' and 'anus'.[104] One Sumerian proverb reads: "When the gala wiped off his ass [he said], 'I must not arouse that which belongs to my mistress [i.e., Inanna].'"[104]

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.[105] Male-male anal sex was not a universally accepted practice in Ancient Greece; it was the target of jokes in some Athenian comedies.[106] Aristophanes, for instance, mockingly alludes to the practice, claiming, "Most citizens are europroktoi ('wide-arsed') now."[107] The terms kinaidos, europroktoi, and katapygon were used by Greek residents to categorize men who chronically[108] practiced passive anal intercourse.[109] Pederastic practices in ancient Greece (sexual activity between men and adolescent boys), at least in Athens and Sparta, 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,[110] while male-male anal intercourse was usually depicted between males of the same age-group.[111] Intercrural sex was not considered penetrative and two males engaging in it was considered a "clean" act.[106] Some sources explicitly state that anal sex between men and boys was criticized as shameful and seen as a form of hubris.[110][112] Evidence suggests, however, that the younger partner in pederastic relationships (i.e., the eromenos) did engage in receptive anal intercourse so long as no one accused him of being 'feminine'.[113]

 
Two Roman males on the Warren Cup, British Museum

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.[114]

A male citizen taking the passive (or receptive) role in anal intercourse (paedicatio in Latin) was condemned in Rome as an act of impudicitia ('immodesty' or 'unchastity'); free men, however, could take the active role with a young male slave, known as a catamite or puer delicatus. 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" (muliebria pati '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.[115] 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.[115] 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".[115] 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".[116]

 
Man and woman having anal sex. Ceramic, Moche Culture. 300 C.E. Larco Museum Collection.

In Japan, records (including detailed shunga) show that some males engaged in penetrative anal intercourse with males.[117] 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.[118] 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.[119]

Western cultures

In many Western countries, anal sex has generally been taboo since the Middle Ages, when heretical movements were sometimes attacked by accusations that their members practiced anal sex among themselves.[120] At that time, celibate members of the Christian clergy were accused of engaging in "sins against nature", including anal sex.[121]

The term buggery originated in medieval Europe as an insult used to describe the rumored same-sex sexual practices of the heretics from a sect originating in Bulgaria, where its followers were called bogomils;[122] when they spread out of the country, they were called buggres (from the ethnonym Bulgars).[122] Another term for the practice, more archaic, is pedicate from the Latin pedicare, with the same meaning.[123]

The Renaissance poet Pietro Aretino advocated anal sex in his Sonetti Lussuriosi ('Lust Sonnets').[124] While men who engaged in homosexual relationships were generally suspected of engaging in anal sex, many such individuals did not. Among these, in recent times, have been André Gide, who found it repulsive,[125] and Noël Coward, who had a horror of disease, and asserted when young that "I'd never do anything – well the disgusting thing they do – because I know I could get something wrong with me".[126]

During the 1980s, Margaret Thatcher questioned the inclusion of "risky sex" in the United Kingdom's AIDS related government advertisements.[127] Thatcher questioned the inclusion of the term "anal sex" in line with the Obscene Publications Act 1959. The term "rectal sex" was agreed upon to be used instead.[128]

Religion

 
François-Rolland Elluin, Sodomites provoking divine wrath, from Le pot-pourri (1781)
Further information: Sodomy
See also: Buddhism and sexual orientation and LGBT topics and Hinduism

Judaism

The Mishneh Torah, a text considered authoritative by Orthodox Jewish sects,[129] 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 [traditionally, 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."[130]

Christianity

See also: Sodomy § Christianity

Christian texts may sometimes euphemistically refer to anal sex as the peccatum contra naturam ('the sin against nature', after Thomas Aquinas) or Sodomitica luxuria ('sodomitical lusts', in one of Charlemagne's ordinances), or peccatum illud horribile, inter christianos non nominandum ('that horrible sin that among Christians is not to be named').[131][132][133]

Islam

Main article: Islamic views on anal sex
 
Ottoman illustration depicting two young men having sex (from Sawaqub al-Manaquib)

Liwat, 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 which talk about smiting on Sodom and Gomorrah, and this is thought to be a reference to unnatural sex, and so there are hadith and Islamic laws which prohibit it.[134] While, concerning Islamic belief, it is objectionable to use the words al-Liwat and luti to refer to homosexuality because it is blasphemy toward the prophet of Allah, and therefore the terms sodomy and homosexuality are preferred,[135] 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.[135][136]

Other animals

As a form of non-reproductive sexual behavior in animals, anal sex has been observed in a few other primates, both in captivity and in the wild.[137][138][139]

See also

References

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Further reading

  • Brent, Bill Ultimate Guide to Anal Sex for Men, Cleis Press, 2002.
  • DeCitore, David Arouse Her Anal Ecstasy (2008) ISBN 978-0-615-39914-0
  • 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. ISBN 978-0-940208-20-9
  • 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. ISBN 978-1-57344-028-8
  • Underwood, Steven G. Gay Men and Anal Eroticism: Tops, Bottoms, and Versatiles, Harrington Park Press, 2003

External links

 
Wikimedia Commons has media related to Anal sex.

April 16, 2023
anal, anal, intercourse, generally, insertion, thrusting, erect, penis, into, person, anus, anus, rectum, sexual, pleasure, other, forms, anal, include, fingering, toys, anal, penetration, oral, performed, anus, anilingus, pegging, although, anal, most, common. Anal sex or anal intercourse is generally the insertion and thrusting of the erect penis into a person s anus or anus and rectum for sexual pleasure 1 2 3 Other forms of anal sex include fingering the use of sex toys for anal penetration oral sex performed on the anus anilingus and pegging 4 5 Although anal sex most commonly means penile anal penetration 3 4 6 sources sometimes use anal intercourse to exclusively denote penile anal penetration and anal sex to denote any form of anal sexual activity especially between pairings as opposed to anal masturbation 6 7 An illustration of anal sex While anal sex is commonly associated with male homosexuality research shows that not all gay men engage in anal sex and that it is not uncommon in heterosexual relationships 2 8 9 Types of anal sex can also be a part of lesbian sexual practices 10 People may experience pleasure from anal sex by stimulation of the anal nerve endings and orgasm may be achieved through anal penetration by indirect stimulation of the prostate in men indirect stimulation of the clitoris or an area of the vagina sometimes called the G spot in women and other sensory nerves especially the pudendal nerve 2 4 11 However people may also find anal sex painful sometimes extremely so 12 13 which may be due to psychological factors in some cases 13 As with most forms of sexual activity anal sex participants risk contracting sexually transmitted infections 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 provide lubrication like the vagina does so they can easily tear and permit disease transmission especially if a personal lubricant is not used 3 2 14 Anal sex without protection of a condom is considered the riskiest form of sexual activity 14 15 16 and therefore health authorities such as the World Health Organization WHO recommend safe sex practices for anal sex 17 Strong views are often expressed about anal sex It is controversial in various cultures especially with regard to religious prohibitions This is commonly due to prohibitions against anal sex among males or teachings about the procreative purpose of sexual activity 5 7 It may be considered taboo or unnatural and is a criminal offense in some countries punishable by corporal or capital punishment 5 7 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 5 7 Contents 1 Anatomy and stimulation 2 Male to female 2 1 Behaviors and views 2 2 Prevalence 3 Male to male 3 1 Behaviors and views 3 2 Prevalence 4 Female to male 5 Female to female 6 Health risks 6 1 General risks 6 2 Physical damage hemorrhoids and rectal prolapse 6 3 Cancer 7 Cultural views 7 1 General 7 2 Ancient and non Western cultures 7 3 Western cultures 7 4 Religion 7 4 1 Judaism 7 4 2 Christianity 7 4 3 Islam 8 Other animals 9 See also 10 References 11 Further reading 12 External linksAnatomy and stimulationSee also Prostate massage Male genital anatomy showing the location of the prostate with respect to the rectum The abundance of nerve endings in the anal region and rectum can make anal sex pleasurable for men or women 4 2 5 The internal and external sphincter 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 2 5 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 eight or nine inches long and has the capacity like the anus to expand 5 Research indicates that anal sex occurs significantly less frequently than other sexual behaviors 1 but its association with dominance and submission as well as taboo makes it an appealing stimulus to people of all sexual orientations 5 18 19 In addition to sexual penetration by the penis people may use sex toys such as a dildo a butt plug or anal beads engage in fingering anilingus pegging anal masturbation or fisting for anal sexual activity and different sex positions may also be included 5 20 Fisting is the least practiced of the activities 21 partly because it is uncommon that people can relax enough to accommodate an object as big as a fist being inserted into the anus 5 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 through the anal wall 4 11 This can result in pleasurable sensations and can lead to an orgasm in some cases 4 11 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 4 11 The prostate is located next to the rectum and is the larger more developed male homologue variation to the female Skene s glands 22 It is also typical for a man to not reach orgasm as a receptive partner solely from anal sex 23 24 General statistics indicate that 70 80 of women require direct clitoral stimulation to achieve orgasm 11 25 26 The vaginal 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 27 28 29 The clitoris is composed of more than the externally visible glans head 2 30 The vagina for example is flanked on each side by the clitoral crura the internal legs of the clitoris which are highly sensitive and become engorged with blood when sexually aroused 31 32 33 Indirect stimulation of the clitoris through anal penetration may be caused by the shared sensory nerves especially the pudendal nerve which gives off the inferior anal nerves and divides into the perineal nerve and the dorsal nerve of the clitoris 4 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 34 35 The Grafenberg spot or G spot is a debated area of female anatomy particularly among doctors and researchers 27 36 28 but it is typically described as being located behind the female pubic bone surrounding the urethra and accessible through the anterior wall of the vagina it and other areas of the vagina are considered to have tissue and nerves that are related to the clitoris 31 27 28 Direct stimulation of the clitoris a G spot area or both while engaging in anal sex can help some women enjoy the activity and reach orgasm during it 2 37 Stimulation from anal sex can additionally be affected by popular perception or portrayals of the activity such as erotica or pornography In pornography anal sex is commonly portrayed as a desirable painless routine that does not require personal lubricant 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 6 38 39 40 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 do not provide lubrication for sexual penetration like the vagina does 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 2 13 41 Additionally ensuring that the anal area is clean and the bowel is empty for both aesthetics and practicality may be desired by participants 21 Male to femaleBehaviors and views 1892 lithograph by Paul Avril depicting male to female anal sex 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 3 37 18 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 5 18 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 6 37 42 43 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 6 Anal intercourse is sometimes used as a substitute for vaginal intercourse during menstruation 5 The likelihood of pregnancy 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 often in the absence of a condom 5 38 44 Male to female anal sex is commonly viewed as a way of preserving female virginity because it is non procreative and does not tear the hymen 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 is often regarded among heterosexuals and researchers as not having yet experienced virginity loss This is sometimes called technical virginity 45 46 47 48 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 45 Prevalence Because most research on anal intercourse addresses men who have sex with men little data exists on the prevalence of anal intercourse among heterosexual couples 6 49 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 6 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 6 The review added that because relatively little attention is given 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 6 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 50 51 With regard to adolescents limited data also exists 49 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 49 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 49 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 39 40 52 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 52 Male to maleBehaviors and views 19th century erotic interpretation of Hadrian and Antinous detail by Paul Avril Historically anal sex has been commonly associated with male homosexuality However many gay men and men who have sex with men in general those who identify as gay bisexual heterosexual or have not identified their sexual identity do not engage in anal sex 8 9 53 54 Among men who have anal sex with other men the insertive partner may be referred to as the top and the one being penetrated may be referred to as the bottom Those who enjoy either role may be referred to as versatile 55 56 Gay men who prefer anal sex may view it as their version of intercourse and a natural expression of intimacy that is capable of providing pleasure 19 53 57 The notion that it might resonate with gay men with the same emotional significance that vaginal sex resonates with heterosexuals has also been considered 57 58 Some men who have sex with men however believe that being a receptive partner during anal sex questions their masculinity 59 60 Men who have sex with men may also prefer to engage in frot or other forms of mutual masturbation because they find it more pleasurable or more affectionate to preserve technical virginity or as safe sex alternatives to anal sex 53 55 61 while other frot advocates denounce anal sex as degrading to the receptive partner and unnecessarily risky 58 62 Prevalence Reports regarding the prevalence of anal sex among gay men and other men who have sex with men vary A survey in The Advocate in 1994 indicated that 46 of gay men preferred to penetrate their partners while 43 preferred to be the receptive partner 55 Other sources suggest that roughly three fourths of gay men have had anal sex at one time or another with an equal percentage participating as tops and bottoms 55 A 2012 NSSHB sex survey in the U S suggests high lifetime participation in anal sex among gay men 83 3 report ever taking part in anal sex in the insertive position and 90 in the receptive position even if only between a third and a quarter self report very recent engagement in the practice defined as 30 days or less 63 Oral sex and mutual masturbation are more common than anal stimulation among men in sexual relationships with other men 1 53 64 According to Weiten et al anal intercourse is generally more popular among gay male couples than among heterosexual couples but it ranks behind oral sex and mutual masturbation among both sexual orientations in prevalence 1 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 9 Female to male A woman wearing a strap on dildo about to engage in anal sex with a man pegging Women may sexually stimulate a man s anus by fingering the exterior or interior areas of the anus they may also stimulate the perineum which for males is between the base of the scrotum and the anus massage the prostate or engage in anilingus 5 21 65 Sex toys such as a dildo may also be used 5 21 The practice of a woman penetrating a man s anus with a strap on dildo for sexual activity is called pegging 20 66 It is common for heterosexual men to reject being receptive partners during anal sex because they believe it is a feminine act can make them vulnerable or contradicts their sexual orientation they may believe being a receptive partner is indicative that they are gay 21 67 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 68 The BMJ stated in 1999 There are little published data on how many heterosexual men would like their anus to be sexually stimulated in a heterosexual relationship Anecdotally it is a substantial number What data we do have almost all relate to penetrative sexual acts and the superficial contact of the anal ring with fingers or the tongue is even less well documented but may be assumed to be a common sexual activity for men of all sexual orientations 69 Female to female A woman performing anilingus anal oral sex on another woman With regard to lesbian sexual practices anal sex includes fingering use of a dildo or other sex toys or anilingus 10 70 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 2 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 71 Anilingus is also less often practiced among female same sex couples 72 73 Health risksGeneral risks Mucous membranes of the rectum Anal sex can expose its participants to two principal dangers infections due to the high number of infectious microorganisms not found elsewhere on the body and physical damage to the anus and rectum due to their fragility 14 16 Unprotected penile anal penetration colloquially known as barebacking 74 carries a higher risk of passing on sexually transmitted infections STIs because the anal sphincter is a delicate easily torn tissue that can provide an entry for pathogens 14 16 Use of condoms ample lubrication to reduce the risk of tearing 2 41 and safer sex practices in general reduce the risk of STIs 16 75 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 16 Unprotected receptive anal sex with an HIV positive partner is the sex act most likely to result in HIV transmission 14 15 16 Other infections that can be transmitted by unprotected anal sex are human papillomavirus HPV which can increase risk of anal cancer 76 typhoid fever 77 amoebiasis chlamydia 15 cryptosporidiosis E coli infections giardiasis gonorrhea 15 hepatitis A hepatitis B hepatitis C herpes simplex 15 Kaposi s sarcoma associated herpesvirus HHV 8 78 lymphogranuloma venereum Mycoplasma hominis Mycoplasma genitalium pubic lice 15 salmonellosis shigella syphilis 15 tuberculosis and Ureaplasma urealyticum 79 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 may consider vaginal intercourse riskier than anal intercourse and believe that a STI can only result from vaginal intercourse 80 81 82 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 80 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 83 84 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 3 85 86 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 3 87 88 Additionally if a man moves from anal intercourse immediately 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 2 3 89 Pain during receptive anal sex among gay men or men who have sex with men is formally known as anodyspareunia 13 In one study 61 of gay or bisexual men said they experienced painful receptive anal sex and that it was the most frequent sexual difficulty they had experienced By contrast 24 of gay or bisexual men stated that they always experienced some degree of pain during anal sex 13 and about 12 of gay men find it too painful to pursue receptive anal sex it was concluded that the perception of anal sex as painful is as likely to be psychologically or emotionally based as it is to be physically based 13 90 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 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 13 90 Unprotected anal sex is a risk factor for formation of antisperm antibodies ASA in the recipient In some people ASA may cause autoimmune infertility 91 Antisperm antibodies impair fertilization negatively affect the implantation process and impair growth and development of the embryo 92 91 Physical damage hemorrhoids and rectal prolapse Anal sex can exacerbate hemorrhoids and therefore result in bleeding in other cases the formation of a hemorrhoid is attributed to anal sex 3 93 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 3 93 Because of the rectum s lack of elasticity the anal mucous membrane being thin and small blood vessels 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 16 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 5 94 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 3 93 Rectal prolapse is relatively uncommon however especially in men and its causes are not well understood 95 96 Kegel exercises have been used to strengthen the anal sphincters and overall pelvic floor and may help prevent or remedy fecal incontinence 3 97 Cancer Most cases of anal cancer are related to infection with the human papilloma virus HPV Anal sex alone does not cause anal cancer the risk of anal cancer through anal sex is attributed to HPV infection which is often contracted through unprotected anal sex 76 Anal cancer is relatively rare and significantly less common than cancer of the colon or rectum colorectal cancer the American Cancer Society states that it affects approximately 7 060 people 4 430 in women and 2 630 in men and results in approximately 880 deaths 550 in women and 330 in 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 76 Though anal cancer is serious treatment for it is often very effective and most anal cancer patients can be cured of the disease the American Cancer Society adds that receptive anal intercourse also increases the risk of anal cancer in both men and women particularly in those younger than the age of 30 Because of this men who have sex with men have a high risk of this cancer 76 Cultural viewsGeneral Depiction of anal sex on 510 BCE Attic red figure kylix Suzuki Harunobu A shunga print depicting an older and a younger man Different cultures have had different views on anal sex throughout human history with some cultures more positive about the activity than others 5 52 98 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 and the passive partner the one who is being penetrated representing femininity 5 7 52 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 7 57 99 In some societies if discovered to have engaged in the practice the individuals involved were put to death such as by decapitation burning or even mutilation 5 Anal sex has been more accepted in modern times it is often considered a natural pleasurable form of sexual expression 5 7 98 Some people men in particular are only interested in anal sex for sexual satisfaction which has been partly attributed to the buttocks and anus being more eroticized in modern culture including via pornography 52 Engaging in anal sex is still however punished in some societies 7 100 For example regarding LGBT rights in Iran Iran 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 100 Ancient and non Western cultures See also Homosexuality in ancient Greece Homosexuality in ancient Rome and Sexuality in ancient Rome Anal sex From the earliest records the ancient Sumerians had very relaxed attitudes toward sex 101 and did not regard anal sex as taboo 101 Entu priestesses were forbidden from producing offspring 102 103 and frequently engaged in anal sex as a method of birth control 102 101 103 Anal sex is also obliquely alluded to by a description of an omen in which a man keeps saying to his wife Bring your backside 103 Other Sumerian texts refer to homosexual anal intercourse 101 The gala a set of priests who worked in the temples of the goddess Inanna where they performed elegies and lamentations were especially known for their homosexual proclivities 104 The Sumerian sign for gala was a ligature of the signs for penis and anus 104 One Sumerian proverb reads When the gala wiped off his ass he said I must not arouse that which belongs to my mistress i e Inanna 104 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 105 Male male anal sex was not a universally accepted practice in Ancient Greece it was the target of jokes in some Athenian comedies 106 Aristophanes for instance mockingly alludes to the practice claiming Most citizens are europroktoi wide arsed now 107 The terms kinaidos europroktoi and katapygon were used by Greek residents to categorize men who chronically 108 practiced passive anal intercourse 109 Pederastic practices in ancient Greece sexual activity between men and adolescent boys at least in Athens and Sparta 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 110 while male male anal intercourse was usually depicted between males of the same age group 111 Intercrural sex was not considered penetrative and two males engaging in it was considered a clean act 106 Some sources explicitly state that anal sex between men and boys was criticized as shameful and seen as a form of hubris 110 112 Evidence suggests however that the younger partner in pederastic relationships i e the eromenos did engage in receptive anal intercourse so long as no one accused him of being feminine 113 Two Roman males on the Warren Cup British Museum 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 114 A male citizen taking the passive or receptive role in anal intercourse paedicatio in Latin was condemned in Rome as an act of impudicitia immodesty or unchastity free men however could take the active role with a young male slave known as a catamite or puer delicatus 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 muliebria pati 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 115 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 115 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 115 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 116 Man and woman having anal sex Ceramic Moche Culture 300 C E Larco Museum Collection In Japan records including detailed shunga show that some males engaged in penetrative anal intercourse with males 117 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 118 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 119 Western cultures In many Western countries anal sex has generally been taboo since the Middle Ages when heretical movements were sometimes attacked by accusations that their members practiced anal sex among themselves 120 At that time celibate members of the Christian clergy were accused of engaging in sins against nature including anal sex 121 The term buggery originated in medieval Europe as an insult used to describe the rumored same sex sexual practices of the heretics from a sect originating in Bulgaria where its followers were called bogomils 122 when they spread out of the country they were called buggres from the ethnonym Bulgars 122 Another term for the practice more archaic is pedicate from the Latin pedicare with the same meaning 123 The Renaissance poet Pietro Aretino advocated anal sex in his Sonetti Lussuriosi Lust Sonnets 124 While men who engaged in homosexual relationships were generally suspected of engaging in anal sex many such individuals did not Among these in recent times have been Andre Gide who found it repulsive 125 and Noel Coward who had a horror of disease and asserted when young that I d never do anything well the disgusting thing they do because I know I could get something wrong with me 126 During the 1980s Margaret Thatcher questioned the inclusion of risky sex in the United Kingdom s AIDS related government advertisements 127 Thatcher questioned the inclusion of the term anal sex in line with the Obscene Publications Act 1959 The term rectal sex was agreed upon to be used instead 128 Religion Francois Rolland Elluin Sodomites provoking divine wrath from Le pot pourri 1781 Further information Sodomy See also Buddhism and sexual orientation and LGBT topics and Hinduism Judaism The Mishneh Torah a text considered authoritative by Orthodox Jewish sects 129 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 traditionally 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 130 Christianity See also Sodomy Christianity Christian texts may sometimes euphemistically refer to anal sex as the peccatum contra naturam the sin against nature after Thomas Aquinas or Sodomitica luxuria sodomitical lusts in one of Charlemagne s ordinances or peccatum illud horribile inter christianos non nominandum that horrible sin that among Christians is not to be named 131 132 133 Islam Main article Islamic views on anal sex Ottoman illustration depicting two young men having sex from Sawaqub al Manaquib Liwat 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 which talk about smiting on Sodom 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Archived from the original on March 10 2021 Retrieved September 15 2014 Nussbaum Martha C 1994 Platonic Love and Colorado Law The Relevance of Ancient Greek Norms to Modern Sexual Controversies Virginia Law Review 80 7 1562 3 doi 10 2307 1073514 JSTOR 1073514 the kinaidos is clearly a person who chronically plays the passive role More recently I have been convince by arguments of the late John J Winkler that kinaidos usually connotes willingness to accept money for sex as well as habitual passivity In any case there is no doubt that we are not dealing with an isolated act but rather a type of person who habitually chooses activity that Callicles finds shameful That and no view about same sex relations per se is the basis of his criticism In fact Callicles is depicted as having a young boyfriend of his own The boyfriend is named Demos also the name for the Athenian people to whom Callicles is also devoted It is likely that the pun on the name is sexual as Callicles seduces Demos so also 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Museum Lima Peru Experience Ancient Peru Permanent Exhibition Museolarco org Archived from the original on March 4 2013 Retrieved March 14 2013 Herbenick Debby Good in Bed Guide to Anal Pleasuring Good in Bed Guides pp 12 13 ISBN 978 0 9843221 6 9 Robert Aldrich Garry Wotherspoo 2002 Who s Who in Gay and Lesbian History Vol 1 From Antiquity to the Mid Twentieth Century Routledge p 116 ISBN 020398675X Archived from the original on March 10 2021 Retrieved December 22 2013 a b Erin McKean ed 2005 New Oxford American Dictionary 2nd edition Oxford University Press ISBN 0 19 517077 6 Pollini John March 1999 The Warren Cup Homoerotic Love and Symposial Rhetoric in Silver BJUI 81 1 21 52 doi 10 2307 3051285 JSTOR 3051285 I have derived the word pedicate from the Latin paedicare or pedicare meaning to penetrate anally Note 6 Daileader Celia R Summer 2002 Back Door Sex Renaissance Gynosodomy Aretino and the Exotic PDF English Literary History The Johns Hopkins University Press 69 2 303 334 doi 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2010 Sexuality in the Middle Ages and the Early Modern Times New Approaches to a Fundamental Cultural historical and Literary anthropological Theme Walter de Gruyter p 13 ISBN 978 3110205749 Archived from the original on March 10 2021 Retrieved September 15 2014 Byrne Fone 2001 Homophobia A History Macmillan p 133 ISBN 1466817070 Archived from the original on March 26 2015 Retrieved September 15 2014 Louis Crompton 2009 Homosexuality and Civilization Harvard University Press p 529 ISBN 978 0674030060 Archived from the original on March 26 2015 Retrieved September 15 2014 Mark M Leach 2014 Cultural Diversity and Suicide Ethnic Religious Gender and Sexual Orientation Perspectives Routledge p 121 ISBN 978 1317786597 Archived from the original on March 26 2015 Retrieved September 15 2014 a b Yahaya Yunusa Bambale 2008 2003 Crimes and Punishments Under Islamic Law Malthouse Press Limited p 40 ISBN 978 9780231590 Archived from the original on March 10 2021 Retrieved September 15 2014 Randy P Conner David Hatfield Sparks Mariya Sparks 2006 1997 Cassell s Encyclopedia of Queer Myth Symbol and Spirit Gay Lesbian Bisexual and Transgender Lore Cassell pp 20 216 ISBN 0304337609 Archived from the original on September 26 2020 Retrieved September 15 2014 Indeed homoeroticism in general and anal intercourse in particular are referred to as liwat while those primarily men engaging in these behaviors are referred to as qaum Lut or Luti the people of Lot Erwin J Maple T 1976 Ambisexual behavior with male male anal insertion in male rhesus monkeys Archives of Sexual Behavior 5 1 9 14 doi 10 1007 bf01542236 PMID 816329 S2CID 46074855 Busia L Denice AR Aureli F Schaffner CM May 2018 Homosexual behavior between male spider monkeys Ateles geoffroyi PDF Archives of Sexual Behavior 47 4 857 861 doi 10 1007 s10508 018 1177 8 PMID 29536259 S2CID 3855790 Archived PDF from the original on October 11 2021 Retrieved November 11 2021 Fang Gu Dixson Alan F Qi Xiao Guang Li Bao Guo April 2018 Male Male Mounting Behaviour in Free Ranging Golden Snub Nosed Monkeys Rhinopithecus roxellana Folia Primatologica Karger Publishers 89 2 150 156 doi 10 1159 000487004 PMID 29621754 S2CID 4597770 Archived from the original on December 3 2021 Retrieved December 3 2021 Further readingBrent Bill Ultimate Guide to Anal Sex for Men Cleis Press 2002 DeCitore David Arouse Her Anal Ecstasy 2008 ISBN 978 0 615 39914 0 Houser Ward Anal Sex Encyclopedia of Homosexuality Dynes Wayne R ed Garland Publishing 1990 pp 48 50 Morin Jack Anal Pleasure amp Health A Guide for Men and Women Down There Press 1998 ISBN 978 0 940208 20 9 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 ISBN 978 1 57344 028 8 Underwood Steven G Gay Men and Anal Eroticism Tops Bottoms and Versatiles Harrington Park Press 2003External links Wikimedia Commons has media related to Anal sex Retrieved from https en wikipedia org w index php 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