Anal Sex
The abundance of nerve endings in the anal region and rectum makes anal sex pleasurable for many men and women.[17] "The opening and closing of the anus is controlled by the internal and external sphincter muscles (the most important muscles when engaging in anal sex). The sphincter muscle is a sensitive membrane with many nerve endings and thus the source of pleasure or pain."[18]In a male receiving partner, being penetrated can produce a pleasurable sensation due to the inserted penis rubbing or brushing against the prostate (also known as the "male G-Spot", "P-Spot" or "A-Spot") through the anal wall.[7][19] This can result in pleasurable sensations and can lead to an orgasm in some cases.[7][8] "For some men, prostate stimulation produces an orgasm that they describe as 'deeper', more global and intense, longer-lasting, and associated with greater feelings of ecstasy than orgasm elicited by penile stimulation only."[8] The prostate is located next to the rectum and is the larger, more developed[20] male homologue to the Skene's glands (which are believed to be connected to the female G-Spot).[21]Research shows that most women (70-80%) achieve orgasm only through direct clitoral stimulation.[22][23][24][25] The clitoris surrounds the vagina somewhat like a horseshoe and its tip or glans alone has more than 8,000 sensory nerve endings, more than any other part of the human body.[26] In addition to nerve endings present within the anus and rectum, women may find anal stimulation pleasurable due to the "legs" of the clitoris which extend along the vaginal lips back to the anus.[27] The Grfenberg spot, or G-Spot - a small area behind the female pubic bone surrounding the urethra and accessible through the anterior wall of the vagina - is considered to have legs in relation to the clitoris.[8][28][29] Besides their accessibility, orgasm by stimulation of the clitoris or G-Spot through anal penetration is made possible because a thin membrane is all that separates the vaginal cavity from the rectal cavity, allowing for indirect stimulation.[6][8][9][10] Only a small percentage of women are able to orgasm from this type of stimulation alone.[10] Direct stimulation of the clitoris, G-Spot, or both, during anal sex can help some women to enjoy the experience and reach orgasm.[9][30]In pornography, anal sex is often presented as routine and painless, but according to Go Ask Alice! and other researchers, anal sex occurs "much less frequently" than other sexual behaviors and can be painful if not performed with care.[1][3][31] The increase of anal activity among heterosexuals has been linked to the increase in anal pornography,[1] and the association with dominance and taboo make anal sex appealing to people of all sexual orientations.[32][33] Moreover, the opening of the anus (its sphincter) is usually tighter than a vagina, which can yield greater tactile pleasure for the man via his penis.[9][32]While each person's sphincter muscles react to penetration differently, the anal sphincter in general has delicate tissue that can tear, and the rectal mucous membrane provides insufficient lubrication for sexual penetration. Researchers say adequate lubrication, relaxation, and communication between sexual partners are crucial to avoid pain or damage to the anus.[1][12][16][34] Ensuring that the anal area is clean and the bowel is empty (for both aesthetics and practicality) is also recommendedSome men may enjoy being the insertive partner in anal sex because the anal sphincter is usually tighter than a vagina, which can yield greater tactile pleasure for the man via his penis.[9][32] The attitude of women towards being the receptive partner in this practice is diverse: while some consider it painful or uncomfortable, others find it pleasurable and some even prefer it to vaginal intercourse.[9][35] Unlike the clitoris or anus, the vaginal walls "contain relatively few nerve endings, making intense sexual stimulation, pleasure, and orgasm from vaginal-only penetration unlikely" and "it's generally only the lower third of the vagina that has enough nerve endings to feel any stimulation at all from a penis, finger, toy, or other penetrative object".[36] Vaginal intercourse may, however, promote a satisfying feeling of fullness or closeness with a sexual partner.[37]In a study of heterosexual anal sex - (8/2010 (n=214)) - female participants stated that stimulation to multiple erogenous zones simultaneously (the clitoris, the G-Spot, the anus, or other erogenous zones) enabled them to enjoy anal intercourse with much less discomfort compared to anal penetration by itself. When accompanied by one or more of the other stimuli, women were able to orgasm and those who did reported that an orgasm during anal sex is more of a full-body experience than an orgasm from clitoral stimulation alone.[30]Anal sex is held to carry a very low risk of unwanted pregnancy when not accompanied with vaginal intercourse, as anal intercourse cannot lead to pregnancy unless sperm is somehow transported to the vaginal opening in the process; in some populations, this activity is frequently used as a means of contraception, often in the absence of a condom.[38]The risk to the woman is greater than the risk to the man during male-to-female anal intercourse.[39] The risk of injury to the receptive partner due to anal intercourse is many times higher than that due to vaginal sex,[40] and the risk of transmission of HIV is higher for anal sex than for vaginal sex.[41] Experts caution couples engaging in this practice to use protection, such as condoms, to stop the transmission of STDs.[1] Additionally, if the man moves from anal sex immediately to vaginal sex without a condom or without changing it, infections can arise in the vagina due to bacteria present within the anus; this also applies to the use of sex toysIn 1992, a study conducted by the U.S. Centers for Disease Control and Prevention found that only 26% of men 18 to 59 and 20% of women 18 to 59 had engaged in heterosexual anal sex; a similar 2005 survey (also conducted by the U.S. Centers for Disease Control and Prevention) found a rising incidence of anal sex relations in the American heterosexual population. The survey showed that 40% of men and 35% of women between 25 and 44 had engaged in heterosexual anal sex.[48] In terms of overall numbers of survey respondents, seven times as many women as gay men said that they engaged in anal intercourse, with this figure reflecting the larger heterosexual population size.[49] According to a study from the National Survey of Sexual Health and Behavior (NSSHB) that was authored by Dr. Debby Herbenick and other researchers, although anal intercourse is reported by fewer women than other partnered sex behaviors, partnered women in the age groups between 18-49 are significantly more likely to report having anal sex in the past 90 days.[50] As of 2011, this survey provides the most up to date data about anal sex at the population level.In a 2007 report entitled Prevalence and Correlates of Heterosexual Anal and Oral Sex in Adolescents and Adults in the United States, published in the Journal of Infectious Disease, a national survey of Family Growth found that 34% men and 30% women reported ever participating in heterosexual anal sex. The percentage of participants reporting heterosexual anal sex was significantly higher among 20- to 24-year-olds and peaked among 30- to 34-year-olds.[51][52] Another survey in, 2008, focused on a much younger demographic of teenagers and young adults, aged 15-21. It found that 16% of 1350 surveyed had had this type of sex in the previous 3 months, with condoms being used 29% of the time.[53] However, given the subject matter, the survey hypothesized the prevalence was probably underestimated.In 2009, Kimberly R. McBride published a clinical report in The Journal of Sex Research which stated that changing norms may affect the frequency of heterosexual anal sex behaviors and suggests that there is a role for the exotic in the sexual repertoires of some heterosexuals" "[F]or a certain number of heterosexuals, anal intercourse is pleasurable, exciting, and perhaps considered more intimate than vaginal 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.[51][54] McBride and Janssen found that 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.[51][54]Figures for prevalence can vary amongst different demographics, regions, and nationalities. A 2001 French survey of five hundred female respondents concluded that a total of 29% had engaged in this practice, with one third of these confirming to have enjoyed the experience.[55] In contrast, in a 1999 South Korean survey of 586 women, 3.5% of respondents reported having had this type of sex.[56]Figures for the prevalence of sexual behavior can also fluctuate over time. Edward O. Laumann's 1992 survey, reported in The Social Organization of Sexuality: Sexual Practices in the United States, found that about 20% of heterosexuals had engaged in male-to-female anal sex. Sex researcher Alfred Kinsey, working in the 1940s, had found that number to be closer to 40% at the time. More recently, a researcher from the University of British Columbia in 2005 put the number of heterosexuals who have engaged in this practice at between 30% and 50%.[57] According to Columbia University's health website Go Ask Alice!: "Studies indicate that about 25 percent of heterosexual couples have had anal sex at least once, and 10 percent regularly have anal penetration.Pegging is a sexual practice in which a woman penetrates a man's anus with a strap-on dildo.[58] Advice columnist Dan Savage wrote that he believes all men should try pegging at least once, as it may introduce them to a new enjoyable sexual activity and illuminate them to the receiver's perspective in sex.[59] A few instructional movies and books have emerged in recent years, including Bend Over Boyfriend, produced by Fatale Media, Inc., and directed by Shar Rednour, SIR Video co-founder. As an accomplished author of numerous sex guides and informational books on various sexual taboos, Violet Blue wrote and released The Adventurous Couple's Guide to Strap-On Sex in 2007.[60]The National Institutes of Health (NIH), with information published in the British Medical Journal (BMJ), states that, "There are little published data on how many heterosexual men would like their anus to be sexually stimulated in a heterosexual relationship", but that, "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