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]
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[75]); typhoid fever;[76] 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);[77] lymphogranuloma venereum; Mycoplasma hominis; Mycoplasma genitalium; pubic lice;[15] salmonellosis; shigella; syphilis;[15] tuberculosis; and Ureaplasma urealyticum.[78]

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Some infections can cause problems during pregnancy, such as Giardia (giardiasis) and Group B Streptococcus (GBS), among others. Giardia can cause chronic diarrhea which may lead to dehydration and malnutrition, both of which can be dangerous during pregnancy both for the mother and fetus. GBS may be transmitted to the baby during delivery and can lead to an infection in the infant. Both Giardia and GBS often colonize the rectum and can be spread to the vaginal tract if vaginal or oral sex follows anal sex, or if there is any touching (hands or genitals) after anal sex.
During filming, they take cut breaks to apply lube, rarely shown on screen, address messes, and switch from anal back to vaginal sex without showing pre-switch cleaning, which is vital to avoid infections. They also, says self-described “aspiring anal queen” Della Dane, who entered porn last year, “do certain angles and positions for entertainment value that you wouldn’t normally do.” And rather than being ready for anal at any time, stars often need to take breaks of a few days or weeks between a given number of anal shoots. All-in-all, the eight-year industry vet Cherie DeVille told me last year, “you can’t expect your female partner at home to just be able to jump into” anal, especially porn-style anal; the same applies to men and non-binary folks as well.
^ Joann S. DeLora; Carol A. B. Warren; Carol Rinkleib Ellison (2008) [1981]. Understanding Sexual Interaction. Houghton Mifflin (Original from the University of Virginia). p. 123. ISBN 978-0-395-29724-7. Retrieved November 6, 2011. Many men find anal intercourse more exciting than penile-vaginal intercourse because the anal opening is usually smaller and tighter than the vagina. Probably the forbidden aspect of anal intercourse also makes it more exciting for some people.
Intra-rectal pressure builds as the rectum fills with feces, pushing the feces against the walls of the anal canal. Contractions of abdominal and pelvic floor muscles can create intra-abdominal pressure which further increases intra-rectal pressure. The internal anal sphincter (an involuntary muscle) responds to the pressure by relaxing, thus allowing the feces to enter the canal. The rectum shortens as feces are pushed into the anal canal and peristaltic waves push the feces out of the rectum. Relaxation of the internal and external anal sphincters allows the feces to exit from the anus, finally, as the levator ani muscles pull the anus up over the exiting feces.
Spreading STIs. Infections and diseases that are shared during sexual intercourse — such as HIV, gonorrhea, chlamydia, and herpes — can be shared through anal sex. In fact, anal sex is the sexual behavior for transmitting and getting HIV for both men and women. People on the receiving end (or “the bottom”) of anal sex are more likely to become infected with HIV than the inserting partner (or “the top”).
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