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][89] 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][89]
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,[73] carries a higher risk of passing on sexually transmitted infections (STIs/STDs) because the anal sphincter is a delicate, easily torn tissue that can provide an entry for pathogens.[14][16] The high concentration of white blood cells around the rectum, together with the risk of tearing and the colon's function to absorb fluid, are what place those who engage in anal sex at high risk of STIs.[16] Use of condoms, ample lubrication to reduce the risk of tearing,[2][41] and safer sex practices in general, reduce the risk of STI transmission.[16][74] 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]
The emotional overture I feel before boarding a roller coaster is about the same as I feel right before embarking on anal sex: excitement, followed by mild hesitation and nervousness. But! The thing about every single roller roaster ride I've been on (so far) is that I've loved them all. No matter how many butterflies are tap-dancing on the bottom of my stomach as the ride lurches up a steep hill, the thrill I feel at the end of the ride is always worth it.
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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