Mine sisu juurde

Kasutaja:Kati Keha/Anaalseks

Allikas: Vikipeedia
Paul Avril 1892 "Anaalseks"

Anaalseks on üks suguühte tüüpidest, kus suguühe toimub anaalselt ehk pärakusse.

Selle levinuimas vormis sisestatakse pärakusse või pärakusse ja pärasoolde jäigastunud peenis, mida seal siis sugulise rahulduse saavutamiseks edasi-tagasi liigutatakse.[1][2][3] Teiste anaalseksi vormide seas on päraku penetreerimine sõrmega või seksileludega (nt anaaltapp), oraalseks pärakus (anilingus) ning rahuldamine dildoga.[2][4][5] Anaalseks hõlmab ka anaalset masturbatsiooni.[6][7]

Ehkki tavaarusaamades seotakse anaalseks peamiselt meeste homoseksuaalsusega, näitavad uuringud, et sugugi kõik homoseksuaalsed mehed ei harrasta anaalseksi, samuti pole see haruldane heteroseksuaalsetes suhetes.[3][8][9][10] Mõnd liiki anaalseksi võivad harrastada ka lesbid.[11] Anaalseksist võidakse tunda mõnu pärakunärvi stimuleerimise teel ning anaalse penetratsiooniga võidakse jõuda orgasmini, stimuleerides kaudselt meeste eesnääret, naiste kõdistit või G-punktiga seostatavat piirkonda vagiinas, samuti teisi närve (eriti häbemenärvi).[2][3][12][13] Samas võib anaalseks olla ka valuline, isegi väga valuline[14][15], mis mõnel juhul võib tuleneda eelkõige psühholoogilistest faktoritest.[16]

Nagu enamiku seksuaaltegevuse vormide puhul, kaasneb ka anaalseksiga oht nakatuda suguhaigustesse. Anaalseksi peetakse riskantseks, kuna päraku ja pärasoole koed on eriti õrnad ja erinevalt vagiinast puudub neis looduslik libestusmehhanism. Seega võivad need kergesti vigastuda ning võimaldada haiguste edasikandumist, eriti kui ei kasutata libestit.[1][3][17] Kondoomita anaalseksi peetakse kõige riskantsemaks seksuaaltegevuse vormiks[17][18][19], seepärast soovitavad tervishoiuorganisatsioonid (näiteks Maailma Tervishoiuorganisatsioon) järgida anaalseksi ajal ohutu seksi nõudeid eriti hoolikalt.[20]

Tihti välijendatakse anaalseksi suhtes tugevaid emotsioone ja kirglikke vaateid. Paljudes kultuurides on see suuremal või vähemal määral taunitav, eriti religioosses kontekstis, tavaliselt seoses homoseksuaalse anaalseksi keeluga või seksuaaltegevuse lubamisega üksnes lapsesaamiseks.[4][5][7] Seda võidakse pidada tabuks või ebaloomulikuks ning mõnes riigis on see kuritegu, mida karistatakse kas ihunuhtluse või surmanuhtlusega. Samas peavad paljud inimesed anaalseksi loomulikuks ja lubatavaks seksuaaltegevuse vormiks, mis võib olla samaväärne seksuaalsuse teiste väljendusvormidega. Seda võidakse pidada oma seksuaalelu täiendavaks osaks või isegi seksuaaltegevuse esmaseks vormiks.[4][5][7]

Anatoomia ja stimulatsioon

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 Pikemalt artiklis Eesnäärmemassaaž

Närvilõpmete rohkus päraku piirkonnas ja pärasooles võib muuta anaalseksi nauditavaks nii meeste kui ka naiste jaoks.[2][3][5] Päraku sisemised ja välimised sulgurlihased kontrollivad päraku sulgumist ja avanemist; need musklid, mis on arvukate närvilõpmetega tundlikud membraanid, tekitavad anaalseksi ajal naudingut.[3][5] Inimseksuaalsuse entsüklopeedia ("Human Sexuality: An Encyclopedia") väidab, et "pärakukanali sisemine kolmandik on puudutuse suhtes vähem tundlik kui kaks välimist kolmandikku, kuid on tundlikum surve suhtes" ja "pärasool on umbes 8-9 tolli pikkune kõver toru, mis venib samuti kui pärak".[5]

Uuringud näitavad, et anaalseks on märksa harvem kui teised seksuaalkäitumise vormid[8][21], ent selle seos domineerimise ja allumisega ning tabudega teeb anaalseksist ligitõmbava stiimuli, sõltumata inimese seksuaalsest orientatsioonist.[5][22][23] Lisaks seksuaalsele penetratsioonile peenisega, võidakse kasutada seksilelusid nagu anaaltapid või anaalhelmed, tegelda sõrmitsemisega, anilingusega, dildo või käega rahuldamise (inglise keeles vastavalt pegging ja fisting) või anaalmasturbatsiooniga. Samuti võidakse kasutada mitmesuguseid seksipoose.[5][24] Loetletud praktikates kõige haruldasem on rahuldamine labakäe või rusikaga (fisting)[25], kuna "vähesed suudavad lõdvestuda piisavalt, et mahutada oma pärakusse midagi nii suurt kui rusikas".[5]

Meesterahvast vastuvõttev partner võib tunda anaalseksist naudingut, kuna sisestatud peenis hõõrub läbi pärakuseina eesnääret (seda hüütakse "meeste G-punktiks").[2][12][26] See võib tekitada meeldivaid aistinguid ning viia mõnel juhul ka orgasmini.[2][12][26] 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.[2][26] Meeste eesnääre paikneb pärasoole kõrval ja on suurem ning väljaarenenum vaste (homoloog) naiste Skene näärmetele.[27] Siiski, ehkki kogemused on erinevad, keskenduvad ka peenise stimuleerimisest saadavad meeste orgasmid eesnäärmele.[28] On tavaline ja tõenäoliselt kõige tüüpilisem, et vastuvõtvast partnerist mehed ei jõua üksnes anaalseksist orgasmini.[29]

Üldine statistika näitab, et 70–80% naistest vajab orgasmini jõudmiseks kõdisti otsest stimuleerimist.[26][30][31] Kõdisti ei koosne üksnes välimiselt nähtavast kõdistilukist. Kõdistis tervikuna on hinnanguliselt umbes 8000 närvilõpet[3][32], see piirab vagiinat ja ureetrat[33] ning võib olla samamoodi ühenduses pärakuga.[34] Mõlemale poole vagiinat ulatuvad kõdistisääred (crura clitoridis), mis on ülimalt tundlikud ja täituvad sugulise erutuse ajal verega.[33][35][36] Lisaks pärakus ja pärasooles olevatele närvilõpmetele võivad naised saada anaalsest stimuleerimisest naudingut ka kõdistisäärte kaudse stimuleerimise tõttu.[37] Anaalse penetratsiooni käigus võidakse kõdistit kaudselt stimuleerida ka ühiste närvide tõttu nagu häbemenärv, millest hargnevad madalamad pärakunärvid ning mis jaguneb lõpuks kaheks haruks: perineaalnärviks ja kõdisti dorsaalnärviks.[2]

Gräfenbergi punkt ehk G-punkt on naiste anatoomias vaidlusalune, eriti arstide ja uurijate seas[38][39][40], kuid tavaliselt kirjeldatakse seda asuvana naiste häbemeluu taga ureetra ümber, nii et see on ligipääsetav läbi vagiina eesseina; G-punktis ja teistes vagiina piirkondades arvatakse olevat koed ja närvid, mis on ühendatud kõdistiga.[33][38][39] Lisaks eelmainitud närviühendusele on orgasm kõdisti või G-punkti piirkonna kaudse stimuleerimise teel anaalseksi ajal võimalik, kuna vagiina ja pärasoole õõnsused asuvad lähestikku.[13][25] Üksnes anaalse stimuleerimise teel jõuavad orgasmini vähesed naised.[41][42] Kõdisti, G-punkti või mõlema otsene stimuleerimine anaalseksi ajal võib aidata mõnel naisel seda tegevust nautida ning ka orgasmini jõuda.[3][13]

Anaalseksiga kaasnevat stimulatsiooni võivad lisaks mõjutada selle tegevuse levinud kujutusviisid nagu erootika ja pornograafia. Pornos kujutatakse anaalseksi tavaliselt ihaldatava ja valutu harjumuspärase tegevusena, mis ei vaja libestit. Seetõttu võidakse harrastada anaalseksi ilma vajalike ettevaatusabinõudeta ning uskudes, et naiste jaoks on ebamugavus või valu anaalseksi ajal haruldane.[6][43][44][45] Tegelikult reageerivad iga inimese sulgurlihased penetratsioonile erinevalt, päraku sulgurlihase koed on tundlikumad ja rebenevad kergemini, ning erinevalt vagiinast ei ole pärakus ja pärasooles looduslikku libestusmehhanismi seksuaalse penetratsiooni tarbeks. Uuringute kohaselt on küllaldane kogus libestit, lõõgastumine ja seksuaalpartnerite vaheline suhtlus äärmiselt olulised, et vältida anaalseksi ajal valu ning päraku või pärasoole kahjustamist.[3][15][46] Samuti võivad asjaosalised soovida, et päraku piirkond oleks puhas ja sisikond tühjendatud, nii esteetilistel kui ka praktilistel põhjustel.[4][25]

Mees naisele

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Käitumisviisid ja vaated

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Paul Avrili litograafia 1892. aastast kujutab mehe ja naise vahelist anaalseksi

Päraku sulgurlihased on tavaliselt tihkemad kui vagiina vaagnalihased, mis peenisele avalduva surve tõttu võib suurendada naisega anaalvahekorras oleva mehe seksuaalset naudingut.[1][13][22] Mehed võivad nautida anaalseksi ajal penetreerimist ka selle seose tõttu domineerimisega, kuna selle ihaldatavust tõstab naispartneri või ühiskonna vaade, et see on keelatud. Samuti pakub anaalseks veel üht täiendavat penetratsioonivõimalust.[5][22]

Mõne naise jaoks on anaalseks vastuvõtva partnerina valuline või ebamugav, nii et nad tegelevad sellega üksnes meespartneri rahuldamiseks, samas kui mõned naised naudivad seda või isegi eelistavad anaalseksi vaginaalsele suguühtele.[6][13][47][48] Tupe seintes on märksa vähem närvilõpmeid kui kõdistis ja pärakus, seepärast on tugev seksuaalne nauding, sealhulgas orgasm, vaginaalsest seksuaalsest stimuleerimisest enamiku naiste jaoks vähem tõenäoline kui otsesest kõdisti stimuleerimisest.[39][38][49] Siiski ei pruugi orgasm anaalse seksuaalse stimuleerimise mõjul olla tõenäolisem kui vaginaalse stimulatsiooni korral. Loevad ka närvitüübid ning nende vastasmõju[2]. On levinud valeuskumus, et vagiina ja kõdisti on teineteisest täielikult eraldatud; eksitusele aitab kaasa vähene teadlikkus kõdisti tegelikust suurusest ja olemusest.[33][34][39]

2010. aastal valdatud meditsiiniartiklis heteroseksuaalse anaalseksi teemal kinnitati, et anaalseks on mõnede heteroseksuaalide jaoks haruldane seksuaalne praktika, kuid samas on see mõnede heteroseksuaalide jaoks nauditav, erutav ja seda võidakse pidada ka intiimsemaks kui vaginaalset seksi.[6]

Vahel kasutatakse anaalseksi vaginaalse suguühte asendajana menstruatsiooni ajal.[5] Rasestumise tõenäosus on anaalseksi ajal oluliselt väiksem, kuna anaalseks iseenesest ei saa põhjustada rasestumist, kui spermat ei viida mingil viisil tupeavasse. Sellepärast harrastavad mõned paarid anaalset suguühet rasestumisvastase vahendina, eriti kondoomi puudumise korral.[5][43][50]

Mehe ja naise vahelist anaalseksi peetakse sageli võimaluseks säilitada naise neitsilikkus, kuna see pole seotud paljunemisega ja ei rebesta neitsinahka. Anaalseksi tegelejat, eriti teismelist tüdrukut või naist, kes pole kunagi olnud vaginaalses vahekorras, peavad heteroseksuaalid ja uurijad sageli neitsiks. Vahel nimetatakse seda "tehniliseks neitsilikkuseks".[51][52][53][54] Heteroseksuaalid võivad pidada anaalseksi eelmänguks või amelemiseks; see vaade "pärineb 1600. aastate lõpust, kuid konkreetsed "reeglid" ilmusid 20. sajandi algul, kui abielukäsiraamatuis määratleti eelmänguna "praktiliselt iga hellitusviisi, mida abielupaar harrastas, peale täieliku suguühte"".[51]

1992. aastal näitas USA Haiguskontrolli ja -ennetuse Keskuse (Centers for Disease Control and Prevention, CDC) korraldatud uuring, et 26% 18-59-aastastest meestest ja 20% 18-59-aastastest naistest oli harrastanud heteroseksuaalset anaalseksi. Sama asutuse analoogne uuring 2005. aastast näitas, et anaalseksi sagedus Ameerika heteroseksuaalse elanikkonna seas kasvas. Uuringu andmeil oli 40% 25-44-aastastest meestest ja 35% naistest osalenud heteroseksuaalses anaalseksis.[55] Uuringus osalejate koguarvust oli anaalseksis enda sõnul osalenud seitse korda rohkem naisi kui homoseksuaalseid mehi, mis peegeldab heteroseksuaalse elanikkonna suurt osakaalu.[56]

2007. aastal National Survey of Family Growthi (NSFG) avaldatud raport heteroseksuaalse anaal- ja oraalseksi leviku ja korrelatsiooni teemal USA noorte ja täiskasvanute seas teatas, et 34% meestest ja 30% naistest oli enda sõnul kunagi osalenud heteroseksuaalses anaalseksis. Heteroseksuaalses anaalseksis osalenute protsent oli märgatavalt kõrgem 20-24-aastaste seas ning kõrgeim 30-34-aastaste seas.[57] 2008. aastal avaldatud uuring, mis keskendus teismelistele ja noortele täiakasvanutele vanuses 15–21, leidis, et 1350 küsitletust 16% olid harrastanud taolist seksi viimase 3 kuu jooksul, neist 29% kondoomiga.[58] Teema tõttu oletati uuringus siiski, et tegelik sagedus oli suurem.

Kimberly R. McBride'i meditsiiniartiklis 2010. aastast heteroseksuaalses anaalse suguühte ja teiste anaalsete seksuaalsete tegevuste teemal leiti, et heteroseksuaalse anaalseksi esinemissagedust võib mõjutada ühiskondlike normide muutumine. McBride j tema kolleegid uurisid mittesuguühtelisi anaalseksi vormide levimust meeste (n=1,299) ja naiste (n=1,919) valimites võrrelduna anaalse suguühte kogemustega ning leidsid, et 51% meestest ja 43% naistest olid osalenud vähemalt ühe korra oraal-anaalseksis, manuaal-anaalseksis või kasutanud anaalseksilelu.[6] Raporti andmeil oli enamik meestest (n=631) ja naistest (n=856), kes olid osalenud viimase 12 kuu vältel heteroseksuaalses anaalsuguühtes, eksklusiivses monogaamses suhtes: vastavalt 69% ja 73%.[6] Artikkel lisas, et "enamik anaalse suguühte uuringuid tegeleb meestega, kes seksivad meestega, pöörates suhteliselt vähe tähelepanu anaalsele suguühtele ja teistele anaalseksi vormidele heteroseksuaalsete partnerite vahel" ja et "harva eristavad uuringud pärakut kui suguorganit või tegelevad anaalse seksuaalfunktsiooniga või düsfunktsiooniga kui tegelike teemadega. Selle tulemusena ei tea me, mil määral erineb anaalne suguühe kvalitatiivselt tavapärasest suguühtest."[6]

2010. aasta uuringu kohaselt, mille korraldas Riiklik Seksuaaltervise ja -käitumise Uuring ning teostasid Debby Herbenick ja teised teadlased, mainivad anaalset suguühet küll vähemad naised kui teisi partneritega seksivorme, ent partneritega naised vanuses 18–49 on märksa sagedamini harrastanud enda sõnul viimase 90 päeva jooksul anaalseksi.[59] 2011. aasta seisuga olid selle uuringu andmed kõige värskemad, mis kogurahvastiku tasandil saada olid.

Anaalseksi levimus võib varieeruda eri rahvastikurühmade, piirkondade ja rahvuste lõikes. 1999. aastal Lõuna-Koreas 586 naise seas tehtud uuringu kohaselt oli 3,5% vastajaist enda sõnul osalenud anaalseksis.[60] Seevastu jõudis 2001. aastal Prantsusmaal korraldatud küsitlus 500 naisvastaja andmete põhjal tulemusele, et seda oli harrastanud 29%, kellest kolmandik oli seda enda sõnul nautinud.[61]

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. 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%.[62] 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."[8] The increase of anal sexual activity among heterosexuals has also been linked to the increase in anal pornography, especially if a person views it more regularly than a person who does not.[4][44][45][63]

Mees mehele

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Käitumisviisid ja vaated

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19. sajandi erootiline tõlgendus keiser Hadrianuse ja Antinoose suhtest (fragment), kunstnik 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][10][64][65] 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.[66][67]

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.[23][64][68] The notion that it might resonate with gay men with the same emotional significance that vaginal sex resonates with heterosexuals has also been considered.[68][69] Some men who have sex with men, however, believe that being a receptive partner during anal sex questions their masculinity.[70][71]

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,[64][66][72][73] while other frot advocates denounce anal sex as degrading to the receptive partner and unnecessarily risky.[69][72][74]

Reports with regard to the prevalence of anal sex among gay men in the west have varied over time. Magnus Hirschfeld, in his 1914 work, The Homosexuality of Men and Women, reported the rate of anal sex among gay men surveyed to be 8%, the least favored of all the practices documented.[75] By the 1950s in the United Kingdom, it was thought that about 15% of gay males had anal sex.[76]

Similar to the Hirschfeld study, scholars state that oral sex and mutual masturbation are more common than anal stimulation among gay men in long-term relationships.[8][64] They say that anal intercourse is generally more popular among gay male couples than among heterosexual couples, but that "it ranks behind oral sex and mutual masturbation" among both sexual orientations in prevalence.[21] 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 18,000 MSM across Europe (EMIS, 2011) showed that oral sex was most commonly practised, followed by mutual masturbation, with anal intercourse in third place".[10] A 2011 survey by The Journal of Sexual Medicine found similar results for U.S. gay and bisexual men.[77]

Various older studies on male-to-male anal sex differ significantly. The 1994 Laumann study suggests that 80% of gay men practice anal sex and 20% never engage in it at all.[78] 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.[66] A survey conducted from 1994 to 1997 in San Francisco by the Stop AIDS Project indicated that over the course of the study, among men who have sex with men instead of solely gay men, the proportion engaging in anal sex increased from 57.6% to 61.2%.[79] The National Institutes of Health (NIH), with their report published in the BMJ in 1999, stated that two thirds of gay men have anal sex.[9] Other sources suggest that roughly three-fourths of gay men have had anal sex at one time or another in their lives, with an equal percentage participating as tops and bottoms.[66] WebMD reports that "an estimated 90% of men who have sex with men" practice receptive anal intercourse.[1]

Naine mehele

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

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][25][80] Sex toys, such as a dildo, may also be used.[5][25] The practice of a woman penetrating a man's anus with a strap-on dildo for sexual activity is called pegging.[24][81]

Commonly, heterosexual men reject the idea of being receptive partners during anal sex because they believe it is a feminine act, can make them vulnerable, or contradicts their sexual orientation (for example, that it is indicative that they are gay).[25][71] National Institutes of Health (NIH) information published in the BMJ in 1999, however, states:

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.[9]

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".[82]

Naine naisele

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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.[11][83] Some lesbians do not like anal sex,[84] and anilingus is less often practiced among female same-sex couples.[85][86]

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).[3] While author Tom Boellstorff, when particularly examining anal sex among gay and lesbian individuals in Indonesia, stated that he had not heard of oral-anal contact or anal penetration as recognized forms of lesbian sexuality but assume they take place,[87] author Felice Newman, in The Whole Lesbian Sex Book, cites anal sex as a part of lesbian sexual practices.[11]

Terviseriskid

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Üldised riskid

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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.[17][19] Unprotected penile-anal penetration, colloquially known as barebacking,[88] 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.[17][19] 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.[19] Use of condoms, ample lubrication to reduce the risk of tearing,[3][46] and safer sex practices in general, reduce the risk of STI transmission.[19][89] 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.[19] As with other sexual practices, people without sound knowledge about the sexual risks involved are susceptible to STIs; for example, because of their definitions of sexual activity and virginity loss, teenagers may consider vaginal intercourse riskier than anal intercourse and believe that a STI can only result from anal intercourse.[90][91]

Unprotected receptive anal sex (with an HIV positive partner) is the sex act most likely to result in HIV transmission.[17][18][19] Other infections that can be transmitted by unprotected anal sex are human papillomavirus (HPV) (which can increase risk of anal cancer[92]); typhoid fever;[93] amoebiasis; chlamydia;[18] cryptosporidiosis; E. coli infections; giardiasis; gonorrhea;[18] hepatitis A; hepatitis B; hepatitis C; herpes simplex;[18] Kaposi's sarcoma-associated herpesvirus (HHV-8);[94] lymphogranuloma venereum; Mycoplasma hominis; Mycoplasma genitalium; pubic lice;[18] salmonellosis; shigella; syphilis;[18] tuberculosis; and Ureaplasma urealyticum.[95]

There are a variety of factors that make male-to-female anal intercourse riskier for a female than for a male. For example, besides the risk of HIV transmission being higher for anal intercourse than for vaginal intercourse,[1][96][97] the risk of injury to the woman during anal intercourse is 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.[1][98][99] Additionally, if a man moves from anal intercourse immediately to vaginal intercourse without a condom or without changing it, infections (including urinary tract infections) can arise in the vagina 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.[1][3][100]

Though 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.[101][102]

Pain during receptive anal sex among gay men (or men who have sex with men) is formally known as anodyspareunia.[15] One study found that about 12% of gay men find it too painful to pursue receptive anal sex, and 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.[103] Another study that examined pain during insertive and receptive anal sex in gay men found that 3% of tops (insertive partners) and 16% of bottoms (receptive partners) reported significant pain.[104] 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.[15][16][103][104]

Füüsilised vigastused ja vähk

[muuda | muuda lähteteksti]

Anal sex can exacerbate hemorrhoids and therefore result in bleeding; in other cases, the formation of a hemorrhoid is attributed to anal sex.[1][105] 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.[1][105] 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.[19] 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][106]

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).[1][105] Rectal prolapse is relatively uncommon, however, especially in men, and its causes are not well understood.[107][108] Kegel exercises have been used to strengthen the anal sphincters and overall pelvic floor, and may help prevent or remedy fecal incontinence.[1][109] A 1993 study indicated that fourteen out of a sample of forty men receiving anal intercourse experienced episodes of frequent fecal incontinence.[110] However, a 1997 study found no difference in levels of fecal incontinence between gay men who engaged in anal sex and heterosexual men who did not, and criticized the earlier study for its inclusion of flatulence in its definition of fecal incontinence.[111]

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.[92] 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."[92] 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."[92]

Vaated teistes kultuurides

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Depiction of anal sex on 510 BC 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][63][112] 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][63] A number of cultures have especially recorded the practice of anal sex between men, and anal sex between men has been especially stigmatized or punished.[7][68][113] In some societies, if discovered to have engaged in the practice, the individuals involved were put to death, such as by decapitation, burning, or mutilation.[5]

Although anal sex has been more accepted in modern times, and is often considered a natural, pleasurable form of sexual expression,[5][7][63][112] with some people, men in particular, only interested in anal sex for sexual satisfaction,[63] engaging in the act is still punished in some societies.[7][114] 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".[114]

Vanaaja kultuurid ja kultuurid väljaspool Läänt

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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.[115] Ancient Greeks accepted romantic or sexual relationships between males as a balanced sex life (having males and women as lovers), and they considered this "normal (as long as one partner was an adult and the other was aged between twelve and fifteen)".[116]

Homosexual anal sex was not a universally accepted practice in Ancient Greece; it was the target of jokes in comedies.[117] Aristophanes, for instance, mockingly alludes to the practice, claiming, "Most citizens are europroktoi (wide-arsed) now."[118] The terms kinaidos, europroktoi, and katapygon were used by Greek residents to categorize men who practiced passive anal intercourse.[119] While pedagogic pederasty was an essential element in the education of male youths, these relationships, at least in Athens and Sparta, were expected to steer clear of penetrative sex of any kind. There are very few works of pottery or other art that display anal sex between men and boys, let alone between adult men. Greek artwork of sexual interaction between men and boys usually depicted fondling or intercrural sex, which was not condemned for violating or feminizing boys.[120] Intercrural sex was not considered penetrative and two males engaging in it was considered a "clean" act.[117] Other sources explicitly state that anal sex between men and boys was criticized as shameful and seen as a form of hubris.[120][121]

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 heterosexual anal intercourse as a means of preventing pregnancy.[122]

A male citizen taking the passive (or receptive) role in anal intercourse was condemned in Rome as an act of impudicitia (immodesty or unchastity); free men, however, frequently took 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.[123] 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.[123] 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".[123] 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".[124]

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

In Japan, records (including detailed shunga) show that some men engaged in penetrative anal intercourse with other men,[125] and evidence suggestive of widespread heterosexual 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 heterosexual anal intercourse significantly more than any other sex act.[126] 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.[127]

19th century anthropologist Richard Francis Burton theorized that there is a geographical Sotadic zone wherein penetrative intercourse between men is particularly prevalent and accepted; moreover he was one of the first writers to advance the premise that such an orientation is biologically determined.[128]

Lääne kultuurid

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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.[129] At that time, celibate members of the Christian clergy were accused of engaging in "sins against nature," including anal sex.[130]

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;[131] when they spread out of the country, they were called buggres (from the ethnonym Bulgars).[131] Another term for the practice, more archaic, is pedicate from the Latin pedicare, with the same meaning.[132]

The Renaissance poet Pietro Aretino advocated anal sex in his Sonetti Lussuriosi (Lust Sonnets).[133] 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;[134] 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".[135]

François-Rolland Elluin, Sodomites provoking divine wrath, from Le pot-pourri (1781)
Ottoman illustration depicting two young men having sex (from Sawaqub al-Manaquib)

The Mishneh Torah, a text considered authoritative by Orthodox Jewish sects,[136] 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."[137]

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).[138][139][140]

Liwat, or the sin of Lot's people, which refers 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.[141] 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,[142] 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, meaning that they are giving in to a universal temptation.[142][143]

The most common formulation of Buddhist ethics is the Five Precepts. These precepts take the form of voluntary, personal undertakings, not divine mandate or instruction. The third of the Precepts is "To refrain from committing sexual misconduct".[144] However, "sexual misconduct" (Sanskrit: Kāmesu micchācāra, literally "sense gratifications arising from the 5 senses") is subject to interpretation relative to the social norms of the followers.[145] Buddhism, in its fundamental form, does not define what is right and what is wrong in absolute terms for lay followers. Therefore the interpretation of what kinds of sexual activity are acceptable for a layman is not a religious matter as far as Buddhism is concerned.[146]

Although Hindu society does not formally acknowledge sexuality between men, it formally acknowledges and gives space to sexuality between men and third genders as a variation of male-female sex (meaning a part of heterosexuality, rather than homosexuality, if analyzed in western terms). Hijras, Alis, Kotis, etc. (the various forms of third gender that exist in India today) are all characterized by the gender role of having receptive anal and oral sex with men. However, sexuality between men (as distinct from third genders) has thrived, mostly unspoken and informally, without being seen as different in the way it is seen in the west; young men involved in "such relationships do not consider themselves to be 'homosexual' but conceive their behavior in terms of sexual desire, opportunity and pleasure".[147]

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  43. 43,0 43,1 Vt lk 560 pornograafia mõju kohta arusaamadele anaalseksist ning lk 286–289 anaalseksi kui sündimuskontrollimeetodi kohta. Robert Crooks, Karla Baur (2010–2011). Our Sexuality. Cengage Learning. Lk 570 pages. ISBN 0495812943. Vaadatud 7. mai 2013.
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  51. 51,0 51,1 Vt siin ja lk 48–49 uurijate ja heteroseksuaalide enamiku kohta, kes määratlevad neitsilikkuse kaotust ja "tehnilist neitsilikkust" selle põhjal, kas inimene on või ei ole olnud vaginaalses vahekorras. Laura M. Carpenter (2005). Virginity lost: an intimate portrait of first sexual experiences. NYU Press. Lk 295 pages. ISBN 978-0-8147-1652-6. Vaadatud 9. oktoober 2011.
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  54. Ken Plummer (2002). Modern Homosexualities: Fragments of Lesbian and Gay Experiences. Routledge. Lk 187–191. ISBN 1134922426. Vaadatud 24. august 2013. "Seksi" sotsiaalne konstrueerimine vaginaalse suguühtena mõjutab seda, kuidas hinnatakse teiste suguliste tegevuste rahuldavust või erutavust; mõnel juhul ka seda, kas mingit tegevust üldse seksuaalseks peetakse. Näiteks juhul, kui naist pole mehe peenisega penetreeritud, on ta tehniliselt endiselt neitsi, isegi kui tal on ulatuslik seksuaalkogemus.
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