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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.The 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".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.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.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.

Anal sex is considered a high-risk sexual practice because of the vulnerability of the anus and rectum.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.With regard to adolescents, limited data also exists.sources sometimes use the term anal intercourse to refer exclusively to penile-anal penetration, and anal sex to refer to any form of anal sexual activity, especially between pairings as opposed to anal masturbation.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 termed the G-spot) in women, and other sensory nerves (especially the pudendal nerve).

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