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The vaginal walls contain significantly fewer nerve endings than the clitoris and anus, 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.

Indirect stimulation of the clitoris through anal penetration may also be caused by the shared sensory nerves, especially the pudendal nerve, which gives off the inferior anal nerves and divides into two terminal branches: the perineal nerve and the dorsal nerve of the clitoris.

Carpenter stated that this view "dates to the late 1600s, with explicit 'rules' appearing around the turn of the twentieth century, as in marriage manuals defining petting as 'literally every caress known to married couples but does not include complete sexual intercourse.'" In Kimberly R.

Mc Bride's 2010 clinical review on heterosexual anal intercourse and other forms of anal sexual activity, it is suggested that changing norms may affect the frequency of heterosexual anal sex.

Because of this, some couples practice anal intercourse as a form of contraception, often in the absence of a condom.

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.

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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.

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.

Men may also enjoy the penetrative role during anal sex because of its association with dominance, because it is made more alluring by a female partner or society in general insisting that it is forbidden, or because it presents an additional option for penetration.

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