Anal sex practices and rectal erogenous zone maps among men and women of diverse sexual orientations: an anatomic-map based questionnaire study.

Background: There is limited research about the prevalence of receptive anal intercourse (RAI), erogeneity and sexual pleasure within the zones of the rectum.

Aim: We describe the experience of RAI within a large and diverse population in an online convenience survey, to map zones of erogenous sensation within the rectum, and to assess orgasm function among individuals who practice RAI.

Methods: Adult subjects were recruited from an online survey platform and were queried about their history of RAI. Those who endorsed RAI were shown illustrations of the rectum divided into four non-overlapping anatomic regions. Subjects designated regions where they experienced pleasure when touched during RAI. Subjects were also asked about their ability to achieve orgasm from RAI alone or if they required co-stimulation of additional regions. Demographics were collected, and differences were analyzed based on gender, age, and sexual orientation identity.

Outcomes: Outcomes include mapped erogeneity of the rectum among men and women and self-reported experiences with RAI, including orgasm function related to RAI among cisgender adults.

Results: A total of 466 cisgender men (mean age ± SD, 46.3 ± 17.5 years) and 498 cisgender women (48.1 ± 16.0 years) completed the questionnaire. Women were significantly more likely to endorse prior RAI, as compared to men (34% vs 24%, P < .01). Men were significantly more likely to endorse achieving orgasm from RAI alone, as compared to women (39% vs 19%, P < .05). Gay men and women were more likely to have participated in RAI. The superficial anterior rectum was the most frequently selected region by both men and women as a site of pleasure when touched during RAI.

Clinical implications: The results of this study will highlight preferred zones of erogeneity in the rectum, which could be impacted by surgeries or pathology in these areas.

Strengths and limitations: This study captured a comprehensive assessment of erogenous sensation within the rectum among a large sample. Limitations include the use of a online subjects for data collection, which can result in both response and selection bias.

Conclusion: Our findings show that RAI is practiced by many adults across ages, gender, and sexual orientation identities. Both men and women report pleasure from various areas within the rectum, primarily the superficial regions of the rectum. These findings may prove helpful in elucidating practices of RAI. Additionally, understanding erogeneity in the rectum may allow providers to better predict changes due to pathology and treatments of or surrounding these areas.