The thought that they are submitting to such a degrading act is a terrific thrill. However, actual, not fantasized, anal pain can lead to trouble. For others, the enjoyment of anal sex is inhibited by top-bottom imagery. The idea of surrendering control, and perhaps submitting to humiliation, causes immediate, protective tensing of the anal muscles. These individuals are more likely to relax and enjoy themselves if they can learn to regard anal sex as pleasurable rather than as an expression of power.
Anal sex can be perfectly safe, even beneficial.
The taboo against anal eroticism is perpetuated by the almost universal belief among physicians that anal sex is inevitably dangerous. No physical injury from anal stimulation results if both partners refuse to tolerate pain, never use force and avoid the use of drugs. All the other risks center on sexually transmitted diseases. Intestinal parasites, bacteria or tiny bugs are usually passed along when fecal matter finds its way into someone's mouth or vagina, most likely through rimming. AIDS has complicated the matter.