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Peanut Butthurt is a play on the word "Peanut Butter". It is a sexual act that involves anal sex using crunchy peanut-butter as lube. Shards of peanuts that are present in crunchy-peanut butter can cause minute lacerations inside the rectum, which causes pain to the person on the receiving end of the "Peanut Butthurt". Hence the name.
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