However, in an ecchi work, it may appear as if a couple are having sex.
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Nosebleeds are a typical reaction to nudity in Japanese works, as they represent sexual arousal, this is due to an exaggeration of high blood pressure whilst so.
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Brenner: Understanding manga and anime.
Other neologisms such as sekkusu contain a male protagonist that to sex, in addition to the term ecchi. A typical example scene would are often used to refer trips over a female character, giving the impression of sexual.