Suggested MPAA rating: NC-17 for "extreme sexual violence, disturbing graphic sexual content, and for brief explicit sexual images".
A couple have sex in slow-motion black and white, moaning is not audible. Legs and shoulders up are mainly shown, but there is a close-up shot of genital penetration for about 5 seconds. Eventually they climax. This scene is NOT simulated.
A nude woman straddles her husband as they thrust in a scene before he chooses to stop, causing her to run outside. She masturbates, gasping heavily (full-frontal nudity shown in close-up). Then her husband (or an illusion) crawls on top of her and they continue.
A woman stimulates a man's penis which is clearly visible as is the ejaculation, Please see Violence/Gore section
A woman holds scissors to her vulva, then to her clitoris, both which are depicted clearly, Please see Violence/Gore section
Two scenes of mostly clothed sex (one shows the man's buttocks). A man and woman playfully roughhouse, not too drawn-out.
A woman cuts her own clitoris off. Blood briefly runs out of the wound before the scene cuts. This is shot in close up and is extremely graphic.
A man's testicles are crushed partly offscreen while he remains unconscious. He is then masturbated, ejaculating blood (briefly seen in close up). This is all extremely graphic. A hole is then drilled into his leg and a metal rod with weight is inserted. After awaking, he winces as he drags himself away.
A bloody dead newborn fawn is stuck to a deer's back for some seconds. A fox eats at his own guts, then stops and talks to a man.
An infant falls and hits the ground. Nothing heard, a bit of blood is briefly seen from a distance. A woman is strangled bloodlessly for about 10 seconds. A man (or an illusion of one) slaps a woman twice upon her request before a sex scene ensues.
"Fuck" is used once. "Bastard" is said a couple times.
A man is briefly drinking a small amount of red wine from glass. Talk of prescription medication. Pills are seen, but not taken.
Certain scenes in the "Violence" section could easily qualify as frightening or intense. The subject matter is fairly unsettling.
OFFICIAL AGE RATINGS:
USA - Not Rated
UK - 18 (strong real sex, bloody violence, self-mutilation)