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Activities and relationships within a BDSM context are often characterized by the participants taking on complementary, but unequal roles; thus, the idea of informed consent of both the partners is essential.

Failure to honor a safeword is considered serious misconduct and could even change the sexual consent situation into a crime, depending on the relevant law, since the bottom or top has explicitly revoked his or her consent to any actions that follow the use of the safeword (see Legal status).

For other scenes, particularly in established relationships, a safeword may be agreed to signify a warning ("this is getting too intense") rather than explicit withdrawal of consent; and a few choose not to use a safeword at all.

The interaction between tops and bottoms—where physical or mental control of the bottom is surrendered to the top—is sometimes known as "power exchange", whether in the context of an encounter or a relationship.

BDSM actions can often take place during a specific period of time agreed to by both parties, referred to as "play", a "scene", or a "session".

For the medical condition in which pain/humiliation is required for sexual arousal and causes distress or impairment, see Sexual masochism disorder.

BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics.

Despite the bottom performing the action and the top receiving they have not necessarily switched roles.

The abbreviations "sub" and "dom" are frequently used instead of "submissive" and "dominant".

Sometimes the female-specific terms "mistress", "domme" or "dominatrix" are used to describe a dominant woman, instead of the gender-neutral term "dom".

Individuals who can change between top/dominant and bottom/submissive roles—whether from relationship to relationship or within a given relationship—are known as switches.

The resulting consent and understanding is occasionally summarized in a written "contract", which is an agreement of what can and cannot take place.