I don't know if this is supposed to be some type of «retention» check, but it makes it a big pain in the butt. (thecollegeinvestor.com)
A twisted ankle would be a real pain in the butt here. (travelfish.org)
I know from personal experience that pregnancy acne can be a huge pain in the butt and that it can definitely impact how you feel about yourself. (hauteandhealthyliving.com)