The movie is basically a festival of shock and gore, but it does show that women don't necessarily need to be victims in this kind of movie. They can fight back -- and indeed, be stronger than just about anyone else. Although it ultimately doesn't feel like much of a victory for the heroine, she at least gets to survive.
Many characters die in many gruesome ways, with lots of blood and gore. Characters are killed with arrows, knives, axes, screwdrivers, blenders, and machetes; heads are smashed; necks are sliced with wire; heads are cut off; and there's a shooting.
A few women are shown topless, and sex is implied between various characters. One character wishes to have sex with a man "on a bed next to his dead mom."
Language isn't constant but does include many uses of "f--k," plus "s--t," "damn," "oh my God," and more.
Adult characters are shown drinking casually (i.e. at dinner). A character takes some Vicodin.