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What are the stages of the sexual response cycle?

To discuss sexual dysfunction, a primer on human sexuality is essential. Human sexuality is not a static concept, but one that is dynamic and multidimensional. It is a product of interpersonal, biological, psychological, and cultural mechanisms that help formulate an individual's personal view of sexuality. Each individual has a personal and unique sexual schema; it is not possible to impose a singular approach and view on sexuality that applies uniformly across races, sexes, and ages. Much of what we understand about normal sexual function is based on the work done by William Masters and Virginia Johnson in the late 1950s through the 1990s. Masters and Johnson are credited with characterizing the physiologic and biological changes that comprise the sexual response. Later, with the addition of input from Helen Singer Kaplan, desire became incorporated into the model.

One act of sexual intercourse burns 200 calories or is about the equivalent of 30 minutes of jogging.

Following is a description of the phases of human sexual response.

Sexual Desire or Interest

Sexual desire is often characterized as innate hunger or interest in pursuing sexual activity. With respect to female subjects, there is often conflicting data as to normative sexual desire. Some emerging research demonstrates that about one-third of women are based in sexual neutrality, which means that they are responsive to sexual cues from their partners or their environment. (For example, she gets the warm fuzzies at the sight of a special bouquet or box of chocolate.) Another third have a baseline of low to moderate desire on a daily basis, and this can be escalated or diminished depending on the situation or circumstances. The final third may operate more like men, with heightened sense of sexual desire and hunger for the pursuit of sexual activity.

Arousal

The arousal stage of the sexual response cycle is characterized by physical changes in your body. Blood pressure and heart rate become more rapid. Breasts may increase in size and nipples may become erect. The vaginal walls swell, and increased lubrication[1] occurs. The clitoris may become swollen, and the inner two thirds of the vagina lengthen. Arousal or excitement is often accompanied with tingling feelings or inner warmth in the genital areas.

Plateau

The plateau is described as the peak of sexual pleasure or plateau right before impending orgasm. Throbbing or feelings of fullness in the pelvis may occur. You may also get a flush on your face, chest, and breasts.

Orgasm

Orgasm is often described as an intense, pleasurable, euphoric, whole-body sensation that is achieved at the peak of sexual stimulation. Rhythmic contraction of the pelvic genital structures (vaginal, anal, and uterine muscles) occurs and an intense feeling of pleasure occurs. Some may have one orgasm and then feel satisfied and complete, whereas others enjoy repetitive multiple orgasms in a row. There are many types of orgasms, including clitoral, vaginal, and uterine orgasms. About a third of women mention that they have rarely or never achieved orgasm from intercourse unless breast and/ or clitoral stimulation occurs simultaneously. Some may feel uterine contractions when orgasm occurs; others enjoy the direct pressure of the cervix[2] being stimulated. Recently, twin studies have reported that the ease of reaching orgasm may be genetically predetermined and inherited.

Resolution

In the resolution phase, heart rate, breathing, and body temperature return to normal or baseline. Blood flows away from the genital and vaginal areas, and you may return to the presexual state of being. Nipples and breasts return to a normal state without arousal. You may feel a sense of euphoria and fatigue.

Originally, sex researchers assumed that women were linear in terms of their progression from one phase of sexual response to another: desire leads to arousal followed by plateau, and then orgasm, and finally resolution. A novel cyclic intimacy-based model developed by prominent sexual health care clinician Dr. Rosemary Basson focuses on a more cyclic experience of female sexual response, where the cycle can be entered at any point. Women experience phases of the sexual response in an overlapping, nonsequential manner that not only incorporates physical but psychological issues as well. An important issue with this model is that sexual desire does not necessarily precede sexual stimulation or arousal. Women may enter sexual activity by being neutral, and then be motivated to enjoy and pursue sexual intimacy to enhance connectedness with their partners. Others may enjoy sex merely for sexual activity.

Sexual activity creates both positive and negative feelings/ motivations toward subsequent episodes. Receptivity and responsive desire (desire felt after your partner has expressed interest) are key elements in the Basson model. Recent data also suggest that some women follow the original stepwise cascade of the progressive concept of the sexual cycle of desire to arousal to orgasm, whereas others follow the circular pattern as described by Rosemary Basson. Women are unique, and you may ascribe to one model or the other in different circumstances. It is important to understand that sexuality is fluid and that perhaps either model suits you.

  • [1] The natural appearance of slippery secretions in the vagina during sexual arousal or the use of artificial lubricants to facilitate sexual activity or intercourse.
  • [2] From the Latin word meaning neck; it is the lower most part of the uterus that protrudes into the vagina.
 
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