Sexual Arousal and Response
Sexual Arousal Has Multiple Roots
I. Sexual arousal – an acute psychological state of excitement marked by sexual feelings,
attractions or desires; it is also a physiological state marked by changes in the genitalia
A. Psychological & physiological arousal usually go together, but not always
B. Sexual arousal may be triggered by external events like appearance of a sexually attractive
person or by some particular aspect of that person (sexually suggestive behavior, their nudity)
C. However, arousal may come entirely from within, apparently triggered by nothing (spontaneous
sexual arousal)
II. Sexual fantasy is imagined sexual experiences during waking hours; it is a route by which internal
mental processes promote sexual arousal
A. The great majority of men & women engage in sexual fantasy
B. Men engage in sexual fantasy quite a bit more than women both in the regular course of the day
& during masturbation or sex with a partner
1. One study – heterosexual male & female college students were asked to keep written records
of all their sexual fantasies as they had them
2. Another study - >4000 men & women were asked whether they had thought about sex within
the previous 5 minutes
C. Content of sexual fantasies varies greatly, but the common items are fairly similar to the kinds
of behaviors people actually engage in, according to one study of heterosexual college students
1. Over half of both males & females reported that they had recently fantasized the following
activities:
2. There are some gender differences in fantasy content
a. Men were much more likely than women to fantasize:
b. The only behavior that women fantasized significantly more often than men was ……..
c. In general, the men were more adventurous in their fantasies
(1) Women nearly always fantasized about sexual behaviors that they had at some time
engaged in
D. Questions about fantasies are often used to assess sex orientation, under the assumption that sex
of person's fantasy partners should give a more truthful indication of what they find arousing…
1. Moreso than asking them directly about their attraction to men and to women
2. This assumption is debatable as shown by another study (Hsu et al., 1994)
E. To some extent, sexual fantasies of males & females differ in a way that is consistent with
stereotypes about male & female sexuality
1. Men are more likely to focus almost exclusively on the visualization of explicit sexual
behavior & their fantasies often involve taking a dominant role in sex acts
F. People sometimes feel guilty about their sexual fantasies, especially if the fantasies involve
behaviors in which they wouldn't want to engage in real life
1. Yet people who can enjoy a range of sexual fantasies without experiencing guilt seem to have
a more satisfying sex life
2. Many women have fantasies in which they are sexually coerced, raped or otherwise subjected
to force by a partner; is this healthy or unhealthy? – one study
III. Arousal occurs in response to a partner – being with an actual or potential sex partner in real life is a
potent trigger to arousal, especially if that person is judged sexually attractive
A. In such a situation, both men & women are aroused by looking at the partner's face, but men also
find looking at their partner's genital area arousing
1. Men are more likely than women to report that they are highly aroused by watching their
partner undress
B. Arousal increases as flirting or other forms of sexual negotiation proceed
C. To identify brain regions that are involved in sexual arousal, researchers showed erotic film clips
to subjects who are undergoing functional brain imaging
1. Among the brain regions that light up under these conditions is a region of the cerebral cortex
called the anterior cingulate cortex
D. For reasons not well understood, sexual arousal appears to operate in a more specific manner in
men than in women
1. Men are aroused (psychologically & genitally) by erotic images that are appropriate to their
sexual orientation (straight men arouse by female images, gay men by male images)
2. Women are aroused by images of both women & men, regardless of whether they identify as
lesbian, straight or bisexual
IV. Sexual arousal is influenced by other forms of arousal
A. Studies suggest that emotional arousal of any kind (whether fear, anger, hilarity or another) can
promote sexual arousal – called misattribution of arousal
B. Donald Dutton & Arthur Aron (1974) – a female interviewer approached men who were crossing
one of 2 footbridges in British Columbia, Canada
1. One bridge was fear-inspiring (rickety, narrow230-ft high foot bridge spanning a rock-strewn
gorge; the other a solid, wide bridge that crossed a small rivulet at a height of only10 ft
2. The interviewer asked the men to write a story based on a picture they were shown; they were
also offered the interviewers phone number
3. Men who crossed the fear-inducing bridge included significantly more sexual content in their
stories than did the men who crossed the safe bridge
C. More recent studies have reported similar findings in better-controlled situations
1. Men & women entering or exiting a roller-coaster ride were shown photos of a person of the
other sex
D. This kind of misattribution of arousal occurs most readily when the original exciting event (the
ride) has already terminated, rather than when it is still happening
1. That's probably because the cause of the arousal is less apparent to the person, so they are
more likely to attribute it to some new stimulus, such as the photograph
V. Hormones influence sexual arousability - sexually arousing stimulus activates endocrine system,
hormones are secreted & changes in body occur; sexual hormones made in testes & ovaries
A. Testosterone - androgen made mostly in testes interstitial cells in men & ovaries in women
(although a small amount is made by adrenal glands); affects sexual interest (libido)
1. More testosterone —> more interest in sex; less testosterone —> less interest
B. A popular misconception is that testosterone influences sexual arousal – particularly in men – on a
minute-by-minute or hour-by-hour basis
1. A man who is feeling horny (experiencing an unfocused sense of sexual arousal & motivated
to find some way of satisfying it) might say that he "can feel the testosterone flowing" or the
like
2. In reality, testosterone does not seem to have any short-term influence on the sexual feelings of
either men or women – Georgia St. Univ., 1992
a. Looked at whether heterosexual couples would be more likely to have sex on evenings
when the testosterone level of one or both partners was high
C. There is evidence, however, that testosterone has a longer-term influence on our capacity to
experience sexual arousal
1. Clearest connection between testosterone levels & sexual arousability is found in boys around
the time of puberty
2. In one study of boys in grades 8,9 & 10 of a public school system, those boys who were
experiencing the rise in testosterone levels associated with puberty were much more likely
to…..
3. This finding is consistent with research in nonhuman animals, which suggests that testosterone
activates brain circuits involved in male-typical sex behavior; could be an alternate
interpretation
a. The rise in testosterone at puberty may stimulate only physical maturation & that
psychosexual development occurs as an indirect effect involving learning or social forces
4. An ideal experiment would be to vary testosterone levels in children artificially & then study
the effects on their sexuality; normally, conducting such an experiment would be unethical
a. However, some boys with delayed puberty receive testosterone as part of their treatment
b. A group of boys agreed to participate in a study in which their testosterone treatments were
alternated with placebo treatments in a double-blind design
5. Testosterone levels do influence sexual arousability in adult men
a. In fact, men who have profound reduction in testosterone levels for any reason
(hypogonadal men) suffer a gradual decline in sexual desire & activity
b. This decline can be reversed by testosterone replacement therapy
D. The situation in women is more complex because at least two groups of hormones are involved —
androgens (including testosterone) & estrogens — & their levels vary around the menstrual cycle
1. Testosterone levels in women are quite low compared with those in men—roughly 10 – 20
times lower—so it is less likely that these levels are at a "ceiling"
E. Penn St. study of children with delayed puberty included girls as well as boys – the girls were
treated with oral estrogens, which had almost no effect on the girls' sexual thoughts or behaviors
1. In general, it appears that testosterone is more important than estrogens in influencing female
sexual arousability, both in adolescent girls & in adult women
2. Estrogens may have important indirect effects on sex, however
F. Some people turn to chemical aids – androstenedione (andro), which is marketed as dietary
supplement & thus not regulated by FDA
1. Athletes use it to help them recover from weight-training workouts; it is a steroid
hormone & close cousin of testosterone, so some use it to enhance sexual satisfaction
2. Two problems with doing this:
VI. Conditioning may influence arousal
A. Classical or Pavlovian conditioning is the name given to a form of associative learning first
studied by Ivan Pavlov in the early 20th century
B. It's plausible that classical conditioning influences sexual arousal; in a Canadian study,
researchers repeatedly showed male subjects a photograph of a moderately attractive, partially
nude woman
1. Some of the subjects viewed the photo by itself; the others viewed it in conjunction with a
highly arousing video of heterosexual sex
2. Over time, the men who viewed the photo alone were less & less strongly aroused by it — this
is an example of habituation
C. Classical conditioning could influence how sexual arousal changes over time in real-life situations
such as steady relationships
1. Thus, we may be more strongly aroused by our partner over time, simply because of the
arousing effect of sexual interactions with that partner
D. It has also been suggested that conditioning could explain the development of unusual sexual
desires such as fetishisms
Aphrodisiacs Are Sometimes Reputed to Be a Root of Sexual Arousal
I. Aphrodisiacs: general background information – named after Greek goddess of love Aphrodite
A. A substance that arouses/improves one's sexual desire, sexual performance or sexual pleasure and/or
enhances sexual response or causes someone else to respond to one's advances or fall in love with oneself
B. Traditionally, the belief that certain substances are aphrodisiacs has been based on magical
thinking, especially the "law of similarity", which holds that "like produces like"
1. Thus, aphrodisiacs have been derived from things that resemble penises (e.g., rhino horns)
or vulvas (e.g., oysters) or from sex organs or secondary sexual structures of animals like:
2. The flower used by Oberon as a love potion (the love-in-idleness or wild pansy) is purple
in color & thus resembles blood, the supposed seat of passionate feelings
C. It's not likely that any of these substances work, at least by objective criteria
1. New Zealand researchers recently conducted a double-blind, placebo-controlled trial of deer
velvet & found absolutely no effect on men's sexual function or that of their partners
II. Substances that have been reputed to be aphrodisiacs
A. Ginseng root – has long been used in Eastern medicine as a treatment for sexual dysfunctions
1. Controlled scientific studies support ginseng's usefulness; it facilitates sexual behavior in
male rats & helps alleviate erectile dysfunction in men
B. Another class of substances that are sometimes used as aphrodisiacs is that of recreational drugs;
here the issue is not so much whether they work — they often do — but their safety
1. Amyl nitrite (poppers) & related drugs like butyl nitrite; these are toxic substances
a. Designed for use by heart patients to reduce chest pain – its container is popped open
when chest pain occurs (hence the nickname poppers)
b. They are administered by inhalation, produce a brief "rush" during which time sexual
feelings are enhanced & the pleasurable sensations of orgasm are intensified
2. Marijuana – the most widely used illicit drug in the US; tends to exaggerate preexisting
personality traits & thus has very different effects in different people
a. Can distort perceptions & make one think that sexual experience continued longer than
it really did; can lead to problems in short run & over prolonged use; also marijuana is
illegal
3. Methamphetamine (speed) – a highly addictive drug that has a reputation as a powerful
aphrodisiac; many people use it primarily to enhance their sexual experiences
4. Cocaine – in moderate doses, can enhance sexual sensations but in high doses or with chronic
use can cause erectile difficulties as well as inability to achieve orgasm (in both men &
women)
5. MDMA ("Ecstasy") – a serotonin-related drug that can increase sexual arousal as well as
general energy & euphoria
a. It can have serious adverse effects in people with cardiovascular problems
6. Alcohol – a central nervous system (CNS) depressant that can facilitate sexual expression by
removing inhibitions
a. In high doses, it can interfere with sexual arousal & impair performance rather than
enhance it
7. Spanish fly (canthardin) – results in irritation of urinary tract; it has led to substances that
make one horny (ground up rhinoceros horns or elephant tusks which do not work)
8. Bupropion (antidepressant; acquired under brand name of Wellbutrin) & L-Dopa (used for
treating Parkinson's disease)
a. Both act on brain receptors that produce dopamine & so can increase libido
9. Yohimbine hydrochloride (from sap of West African tree, the yohimbine tree) – has
potential; reported to aid some men with erectile dysfunction
a. Helps to achieve & maintain erection for long-enough period to engage in sexual
intercourse; does not work for all men with erectile dysfunction
10. Drugs that inhibit sexual desire also being looked at – used by military to diminish sexual
desire of soldiers & used in summer camps to control urges of teenagers
a. All potassium nitrate does is increase need to urinate; some people think that is enough
to interfere with sex
b. Some drugs do interfere with sexual response – tend to be CNS depressants like:
C. A safety issue that applies to use of all recreational drugs in a sexual context is that they may
impair judgment, thus promoting unsafe sex, sexual victimization or sexual encounters that are
later regretted
How the Mind and Body Control Sexual Response
I. Unaroused state in males & females - after sexual excitement diminishes, structures below return
to prearoused state; this takes some time & varies from person to person
A. Male: penis – flaccid; scrotal sac – skin is wrinkled, thin, loose; testes – hang down from
body
B. Females: labia – thin & enclose vestibule; clitoris - extends from under the clitoral hood; vagina
– inner part remains elongated; nipples of breast – not erect
II. Sexual pleasure & satisfaction – both psychological & physiologically based
A. Without subjective feeling of pleasure, physiological arousal will not occur; if body odor is
bad, arousal for male or female will be difficult
III. With sexual arousal, several different parts of body work together to create psychological
feeling of arousal & accompanying physiological reactions
The Brain, Nervous System and Sexual Response
I. The brain: the body's master, a key player – brain interprets stimulation (visual, olfactory or
other) & begins process of activating other body parts
A. Brain includes 2 major components – cerebral cortex (upper part) & subcortex (lower part);
subcortex includes cerebellum, medulla oblongata, pons & diencephalon
1. Cerebellum –
2. Medulla oblongata –
3. Pons –
4. Diencephalon –
a. Thalamus –
b. Hypothalamus –
B. Limbic system (seat of emotions) – consists of thalamus & hypothalamus (the diencephalon)
& other structures important in sexual arousal
1. Connected to diencephalons & primarily concerned with emotions & their behavioral
expression
C. Cerebral cortex (gray matter) – controls higher order abstract functioning (language,
judgment); can also control more primitive areas of brain
D. Reticular activating system (RAS) – in past, cortical & subcortical functions considered to be
dichotomized; behavior was thought to be function of one area of brain or other
1. Now believed to be neurological connections between cortex & subcortex that feed
information back & forth
2. This network of nerves, the RAS, can be considered the connection between mind &
body; reticular body is a kind of two-way street
II. The brain & sexual response – if you encounter a sexual stimulus, message is passed to brain via
nerves; generalized no 2 people exactly the same so no 2 react exactly the same
A. Once reaching brain, message passes through RAS either from or to the limbic system &
thalamus
B. Next, hypothalamus is activated & in turn activates autonomic nervous system (ANS) &
endocrine system through messages sent via nerves or substances released into blood
1. Language development, body organ & NS growth & perceptual/motor development
proceed in sequence
III. Great deal of variation in sexual response, even though there are certain typical means of
responding to sexually stimulating stimuli
A. No 2 people exactly the same so no 2 people react exactly the same
B. Due to illness or injury, some typical responses may be precluded for some people
C. Some people have little control over apparently involuntary responses; others are able to
exercise some control
IV. Autonomic nervous system (ANS) – consists of sympathetic & parasympathetic nervous
systems; these subnervous systems connect to various parts of body through nerves
A. As sexually arousing stimuli are experienced, messages are sent via nerves to body parts,
instructing them to react
1. Heart rate increases, muscles tense, perspiration occurs, mind starts racing
2. Certain arteries are instructed to open (dilate) & allow more blood to flow through
3. Increase of blood to genital area is called engorgement; also creates pressure on walls of
vagina leading to vaginal lubrication
B. Muscles also contract as a result of messages sent through nerves that make up ANS
1. In men, contractions of Cowper's gland, seminal vesicles & prostate gland result in fluids
being secreted into semen
Masters & Johnson Sexual Response Cycle: Four Phases of Human Sexual Response
I. Excitement phase – the period during which sexual arousal begins; sexual stimuli result in a
number of specific changes in the bodies of men & women
II. Plateau phase – excitement becomes enhanced; a state of high arousal that may be maintained
for some time, from several minutes to several hours (in the case of extended lovemaking)
III. Orgasm phase – orgasm is the subjective experience of intense pleasure & release at sexual
climax, as well as the accompanying physiological processes; it is very similar in men & women
IV. Resolution phase – return to unaroused state; the period during which the physiological signs of
arousal reverse themselves
Masters & Johnson Sexual Response Cycle: Excitement Phase
I. Excitement phase – the period during which sexual arousal begins; sexual stimuli result in a
number of specific changes in the bodies of men & women
II. Changes that occur during this phase - heart rate, blood pressure & muscle tension all increase in
both sexes; various components of the excitement phase don't always occur together or to the same
degree
A. In women - blood engorges abdominal area, resulting in increase in clitoral & nipple erection
as well as increase in size (swelling) of labia minora & vagina & opening up of labia minora
1. Vaginal lubrication (transudation [see below]) occurs; there's also a deepening in the color
of the labia minora & the vaginal walls (caused by vasocongestion)
a. When female is sexually aroused, blood flows into area surrounding walls of vagina
(vasocongestion)
2. There is also swelling of the breasts & the labia majora spread & separate to make
vestibule more accessible
B. In men - blood engorges the abdominal area, resulting in increase in penile erection
1. In healthy & highly aroused young men, process of erection takes only a few seconds; usually,
the corpora cavernosa become erect first, followed more slowly by the corpus spongiosum
2. Testes move closer to body (elevate) due to contraction of the cremaster muscle
3. Scrotal sac skin thickens, tightens & becomes more wrinkled during this phase (due to
contraction of an underlying muscle layer)
C. Engorgement of blood is also responsible for darkening of skin on chest & breasts called sex
flush (occurs in both genders but is more common in women)
III. Phase may be short (less than a minute) or last for an hour to several hours – the longer it lasts
the more variability there is
A. Changes in penis & vagina vacillate over time in extended excitement phase; penis may
occasionally become less erect & vaginal lubrication may diminish periodically
B. Some people respond quickly; others need more time
Masters & Johnson Sexual Response Cycle: Plateau Phase
I. Plateau phase – excitement becomes enhanced; a state of high arousal that may be maintained for
some time, from several minutes to several hours (in the case of extended lovemaking)
II. Events during plateau phase in both males & females - heart rate & blood pressure rise further,
muscle tension increases generally throughout the body (myotonia), breathing is faster
A. Men – Cowper's (bulbourethral) gland secretions (pre-cum) may appear at the urethral
opening as a result of muscular contractions
B. Women – clitoris usually retracts (disappears) under its clitoral hood
1. Outer third of vagina engorges with blood, thickens & tightens; the surrounding muscles of
the pelvic floor also thicken & tighten
2. Inner 2/3 of vagina fully extends (lengthens) & balloons out forming a tenting effect &
creating a receptacle for semen; it does not grip the penis at all tightly during coitus
3. Breasts may swell further & the areolae may become engorged & swollen, making the nipples
appear less prominent than before
III. The term "plateau" suggests a steady state in which not much is changing, physiologically
speaking; this may be misleading, however
A. Sometimes a person may pass rapidly from excitement through plateau to orgasm, in which case
plateau may be brief period of rapidly rising arousal that is difficult to tell from excitement phase
B. But if plateau is maintained for extended time, there are likely to be periodic increases/decreases
in arousal depending on stimulation person experiences, distraction, fatigue & other factors
C. Plateau phase usually lasts only a few minutes, but there are reports of more intense orgasms
in people who have purposely extended the plateau phase
Masters & Johnson Sexual Response Cycle: Orgasm Phase
I. Orgasm phase – orgasm is the subjective experience of intense pleasure & release at sexual
climax, as well as the accompanying physiological processes; it is very similar in men & women
A. Experience varies from person-to-person & sexual encounter to sexual encounter
II. Orgasmic sensation – feelings accompanying orgasm are quite different from the physiological
responses & may even contradict what we know is occurring physiologically
A. Woman might experience a physiologically intense orgasm (~12 measurable muscular
contractions) but report it to be mild or vice versa with 4 contractions
1. Reason for discrepancy is that sexual experience is interpreted by the mind as well as
body
B. It is usually felt as a brief sequence of muscle contractions in the genital area, but the
sensation often radiates out to involve other parts of the body
1. Respiration rate, heart rate & blood pressure all reach peak levels during orgasm
C. Generally, orgasm sensations are experienced similarly by males & females, but there are
exceptions
1. Women – highly pleasurable feeling that usually begins at clitoris but quickly spreads to whole
pelvic area
2. Men – experience is also highly pleasurable; usually experience warmth, pressure &
sometimes throbbing during moment when they have reached point of no return
a. This point is called ejaculatory inevitability; ejaculation can't be prevented
b. Males generally experience intense sensations during first couple of contractions & less
sensation during later contractions
III. In both males & females – other changes occur during orgasm
A. Heart rate increases dramatically, blood pressure rises, breathing becomes rapid & shallow;
muscles throughout body contract; perspiration is evident
B. Intense, pleasant psychological feeling associated with the release of sexual tension afforded
by orgasm occurs
C. Orgasm is accompanied by surgelike release of the hormone oxytocin from pituitary gland; it
contributes to contraction of smooth (involuntary) muscles (those in uterine wall & breast tissue)
1. It plays an important role in childbirth & breastfeeding & possibly also in the formation of
durable sexual relationships
D. Similarity of male & female orgasms demonstrated in 2 studies of college students – Proctor,
Wagner & Butler (1974) & Wiest (1977)
1. Students wrote description of their orgasms & descriptions were analyzed by experts
2. Could not distinguish between male & female descriptions; concluded that males &
females experience similar sensations as result of orgasm, but orgasms do differ
IV. For males, it consists of 2 stages or genital events: emission stage & expulsion stage
A. Emission stage – muscular contraction of vas deferens, seminal vesicles & prostate gland
create buildup of semen in urethral bulb located at base of penis
1. The various components that make up semen are loaded into the urethra during this stage
2. At same time, external urethral sphincter contracts, holding in semen &
a. Internal urethral sphincter contracts, preventing semen from entering bladder (retrograde
ejaculation) & urine from entering the urethral bulb where the semen is
B. Expulsion stage – the semen is forcefully expelled from the urethral opening; some women also
ejaculate during orgasm
1. Internal urethral sphincter remains contracted so urine & semen do not mix, but…
2. External urethral sphincter relaxes; muscles surrounding urethral bulb & urethra contract —>
accumulated semen is expelled from urethral opening
IV. M & J & others more recently have investigated the physiological basis of the spasms experienced
during orgasm; in females, orgasm phase consists of muscular contractions & intense sensations
A. In women, the spasms derive from intense contractions of the bulbospongiosus muscle &
nearby pelvic-floor muscles, which cause tightening of the outer portion of the vagina
1. Pelvic muscles surrounding vagina in particular those of orgasmic platform, contract 3 –
15 times (a total of ~8 – 10 occur in a typical orgasm), each contraction lasting ~1 sec
B. Other weaker & slower contractions follow
V. Controversies about types of orgasm – experts disagree about types; there has long been a debate
about whether women experience different kinds of orgasms depending on what parts of genitals are
stimulated
A. Early 1900s – Freud theorized there were 2 types of female orgasm: clitoral & vaginal
1. Saw clitoral orgasm as immature sexual response that women outgrew; thought it was
stunted penis
2. Believed clitoral orgasm was expression of masculine rather than feminine sexuality
B. Masters & Johnson (1966) – identified only 1 type of orgasm
1. According to M & J, the key physiological sign of orgasm in women (spasmodic contraction
of muscles around the outer part of the vagina) are the same no matter how orgasm is reached
2. Regardless of stimulation point (clitoris or vagina) or method (penile insertion or vibrator),
they reported the same physiological occurrences during orgasm
C. Hite (1976) – validated above results; noncoital orgasms more intense than coital; also found
coital orgasm to be more diffused through body than locally intense clitoral one
D. Josephine & Irving Singer (1972) – claimed there are 3 distinct orgasm types: vulval, uterine,
blended; included emotional satisfaction as consideration; no one form better than others, just
different
1. Vulval orgasm – same as orgasm reported by M & J; includes orgasmic platform
contractions; not sexually satiating so another orgasm can be experienced immediately
2. Uterine orgasm – can occur only in presence of vaginal penetration & involves woman
holding her breath just before orgasm & exhaling when climax occurs
a. They say that it occurs in response to deep vaginal penetration when penis (or other
penetrating object) makes direct contact with cervix
b. They claimed that this contact causes the uterus to move slightly, thus stimulating nerve
endings in the lining of nearby abdominal organs
3. Blended orgasm – combination of above 2
E. Researchers who study the G-spot also claim that stimulation of that spot triggers an orgasm
different from the kind that results from clitoral stimulation
1. Although both types of orgasms involve contraction of the pelvic floor muscles, only a Gspot orgasm involves major contractions of the uterine musculature, it is claimed
F. There is definitely room for more research on this
VI. Orgasm is not just physiological response to stimulation; the human mind & human body
interact; it is impossible to separate influence of the two; without mind, no orgasm
A. Brain imaging suggests where orgasm may be experienced – the subjective experience of
orgasm must result from some kind of activity in the brain, but where in the brain does that
activity occur?
B. A Dutch group (Holstege, et al., 2003) used a functional brain imaging technique (PET
scanning)
1. The researchers took scans in 2 conditions:
a. When the subject was being manually stimulated by his female partner but not
experiencing orgasm &……
b. In the same situation when he was experiencing orgasm
2. One scan was then digitally subtracted from the other to show the pattern of activity that was
specifically associated with orgasm
a. They found that the most active region was a zone in the midline of the brain including
part of the thalamus & nearby structures
3. Activity in the cerebral cortex (seat of our intellectual lives) decreases greatly during orgasm
C. More recently, the Dutch group extended their observations to women
1. Again, there was activation of dopamine-related systems & a general drop in activity in the
cerebral cortex
Masters & Johnson Sexual Response Cycle: Resolution Phase
I. Resolution phase – return to unaroused state; the period during which the physiological signs of
arousal reverse themselves
A. Males – drop in penis size as erection is lost; 2 stages: first lasts ~1 min as blood exits
corpora cavernosa; second lasts several minutes as blood leaves corpus spongiosum
1. Results from opening of veins in penis, allowing blood to be removed from area
B. Women – muscles relax; uterus, vagina & labia return to unaroused positions & color; clitoris
returns from under clitoral hood & sex flush dissipates
1. Clitoral erection, vasocongestion, & lubrication subside; vaginal & pelvic floor muscles
relax, breasts lose their swollen appearance; heart rate & blood pressure return to normal
levels
2. After return of uterus to normal position, cervix lowers into seminal pool
C. Both males & females – heart rate, blood pressure & breathing rate return to normal; muscle
tension decreases
1. Males experience refractory (recovery) period during which they cannot have another
orgasm; may be several minutes long for young men but usually longer in older males
2. Females can have multiple orgasms before having to recover
The Phases of Orgasm May Be Linked in Different Ways
I. Although excitement, plateau, orgasm & resolution phases are building blocks of sexual response
cycle, individual cycles may be assembled in variety of ways
II. One type of cycle (orange) – person passes sequentially through the 4 phases in the sequence (the
standard version of the response cycle)
A. Males typically start with excitement phase, move to plateau then to orgasm & finally to
resolution phase
1. Either move through resolution to prearoused state or to a refractory period (part of
resolution state); standard pattern although men report variations on model
2. During refractory period, males recover from orgasm & prepare for another
a. During this period, further sexual stimulation does not lead to renewed erection or a
second orgasm
b. According to M & J, the refractory period lasts between 30 & 90 minutes
c. While the early part of refractory period may be absolute (man cannot be physiologically
aroused by any means), it may be followed by a relative refractory period
B. Females – more varied in their sexual responses
1. 1st pattern - similar to male's with progression from excitement to plateau, orgasm & then
resolution with females able to have multiple orgasms without refractory period (orange)
2. 2nd pattern – excitement to enhancement of excitement during plateau & directly to
resolution, bypassing orgasm; woman may be sexually satisfied without orgasm (red)
3. 3rd pattern –no definitive plateau phase but rapid escalation to orgasm & very quick
resolution
III. Second type (red) – skips the orgasm phase; the person passes from excitement to plateau & then
directly to resolution; we are acculturated to think of this as something wrong or missing
A. Might say they failed to achieve orgasm; still, it is a common type of cycle
B. Women may define it as a fully satisfying sexual experience; in fact, some women never
experience orgasm but nevertheless express satisfaction with their sex lives
C. Alternatively, they may feel frustrated, & they may even be left with an aching sensation in their
pelvic area, perhaps due to prolonged vasocongestion & the resulting tissue anoxia
D. Men are less likely than women to be satisfied with a sexual experience that does not include
orgasm
IV. Some people experience multiple orgasms (blue) – a multiple orgasm means a sequence of at least 2
orgasms, between which the person descends only to the plateau phase of genital arousal
A. It does not refer to having an orgasm, losing one's arousal completely & then quickly entering
another arousal cycle that culminate in a second orgasm
B. Multiple orgasms are far more common in women than in men; a survey of college-educated US
nurses found that ~43% of then usually experienced multiple orgasms
1. No doubt many more women could experience multiple orgasms if they wanted to or if they
had the cooperation of their partners
C. M & J reported that women can sometimes experience a sequence of orgasms that follow directly
one upon the other, so that the woman does not even descend into the plateau phase between them
D. A few men also experience multiple orgasms – often, only one orgasm in the series – usually the last
— is accompanied by ejaculation, while the previous ones are dry
Orgasm Miscellany
I. Recognizing orgasms – sometimes males can have orgasm without ejaculate (men with prostate
disease & in prepubescent boys
A. Implications of questions about recognizing female orgasm
1. Expresses concern for woman's sexual satisfaction – on surface, this appears to be healthy;
however, often more related to man's ego than to woman's satisfaction
B. Faking orgasm is dishonest & deceitful & may lead partner to believe something unsatisfying
was great & should be repeated next time
1. If what partner does is pleasurable but does not lead to orgasm, it might be enough
C. Men also prone to faking orgasm if unable to achieve one
1. Man drinking alcohol who can't reach orgasm may feel threatened by how this might be
interpreted by partner (dysfunctional, less than real man, partner not attractive, etc.)
D. Faking orgasm should be discussed candidly with partner —> could make relationship closer
II. Simultaneous orgasm – difficult to achieve, but focusing on this can detract from enjoyment of
experience
The Masters & Johnson Cycle May Be Incomplete
I. M & J's 4-stage model is primarily a description of physiological processes, things that can be
measured/observed during sex behavior (erection, blood pressure)
A. Since M & J, there have been efforts to place the physiological response in a larger psychological
context
B. Important issue – do the physiological markers of sexual arousal correspond to psychological or
subjective arousal, meaning the person's sense of being sexually excited?
1. There appears to be a difference between men & women in this respect
2. A man's psychological arousal is usually tied closely to his genital arousal — his mind & his
penis are one, so to speak
3. Women, however, do not always feel sexually excited when their genitals are showing every
sign of arousal
C. Another issue – where does sexual desire fit into the overall response cycle? – Helen Singer
Kaplan
1. According to Kaplan, sexual desire is the psychological state that precedes & leads to
physiological arousal; this makes intuitive sense
II. Kaplan's Triphasic Model – proposed by noted sex therapist Helen Singer Kaplan (1974)
A. Initially proposed a biphasic model conceptualizing human sexual response as having 2
identifiable phases
1. Vasocongestion of genitals
2. Reflexive muscular contractions of orgasm
B. Argued that the 2 phases were each controlled by a different part of NS, both part of ANS
1. Vasocongestion – by parasympathetic NS
2. Orgasm – by sympathetic NS
C. Explained that different structures are involved in each of these phases: blood vessels for
vasocongestion & muscles for orgasm
1. Interference with vasocongestion results in male erection problems; different sexual
dysfunctions (premature & retarded ejaculation) were result of orgasm impairment
D. Since vasocongestion problems were quite different from & mutually exclusive with
orgasm problems, Kaplan believed the biphasic model to be correct
E. Over the years, her biphasic model evolved into a triphasic model (Kaplan, 1979)
consisting of desire phase, excitement phase & resolution phase
1. Found that sexual dysfunctions fall into one of these 3 categories & that they are
separate & distinct
2. Possible to function well in 1 or 2 phases with problems in another
III. Psychiatrist Rosemary Basson says many women, especially those in established relationships, are
not motivated to have sex by what we would usually think of as sexual desire (horniness, sex hunger,
etc.)
A. Rather, they have an interest in sex that flows from a wish for intimacy with her partner or from
an expectation of benefits that may flow from a sexual interaction
1. This interest is responsive, cognitive or even intellectual in quality, rather than being the
expression of a biological drive
2. Once physical interactions begin, however, & the physiological processes of sexual arousal are
triggered, genital sensations provide a "feedback" stimulus that reinforces sexual interest
IV. (Bernie) Zilbergeld & (Carol) Ellison's Model (1980) – consists of 5 components
A. Concerned that Masters & Johnson ignored cognitive & subjective aspects of sexual
response, while focusing exclusively on physiological aspects
1. Defined sexual desire as frequency with which a person wants to engage in sexual
activity
2. Defined sexual arousal as how excited one becomes during sexual activity
B. The 5 components of the model: interest (desire), arousal, physiological readiness (erection,
vaginal lubrication), orgasm, satisfaction (ones evaluation of how one feels)
C. This model allows for sexual dysfunctions that pertain to desire although other responses
may be normal
V. These other models are more inclusive of psychological aspects of sexual response whereas Masters
& Johnson are more concerned with physiological aspects
A. Cognitive psychologists have developed quite complex models of the thought processes that
underlie sexual behavior
B. Susan Walen & David Roth developed a cognitive model of the sexual response cycle that
explicitly incorporates mental processes & causal connections
1. This model begins with perception of a sexual stimulus, which triggers the evaluation of that
perception, which in turn (if positive) triggers sexual arousal
C. This model has definite merits in terms of its focus on mental events & how they are connected; it
might also help explain some sexual dysfunctions
1. For example, a young woman might be distracted from monitoring her own arousal by other
concerns (Is her partner going to withdraw in time?; Is her partner being satisfied?)
D. The Walen-Roth model does not include any explicit inhibitory processes, but in reality cognitive
mechanisms can exert a strong inhibitory influence on sexual arousal
1. Such inhibition can save people from becoming aroused under socially inappropriate
circumstances, such as when a doctor is examining a patient
Erotic Stimulus Pathway (ESP) Theory
I. Erotic Stimulus Pathway Theory proposed by David M. Reed (Haffner & Stayton, 1998) –
enhances our understanding & ability to treat sexual dysfunctions
A. Divides sexual response cycle into 4 phases that correspond to those of Kaplan & Masters and
Johnson
II. Seduction phase – person learns how to get aroused sexually & how to attract someone else
sexually; seduction translates into memories & rituals
A. Adolescents may spend much time on personal appearance, clothes choice & mannerisms, all
of which can enhance positive self-esteem if adolescents like the way they feel
B. These seductive techniques are stored in memory & can be activated later in life
III. Sensations phase – different senses can enhance sexual excitement & ideally prolong plateau
phase
A. Early experiences of touch (holding hands, putting arm around loved one) become very
important
B. Sense of vision is way of maintaining interest & arousal
C. Hearing loved one in intimate conversation or over phone becomes important; hearing sounds
of partner responding to sexual stimulation can be titillating
IV. Surrender phase – orgasm is psychophysiological surprise psychodynamic issues surrounding
orgasm are power & control
A. Those with orgasmic dysfunction may be in power struggle with themselves or with their
partners or with the messages received about sex
V. Reflection phase – meaning is given to the experience
A. Whether sexual experience interpreted as "+" or "-" may determine desire for later sexual
activity at least with that partner under those circumstances or with those behaviors