The sexual response cycle refers to the normal stages one goes through during sexual intercourse.

There are important differences between the sexual response cycle in men and women. This difference is important when counseling individuals with sexual problems. The most important difference in the sexual response between men and women is the longer time taken by women to reach the arousal phase.

The sexual response cycle (Sex Drive) , consists of four phases:

1)Desire (Excitement)

2)Arousal (can be divided into excitement and plateau).

3) Orgasm

4) Resolution.

The sexual response staircase:

This is a similar concept to the sexual response cycle (above)

Here we try to give climbing up the stairs as an analogy to the human sexual response. This is very useful for education, diagnostic and therapeutic purposes.

Ground Level: Non-Sexual

Step 1: Here there is desire without any physical changes.

Step 2 :Arousal begins. In men the penis begins to get hard, but not firm enough for penetration. The woman begins to lubricate.

Step 3: Progress of arousal. Here the man gets a firm erection, that could achieve penetration. In women there is more lubrication and vaginal ballooning.

Step 4: Imminent orgasm

Step 5: Orgasm.

Sliding down the banisters: This is the process of resolution.

Physiological changes (Body Changes) in Women during Sexual Intercourse.

In women fluid is secreted onto the vaginal walls during sexual excitement. The secretion of fluids is probably mediated by the release of VIP (Vasoactive intestinal polypeptide ) from the vaginal nerves.

There is also release of mucus from the vestibular glands. The mucus helps in the lubrication during the sexual activity.

The upper two-thirds of the vagina stretches easily during sexual excitement.

The most sensitive part of the female genetalia is the clitoris and labia minora. Touching these parts can further add to the sexual excitement.

Tactile stimuli from the breast can also reinforce the sexual excitement.

Throughout orgasm there are rhythmic contractions of the vaginal wall which are automatically mediated. During orgasm there are also rhythmic contractions of the bulbocavernosus and ischiocavernosus muscles. This is due to the impulses travelling in the pudendal nerves.

It is thought that vaginal contractions may aid sperm transport, but it is not very important for fertilization to occur, since fertilization is not dependent on orgasm.

For more details see female sexual response (Below)

Physiological changes (Body Changes) in Men during Sexual Intercourse.

In men the sexual stimuli are reinforced by visual, auditory and olfactory stimuli.

For more details see male sexual response (Below)

The Male Sexual Response

Excitement:

Here there is erection of the penis.

The pulse rate and blood pressure are increased.

The testes is raised and the skin thickness of the scrotum increases.

Plateau:

In the plateau phase erection is maintained and the testes rises further.

There is further increase in the pulse rate and blood pressure.

The respiratory rate increases.

Orgasm:

During orgasm the urethra contracts repeatedly. There is also contraction of the prostate and seminal vesicles with emission of seminal fluid to the urethra.

There is further rise in the blood pressure, pulse rate and respiratory rate.

Resolution:

The erection gradually goes down (Gradual detumescence)

The scrotum thickness, blood pressure, pulse rate and respiratory rate return to normal.

The Female Sexual Response

Excitement:

During the excitement phase of the sexual response there is a slight elevation in the pulse rate and blood pressure.

Some women may have nipple erection.

The head of the clitoris swells, while the body of the uterus and cervix is raised.

There is expansion, lubrication and distension of the inner two-thirds of the vagina.

Plateau:

The areolar of the breasts get engorged and enlarged. There is also engorgement of the labia

There is withdrawal of the head of the clitoris and further elevation of the uterus.

The respiratory rate rises and there is further increase in the blood pressure and pulse rate.

There is swelling of the outer third of the vagina and further distension of the inner two-thirds.

Orgasm:

During orgasm there are contractions in the uterus and outer third of the vagina.

There is further rise in the blood pressure, pulse rate and respiratory rate.

Resolution:

The uterus returns to normal position while the os gapes open.

The changes in the breasts,vagina, clitoris,labia,uterus,pulse rate,blood pressure and respiratory rate all return to normal.

References:

Page 423, Chapter 23, Changes During Sexual Intercourse. The gonads, development and function of the reproductive system. Review of medical physiology. 20th edition by William F Ganong. Lange Publications.

Page 247 Specific sex therapy concepts and strategies. Sexual problems . Psychological aspects of gynecology.Chapter 20. Gynaecology by ten teachers, 17th edition by Stuart Campbell and Ash Monga.

Chapter 14,Problems of Sexuality and Gender. Psychiatry 2nd edition Oxford Core Texts by Michael Gelder, Richard Mayou and John Geddes.

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