The Normal Sexual Response Ccyle

The first phase is the desire phase in which wishes and fantasies are entertained to engage in sexual activity. This response is psychic in origin but is mediated by circulating androgens. This is usually more pronounced in males because of the higher testosterone levels.

The second phase is the arousal phase and consists of a number of physiologic changes plus the subjective sense of sexual pleasure. There is an increased heart rate, breathing rate, and development of muscular tension throughout the body, most pronounced in the pelvic area and thighs. The major physiologic change is the development of vascular congestion in the genital area. In females it manifests as vaginal lubrication and swelling of the external genitalia and in males leads to an erection of the penis.

The third phase is orgasm. This consists of a peaking of sexual pleasure accompanied by a sense of release from sexual tension. The most obvious physiological manifestation in the male is ejaculation. In the female, the rhythmic contractions take place within the musculature of the outer third of the vagina and perineal muscles.

The fourth phase is called resolution and consists of a sense of pleasure, warmth, well-being, and relaxation. There is a gradual return of the breathing rate and heart rates to normal and muscle tension to its baseline state. Most males are refractory to entering into another cycle of sexual activity for some period of time but women are not refractory and may experience multiple orgasms following continued or additional stimulation.

Sexual dysfunction can result from issues arising in any one or more phases of the sexual response cycle. Sex therapy is behavioral modification therapy that should be considered the first line of therapy for couples experiencing problems of any type in the bedroom.

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