Sexual Response Cycle- Dr Shahjada Selim

Sexual Response Cycle and Sexual Response Models- Dr Shahjada Selim

1. Dr Shahjada Selim Associate Professor Department of Endocrinology, BSMMU Faculty in Endocrinology, Texila American University, USA Executive Committee Member, ISSM Website: shahjadaselim.com Human Sexual Response Cycle

2. The  human sexual response cycle  is a four-stage model of physiological responses to  sexual stimulation , which, in order of their occurrence, are the excitement-, plateau-, orgasmic-, and resolution phases . This physiological response model was first formulated by  William H. Masters and Virginia E. Johnson , in their 1966 book  Human Sexual Response . Since then, other human sexual response models have been formulated ( Master & Johnson Model ). Masters & Johnson  Human Sexual Response , Bantam, 1981  ISBN   978-0-553-20429-2 ; 1st ed. 1966 Human Sexual Response

3. Master & Johnson In 1966, they first systematically study the physiology of the human sexual response in men and women in US Linear model of sexual behaviour. called EPOR model

4. Master & Johnson’s EPOR Model Excitement Plateau Orgasm Resolution

5. Excitement phase The  excitement phase  (also known as the  arousal phase  or  initial excitement phase ) is the first stage of the human sexual response cycle, which occurs as a result of physical or mental  erotic stimuli , such as  kissing ,  making out , or  viewing erotic images , that leads to  sexual arousal . During this stage, the body prepares for  sexual intercourse , initially leading to the plateau phase [1]. There is wide socio-cultural variation regarding preferences for the length of foreplay and the stimulation methods used. Physical and emotional interaction and stimulation of the erogenous zones during foreplay usually establishes at least some initial arousal. John Archer, Barbara Lloyd (2002).  Sex and Gender .  Cambridge University Press . pp.  85 –88.  ISBN   0521635330 . Retrieved August 25, 2012.

6. Excitement Phase- In response to sexual stimuli, the process of vasocongestion occurs. Increase HR, BP, muscle tension in male and female In case of male more blood flows into penis. Man gets erection (partial of full) as a result. The erection may be partially lost and regained repeatedly during an extended excitement phase. Both  testicles  become drawn upward toward the  perineum , notably in  circumcised  males where less skin is available to accommodate the erection. Also, the  scrotum  can tense and thicken during the erection process [1]. John Archer, Barbara Lloyd (2002).  Sex and Gender .  Cambridge University Press . pp.  85 –88.  ISBN   0521635330 . Retrieved August 25, 2012.

7. Excitement phase- In females, the excitement phase can last from several minutes to several hours. The onset of  vasocongestion  results in swelling of the woman's clitoris, labia minora and vagina. The muscle that surrounds the vaginal opening grows tighter and the uterus elevates and grows in size. The vaginal walls begin to produce a  lubricating organic liquid . This results in clitorial engorgement, alteration of size and shape of labia, expansion of inner 2/3 rd of vagina. Meanwhile, the breasts increase slightly in size and nipples become hardened and erect [1]. John Archer, Barbara Lloyd (2002).  Sex and Gender .  Cambridge University Press . pp.  85 –88.  ISBN   0521635330 . Retrieved August 25, 2012.

8. The  plateau phase  is the period of sexual excitement prior to  orgasm . The phase is characterized by an increased circulation and heart rate in both sexes, increased sexual pleasure with increased stimulation and further increased muscle tension [1]. Also, respiration continues at an elevated level.  Both men and women may also begin to vocalize involuntarily at this stage. Prolonged time in the plateau phase without progression to the orgasmic phase may result in  sexual frustration . Plateau Phase John Archer, Barbara Lloyd (2002).  Sex and Gender .  Cambridge University Press . pp.  85 –88.  ISBN   0521635330 . Retrieved August 25, 2012.

9. In male: Increase size of head of penis, change of colour of penis, purplish Cowper’s gland secrets fluid, pre-cum, which comes out of the tip of penis Testis move further in towards the body, and increase in size Sex flush, muscle tension During this phase, the male  urethral sphincter  contracts (so as to prevent  urine  from mixing with  semen , and to guard against  retrograde ejaculation ) and muscles at the base of the penis begin a steady rhythmic contraction. Plateau Phase

10. In female: The plateau stage in females is basically a continuation of the same changes evident in the excitement stage. Vaginal swelling, contraction of vaginal opening Clitoris withdraw into clitorial hood and external clitoris shorten in size Labia minora increase in size and purple colour Plateau Phase

11. Orgasm is the conclusion of the plateau phase of the sexual response cycle and is experienced by both males and females. It is accompanied by quick cycles of muscle contraction in the lower pelvic muscles, which surround both the anus and the primary sexual organs [1]. Women also experience uterine and vaginal contractions. Orgasms are often associated with other involuntary actions, including vocalizations and muscular spasms in other areas of the body and a generally euphoric sensation. Heart rate is increased even further. Orgasm John Archer, Barbara Lloyd (2002).  Sex and Gender .  Cambridge University Press . pp.  85 –88.  ISBN   0521635330 . Retrieved August 25, 2012.

12. First stage: contractions in the vas deference, seminal vesicles, and the prostate cause seminal fluid, to collect in a pool at the base of the penis, in the urethra (“come” or ejaculate) This collection is usually felt as ‘tickling’ sensation Second stage: Contraction of muscles in a throbbing manner around the urehtra , propel ejaculate through the urethra and out of the body Highly pleasurable feeling Orgasm (In Male)

13. Contractions of pelvic muscles around vagina Contractions of the uterus and anal sphincter in a throbbing manner/rhythmic way) Muscle spasm, Increase BP, HR reach peak The contractions (which occurs at different speeds and in different numbers) are usually experienced as highly pleasurable feelings of release. No difference between vaginal and clitoris orgasms. Orgasm (In female)

14. The  resolution phase  occurs after orgasm and allows the muscles to relax, blood pressure to drop and the body to slow down from its excited state [1]. The refractory period, which is part of the resolution phase, is the time frame in which usually a man is unable to orgasm again, though women can also experience a refractory period. Resolution John Archer, Barbara Lloyd (2002).  Sex and Gender .  Cambridge University Press . pp.  85 –88.  ISBN   0521635330 . Retrieved August 25, 2012.

15. Male: Loss of erection as blood flows out of penis Scrotum and testis returns to normal stage A general feeling of relaxation Refractory period in which the person generally is incapable of getting another erection Masters and Johnson described the two-stage detumescence of the penis: In the first stage, the penis decreases from its erect state to about 50 percent larger than its flaccid state. This occurs during the refractory period. In the second stage (and after the refractory period is finished), the penis decreases in size and returns to being flaccid [2]. Resolution John Archer, Barbara Lloyd (2002).  Sex and Gender .  Cambridge University Press . pp.  85 –88.  ISBN   0521635330 . Retrieved August 25, 2012 Masters & Johnson  Human Sexual Response , Bantam, 1981  ISBN   978-0-553-20429-2 ; 1st ed. 1966 .

16. Female: Blood that had engorged areas of the body now flows out, swelling decreases, eventually muscle tension and skin flushes go away A general feeling of relaxation According to Masters and Johnson, women have the ability to orgasm again very quickly, as long as they have effective stimulation. As a result, they are able to have multiple orgasms in a relatively short period of time [1,2]. Resolution Masters & Johnson  Human Sexual Response , Bantam, 1981  ISBN   978-0-553-20429-2 ; 1st ed. 1966 . Dunn ME, Trost JE (October 1989). "Male multiple orgasms: a descriptive study".  Archives of Sexual Behavior .  18  (5): 377–87. 

17. Masters And Johnson’s Linear Model

18. Desire Arousal Orgasm Resolution Kaplan Model (DAOR)

19. Kaplan’s DAOR Model Kaplan

20. (Bio-Psycho-Social Model) Drive: the biological (hormonal) Motivation: the psychological (relational issues) Wish: in some culture low desire is normal high desire problematic Normal Sexual Desire has following components:

21. Proposed by Michael Perelman Sexual response is a balance between excitatory or inhibitory factors that may be psychological, organic, psycho social or cultural The Sexual tipping point model

22. According to Michael Perelman, the STP is represented by normal distribution curves. Sexual attitude, response, and behaviour follows normal distribution curves Sexual arousal is normally distributed (like height and weight ) Orgasm latency is best described by skewed distribution (like hair, eye colour) Sexual response can be affected by psychosocial and organic causes Sexual tipping point (STP) model

23. Is the male and female sexual response different?

24. Basson R. Obstet Gynecol. 2001;98(2):350-353 Basson’s Model of female sexual response

25. Sexual desire is not a pre requisite for the sexual response to be initiated Desire may be initiated after a woman has received pleasurable sexual stimuli Emphasize on women’s willingness to receive sexual stimuli Key Points of basson’s model

26. Development

27. Thank You