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Human Sexual Response Cycles
(05/04/2004)

by Unknown


Masters and Johnson's Model of The Human Sexual Response Cycle

Masters and Johnson were sex researchers who described sexual response as the result of two principal physiological changes -- increase in blood flow to various parts of the body (vasocongestion) and increase in muscle tension (myotonia). Masters and Johnson chose to use the words "excitement," "plateau," "orgasm," and "resolution" to specify phases of the human sexual response cycle. According to Masters and Johnson, these phases correspond to the level of sexual arousal and describe typical responses.

Immediate signs of sexual excitement we are most familiar with are erections of the penis or clitoris and lubrication. Masters and Johnson also described other physiological effects of sexual stimulation on both men and women. As we get excited, an increase in heart rate and blood pressure, and often a noticeable "sex flush" in the chest, neck, face and ears are associated with increased blood flow and vasocongestion. In addition, there is nipple erection and an increase in muscle tension throughout the body. As excitement moves to plateau there are significant increases in heart rate, blood pressure, sex flush, breast size, respiration rate (heavy breathing), and muscular tension. At orgasm all physiological responses peak followed by a rapid release of muscular tension and return to pre-excitement levels for physiological measures.

After experiencing changes in sexual functioning that often accompanies disability or illness, we may or may not experience erection or lubrication when we feel sexually aroused. Men may not experience emission or ejaculation usually associated with orgasm or may experience retrograde ejaculation (the seamen is forced into the bladder instead of out of the penis). Women may or may not experience contractions in the uterus and around the vagina (pubococcygeous or PC muscle). Women who experienced ejaculation before injury may or may not continue to experience ejaculation. However, if we pay attention, we will notice that we are experiencing all of the other responses described. Sex flush may be exaggerated and increase and rapid release of muscle tension may be experienced as spasms, depending on the disability or illness. Increase in blood pressure during sexual response may result in automatic dysreflexia (dangerously high blood pressure that may be experienced as a severe headache), especially in people with SCI at or above T6. It is important to recognize all these as sexual responses, especially with impaired sensation in the genitals. We can learn to focus in on non-genital bodily changes, use stimulation to areas where we may have heightened sensation, and learn to use breathing and imagery to enhance our sexual response and pleasure.

Kaplan’s Model of Sexual Response

Masters and Johnson’s model of the human sexual response cycle focused mainly on the body’s physiological changes. However, a sex therapist named Helen Singer-Kaplan pointed out that without the desire to be sexually active, we are not going to get excited or have orgasms. The inclusion of desire as part of the human sexual response cycle leads to consideration of psychological and physical factors that many inhibit sexual desire. Factors that might block sexual desire include stress, fatigue, depression, pain, fear, some prescribed medication and recreational drugs, negative past sexual experiences, power and control issues in a relationship, loss of interest in a partner, low self-image, and hormonal influences. Many of these factors are associated with early stages of disability or illness. As rehabilitation progresses and we learn to manage these non-sexual aspects of our lives, we are likely to experience an improvement in sexual response over time.

David Reed's Erotic Stimulus Pathway

Another model of sexual response which focuses more on the psychosocial aspects of human sexual response was suggested by therapist, David Reed. Reed's four stages are "seduction," "sensation," "surrender," and "reflection." Seduction includes all those things we might do to either entice ourselves or someone else into sexual activity -- wearing cologne and perfumes, using makeup, dressing sexy, making eye contact, sending love notes, buying flowers, arranging time, sharing feelings, and asking for sex. In the next stage of sensation, we are open to sexual stimulation from all of our senses. Sight, sound, taste, smell, touch, imagination and fantasy all have potential to arouse. This potential is dependent on how we interpret sensations. How we interpret sensations is often influenced by our prior learning about what is sexually stimulating. During the next stage of surrender we can experience orgasm. According to Reed, orgasm requires momentarily surrendering and giving up control. It requires us to take our mind off our performance or to stop "spectatoring." To experience orgasm requires us to stop worrying about how we look or smell, or about making too much noise, or about whether we are going to have a bowel or bladder accident. It also requires trust of ourselves and of our partner if we are with a partner. The last stage of reflection is a very important stage for us after a new experience, especially after experiencing sex for the first time after acquiring a disability or illness. In this stage, we look back over our sexual experience and examine how we felt about it. If it was a positive experience then we would most likely look forward to the next cycle beginning with seduction. However, if it was a negative experience we may tend to avoid future sexual encounters. That is why it is important to understand and be prepared for the possible changes in sexual function and to communicate possible changes with sexual partners. A new sexual experience is something that needs to be worked on like everything else in the rehabilitation process. It may not be perfect the first time but there are ways to adapt and there is hope for a fulfilling sexual life.

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