Master and Johnson described the different phases of the sexual response as they are currently recognized, except the first one, referring to sexual desire, which was proposed by Dr. Helen Singer Kaplan in 1979 and later accepted by the entire scientific world. .

Five phases are recognized that manifest in different ways according to sex: sexual desire, arousal, plateau, orgasm and resolution.

Tables 1 and 2 summarize the physical changes that occur during sexual response in men and women.

Table 1. Changes in men during the sexual response cycle.

Desire phase

  • No specific physical change.

Excitement

  • The erection begins.
  • The scrotum (skin bag that contains the testicles) begins to thicken.
  • The testicles begin to ascend.
  • The nipples may become erect.
  • They increase heart rate and blood pressure.
  • Increases general muscle and nerve (neuromuscular) tension.
  • Increases the rigidity of the erection.

Plateau

  • The glans is slightly enlarged.
  • The testicles increase in size and come closer to the body
  • Fluid may appear prior to ejaculation.
  • Sexual flushing (a reddish rash on the skin of the chest and upper abdomen that occurs in one in four men) may appear.
  • Heart rate and blood pressure increase further.
  • Breathing may become shallower and faster.
  • Voluntary contraction of the rectal sphincter, used by some men as a stimulation technique.
  • Greater increase in neuromuscular tension.
  • Visual and auditory acuity are diminished.

Orgasm

  • Involuntary rhythmic contractions begin in the prostate, seminal vesicles, rectum, and penis.
  • Shortly after, ejaculation takes place.
  • The testicles are very close to the body.
  • The sexual blush, if present, reaches its maximum color and extension.
  • Heart rate, blood pressure and respiratory rate at maximum.
  • Loss of voluntary muscle control, cramp-like spasms may occur in the muscles of the face, hands, and feet.

Resolution

  • Rapid loss of most of the penile erection, with a slow return to normal size.
  • The testicles return to their usual position and regain their normal size.
  • The scrotum loosens.
  • The refractory period occurs, during which another ejaculation is not possible (the duration of the refractory period is highly variable, it is generally shorter in young men and increases in duration with age).
  • Loss of erection in the nipples.
  • Rapid disappearance of sexual flush.
  • Neuromuscular tension may continue, with tremors or involuntary contractions of isolated muscle groups.
  • Heart rate, blood pressure, and respiratory rate return to pre-arousal levels.
  • There is a general feeling of relaxation.
  • Visual and hearing acuity return to normal levels.

Table 2. Physical changes in women during the sexual response cycle.

Desire phase

  • No specific physical change.

Excitement

  • Vaginal lubrication begins.
  • The inner two thirds of the vagina expand.
  • The outer lips of the vagina swell and withdraw from the vaginal opening.
  • The inner lips become thicker.
  • The uterus moves up.
  • The nipples become erect.
  • The size of the breasts increases slightly.
  • Sex flush may appear in some women (one in two).
  • They increase heart rate and blood pressure.
  • General neuromuscular tension is increased.

Plateau

  • Vaginal lubrication continues, but may wax and wane.
  • There is swelling of the outer third of the vagina (orgasmic platform) that expands inward and narrows inside.
  • The uterus rises even higher.
  • The inner two thirds of the vagina are further expanded and lengthened.
  • The clitoris recedes under the clitoral hood.
  • The vaginal lips swell and change color.
  • Sex flush, if present, intensifies and spreads.
  • Greater increase in the size of the breasts; the areola (dark skin surrounding the nipples) becomes more prominent.
  • Heart rate and blood pressure increase further.
  • Breathing may become shallower and faster.
  • Voluntary contraction of the rectal sphincter, used by some women as a stimulation technique.
  • Greater increase in neuromuscular tension.
  • They reduce visual and hearing acuity.

Orgasm

  • Involuntary rhythmic contractions of the orgasmic platform and uterus are initiated.
  • The sexual blush, if present, reaches its maximum color and expansion.
  • Involuntary contractions of the rectal sphincter.
  • Heart rate, blood pressure and respiratory rate at maximum.
  • Loss of voluntary muscle control, cramp-like spasms of muscle groups in the face, hands, and feet may occur.

Resolution

  • The clitoris returns to its normal position about five to ten minutes after orgasm.
  • The orgasmic platform disappears.
  • The vaginal lips return to their normal thickness, position, and color.
  • The vagina quickly returns to the resting position; the return to the resting color can take between ten and fifteen minutes.
  • The uterus and cervix return to their unstimulated position.
  • The areola quickly returns to its normal size; the erection of the nipples disappears more slowly.
  • Rapid disappearance of sexual flush.
  • Unusual neuromuscular tension may continue, as evidenced by tremors or involuntary contractions of isolated muscle groups.
  • Heart rate, blood pressure, and respiratory rate return to pre-arousal levels.
  • The general feeling of relaxation prevails.
  • Visual and hearing acuity return to normal levels.

Author

Dr P K Gupta is a renowned sexologist in Delhi, specialized in sexual problems treatment by counseling or medication or exercises.