1

Human sexual response The human sexual response cycle is a four-stage model of physiological responses during sexual stimulation. Stages: 1. 2. 3. 4. Excitement Plateau Orgasm Resolution

Excitement phase occurs as the result of any erotic physical or mental stimulation, such as kissing, petting, or viewing erotic images, that lead to sexual arousal

BOTH SEXES increase in heart rate increase in breathing rate rise in blood pressure erection of the nipples vasocongestion of the skin, commonly referred to as the sex flush (occur more often under warmer conditions and may not appear at all under cooler temperatures) intense sweating increase in muscle tone external anal sphincter may contract randomly upon contact

MALE - penis becomes partially erect - the erection may be partially lost and regained repeatedly during an extended excitement phase. - both testicles become drawn upward toward the perineum, - scrotum can tense and thicken - coloration of the skin starts with the epigastrium (upper abdomen), spreads across the chest, then continues to the neck, face, forehead, back, and sometimes, shoulders and forearms. (SEX FLUSH)

rjebinbin

FEMALE - flushed skin or blotches of redness may occur on the chest and back - breasts increase slightly in size - nipples become hardened and erect. - swelling of the clitoris and labia minora - vagina begins to swell - The muscle that surrounds the vaginal opening grows tighter - uterus elevates and grows in size. - vaginal walls begin to produce a lubricating organic liquid

Plateau phase period of sexual excitement prior to orgasm

BOTH SEXES increased circulation increased heart rate increased sexual pleasure with increased stimulation further increased muscle tension respiration continues at an elevated level involuntary vocalization (moaning)

MALE - urethral sphincter contracts (to prevent urine from mixing with semen, and to guard against retrograde ejaculation) - muscles at the base of the penis begin a steady rhythmic contraction - may start to secrete seminal fluid or pre-ejaculatory fluid - testicles rise closer to the body FEMALE - clitoris becomes extremely sensitive and withdraws slightly - Bartholin glands produce further lubrication - tissues of the outer third of the vagina swell - pubococcygeus muscle tightens - reduction of diameter of the opening of the vagina

rjebinbin

Orgasmic phase conclusion of the plateau phase of the sexual response cycle and is experienced by both males and females

BOTH SEXES - quick cycles of muscle contraction in the lower pelvic muscles, which surround both the anus and the primary sexual organs. - involuntary actions, including vocalizations and muscular spasms in other areas of the body - euphoric sensation - heart rate is increased even further MALE - orgasm is usually associated with ejaculation - each ejection is associated with a wave of sexual pleasure, especially in the penis and loins - other sensations may be felt strongly among the lower spine, or lower back - first and second convulsions are usually the most intense in sensation, and produce the greatest quantity of semen - each contraction is associated with a diminishing volume of semen and a milder wave of pleasure FEMALE - increase in vaginal lubrication - tightening of the vaginal walls - overall pleasure

Resolution phase occurs after orgasm

BOTH SEXES - allows the muscles to relax - blood pressure to drop - body to slow down from its excited state - refractory period, which is part of the resolution phase, is the time frame in which men and women are unable to orgasm again

rjebinbin

MALE - two-stage detumescence of the penis: first stage, the penis decreases from its erect state to about fifty percent larger than its flaccid state. This occurs during the refractory period. second stage (and after the refractory period is finished), the penis decreases in size and returns to being flaccid - Resolution period: 30 minutes FEMALE - ability to orgasm again very quickly, as long as they have effective stimulation. - able to have multiple orgasms in a relatively short period of time - do not experience a refractory period and thus can experience an additional orgasm, or multiple orgasms - clitoris is very sensitive after climax, making additional stimulation initially painful

Controversies About Female Orgasm Freud 2 Types of Female Orgasm 1. Clitorial Orgasm originating from masturbation and noncoital acts sexual immaturity neurotic because orgasm does not come from sexual intercourse 2. Vaginal Orgasm originating from coital acts authentic mature form of sexual behavior Masters (1998) There is no physiologic difference between an orgasm achieved through intercourse and by direct stimulation of the clitoris.

rjebinbin

Types of Sexual Orientation 1. Heterosexuality Heterosexual one who finds sexual fulfillment with a member of the opposite gender 2. Homosexuality Homosexual one who finds sexual fulfillment with a member of the same gender Gay preferred term used by homosexual men Lesbian preferred term used by homosexual women Genetic evidence: effect of the abnormal increase level of the estrogen or testosterone in the utero 3. Bisexuality Bisexual one who finds sexual fulfillment from both homosexual and heterosexual relationships 4. Transexuality Transexual or Transgender individual who feels as if he or she should be of the opposite gender

Types of Sexual Expression 1. Celibacy - abstinence from sexual activity - avowed state of certain religious orders - a way of life for many adults - ADVANTAGE: ability to concentrate on means of giving and receiving love other than through sexual expression 2. Masturbation - self-stimulation for erotic pleasure - can also be mutually enjoyable activity for sexual partners - offers sexual release - offers anxiety relief or overall tension 2 6 years old - discovers maturbation as an enjoyable activity as they explore their bodies - may become accustomed as means of falling asleep at night or naptime (under high level of tension) - without attempt of concealment (they have not yet been affected by societys view)
rjebinbin

School-age - use for enjoyment or to relieve tension (with concealment) 3. Erotic Stimulation - use of visual materials such as magazines, photographs or videos for sexual arousal 4. Fetishism - sexual arousal resulting from use of certain objects or situations - leather, rubber, shoes, feet (perceived to have erotic qualities) - does not enhance the experience but rather becomes the focus of arousal 5. Transvestism Transvestite a person who dresses to take the role of the opposite sex - can be heterosexual, homosexual, or bisexual 6. Voyeurism - obtaining sexual arousal by looking at another persons body 7. Sadomasochism - Involves inflicting pain (sadism) or receiving pain (masochism) to achieve sexual satisfaction - a practice generally considered to be within the limits of normal sexual expression as long as the pain is minimal and the experience is satisfying to both sexual partners - AUTOEROTIC ASPHYXIA practice of causing oxygen deficiency during masturbation with the goal of producing a feeling of extreme sexual excitement 8. Exhibitionism - the act of exposing in a public or semi-public context those parts of one's body that are not normally exposed for example, the genitals or buttocks - practice may arise from a desire or compulsion to expose themselves in such a manner to groups of friends or acquaintances, or to strangers for their amusement or sexual satisfaction or to shock the bystander 9. Scatalogia - unsolicited telephone call where a person derives sexual pleasure by using sexual or foul language to an unknown person 10. Pedophilia Pedophile individual who is interested in sexual encounters with children - known sex offenders
rjebinbin

Sexual Harassment - unwanted, repeated sexual advances, remarks or behavior toward another that: 1. offensive to the recipient 2. interferes with job performance TYPES: a. quid pro quo (an equal exchange) an employer asks something in return for sexual favors, such as hiring or promotion preference b. hostile work environment an employer creates an environment in which an employee feels uncomfortable and exploited (being called honey, asked to wear revealing clothes Psychosocial consequences a. emotional distress b. anxiety c. depression d. posttraumatic stress disorder e. substance abuse f. interpersonal conflict g. impaired intimacy h. impaired sexual functioning

rjebinbin

Disorders of Sexual Functioning 1. Primary lifelong 2. Secondary acquired 3. Psychogenic origin produced by psychic 4. Biogenic origin produced by biologic processes Sexual Desire Disorders - Lack of desire for sexual relations REASONS: Circumstances: death of a family member, divorce, stressful job change Side effects of medications Chronic diseases Obesity (difficulty of deep penetration) Perimenopause

Disorders of Sexual Arousal Causes: 1. Physical Factors 2. Psychological Factors A. Failure to Achieve Orgasm Poor sexual technique Concentrating too hard on achievement Negative attitude toward sexual relationship TREATMENT - Relieving the underlying cause - Instructions and counseling for the couple about sexual feelings and needs

Disorders of Sexual Orgasm A. Erectile Dysfunction (ED) - Impotence (before) - Inability of a man to produce or maintain an erection long enough for vaginal penetration or partner satisfaction CAUSES: -

Aging Atherosclerosis Diabetes

rjebinbin

Side effect of some drugs

DRUG OF CHOICE: taken up once a day to stimulate penile erection sildenafil (Viagra) tadalafil (Cialis) vardenafil (Levitra) DRUG ACTION: Causes smooth muscle relaxation and inflow of blood to the corpus cavernosum of the penis, achieving erection DRUG DOSAGE: 50 mg PO prn 1 hr before sexual activity, up to one dose per day POSSIBLE ADVERSE EFFECTS: headache, dizziness, ventricular arrhythmia, impairment of blue/green discrimination CONTRAINDICATION: risk of cardiovascular illness; taking medications with nitrates TREATMENT - Drugs - Surgical implants - Vacuum pressure - Testosterone injection B. Premature Ejaculation - ejaculation before penile-vaginal contact - ejaculation before the sexual partners satisfaction has been achieved CAUSES -

psychological masturbating to orgasm doubt of masculinity fear of impregnating the woman

TREATMENT - serotonergic antidepressants - sexual counseling

rjebinbin

10

Sexual Pain Disorders A. Vaginismus - involuntary contraction of the muscles at the outlet of the vagina when coitus is attempted - the contraction prohibits penile penetration - may occur in women who have been raped - may be a result of early learning patterns in which sexual relations were viewed as BAD or SINFUL TREATMENT - sexual counseling - psychological counseling B. Dyspareunia/Vestibulitis - pain during intercourse - inflammation of the vestibule CAUSE -

endometriosis (abnormal placement of endometrial tissue) vaginal infection hormonal changes vaginal drying psychological factor

TREATMENT - underlying cause - open communication between sexual partners

rjebinbin