Week 2 (SEX)
Learning goals
1. Describe the sexual response cycle and its advantages and disadvantages
2. Explain how psychological processes affect sexuality
3. Discuss the importance of sex and orgasm on life satisfaction
4. Report in-depth knowledge of all aspects of sexual dysfunction in men and
women described in the DSM V (Delayed Ejaculation, Erectile Disorder, Male
Hypoactive Sexual Desire Disorder and Premature Ejaculation in men and Female
Orgasmic Disorder, Female Sexual Interest/Arousal Disorder and Genito-pelvic
Pain/Penetration Disorder in women)
5. Discuss the impact of childhood sexual abuse on women’s sexual health
6. Describe (evidence-based) treatments of sexual dysfunctions; with a focus on the
working mechanisms and effectivity.
Source: Hock & Roger, R.: Human Sexuality
(Understand the basics of biology, but mainly interested in the psychological)
BIOLOGY, PSYCHOLOGY, AND HUMAN SEXUAL RESPONDING
Compared to most nonhuman animals,' our reasons for engaging in sexual behavior
are far more varied and complicated because psychological processes play a role at
least as great as, or arguably greater than, biology.
Why do humans become sexually aroused? In addition to any impulse toward
rproduction that may exist, the reasons may include feeling pleasure, giving
pleasure, expressing feelings of closeness and love, relieving stress, feeling valued by
another person, expressing how much another person is valued, feeling more
dominant or submissive, and many other reasons that you can probably cite.
These are not purely biological reasons for sexual desire; they are, essentially,
psychological reasons and, as such, are fundamentally human.
MASTERS AND JOHNSON: THE EXCITEMENT-PLATEAU-ORGASMRESOLUTION (EPOR)
MODEL
To facilitate explanations of how our bodies change during sexual stimulation,
Masters and Johnson (1966) divided the process into four phases of sexual response
—excitement, plateau, orgasm, and resolution—often called the EPOR model.
As they readily noted, it is fundamentally impossible to identify exactly when
excitement stops and plateau begins or the precise instant orgasm starts or ends.
Sexual responding is a much more seamless process. However, the four-phase model
was simple to understand; it made sense for many people when they thought about
their own sexual reactions, and converted the complex experience of sexual
responding into a more clearly defined phenomenon.
Excitement and plateau: the first two stages
Early arousal responses can occur from any type of pleasurable sexual stimulation,
for example, kissing, erotic touching, sexual fantasy, sexually arousing visual
materials, masturbation, or intercourse. Exactly what triggers sexual arousal depends
on many factors, including each person's sexual history and cultural beliefs about
sexuality.
, During the excitement stage for both sexes, blood begins to circulate into erectile
structures throughout the body, causing them to expand and enlarge, in a process
called vasocongestion. A sex flush or reddening of the skin of the chest and abdomen
may occur in some people, the nipples become erect, breathing becomes heavier
and faster, heart rate increases, and voluntary muscles tense in a process called
myotonia.
For men, the first and most obvious sign that sexual excitement has started is
erection of the penis. The scrotal skin tightens, the testicles begin to rise up toward
the underside of the penis, and the testicles themselves enlarge somewhat.
For women, the first physical change is erection of the clitoris (see Figure 3), but
because most of the clitoris is inside the body, the most perceptible sign that sexual
excitement has begun is vaginal lubrication. During this phase, the shaft of the
clitoris increases in size, and the labia minora swell and may separate slightly from
around the opening to the vagina. Various internal changes are occurring as well.
The uterus engorges with blood, enlarges, and moves slightly upward in the
abdominal cavity. The vagina begins to change shape, becoming longer and widening
out along the inner two-thirds of its length. Also, the breasts, nipples, and areolas
enlarge slightly.
In their early studies, Masters and Johnson observed that for many individuals and
couples, a leveling off of arousal seemed to occur at some point in the excitement
phase, during which both men and women continued to be very aroused but did not
appear to be experiencing much additional elevation in their level of arousal. They
called this the plateau phase.
For both sexes during the plateau phase, erectile tissues throughout the sexual
anatomy are now fully engorged with blood. Respiration, heart rate, blood pressure,
and muscle tension are all at high levels as orgasm approaches. The sexual flush on
the skin in some people spreads and darkens.
Clitoral Erection and the Myth of Female Orgasms During Heterosexual Intercourse
Only about 25 to 30% of women experience orgasms routinely through sexual
intercourse exclusively, without additional stimulation of the clitoral area during
intercourse.
One of the most common reasons women do not experience orgasm during
intercourse relates to differences in sexual anatomy and a woman's sexual
stimulation needs.
Orgasm
The climax of sexual arousal is the orgasmic phase. Although this is the shortest of
the four phases, usually lasting less than 15 seconds, most people would agree that
orgasm is the most intensely pleasurable experience of sexual responding.
For both sexes, as orgasm approaches, respiration increases dramatically, and pulse
rate and blood pressure continue to rise. Any existing sexual flush may spread over
more of the body. Usually, a loss of control over some voluntary muscles results in
muscle contractions and spasms, especially in the hands and feet. Muscles in the
pelvic area begin to contract rhythmically at the rate of once every 0.8 second
(however, you would find it quite a challenge to try to time these as they are
happening!).
,
During orgasm, the person is usually very self-focused and, at the climactic peak,
typically experiences some loss of awareness of his or her surroundings. Orgasm
typically brings about an immense release of psychological and physical tension,
leading to satisfied, warm sensations of emotional well-being and a sense of bonding
with the partner.
Orgasms not only provide great physical and emotional pleasure but may actually
enhance biological and psychological health as well. However, most sex
educators and sex therapists stress that, although orgasm is a natural part of human
sexual response, it should not be the goal of sexual interactions. In fact, focusing on
orgasm as the main objective of lovemaking may detract, rather than enhance, the
intimate experience.
When couples value and embrace the entire lovemaking process, they often discover
new and deeper levels of closeness and intimacy. An orgasm-as-the-goal approach to
sexual intimacy often leads to repetitive, mechanical sexual interactions that are
targeted at that goal but may fail to produce the expressions of love and intimacy
couples seek. Moreover, if one partner does not experience orgasm, the sexual
encounter may be interpreted as a failure. Instead, sexuality educators and
therapists try to assist couples in learning to experience all sexual activities as
pleasurable in and of themselves.
HEALTH BENEFIT RESEARCH FINDIGNS
General health An orgasm at least once or twice per week appears to strengthen the immune
system's ability to resist flu and other viruses
Pain relief Some women find that an orgasm's release of hormones and muscle
contractions help relieve the pain of menstrual cramps and raise pain tolerance
in general
Lower cancer rate Men who have more than five ejaculations per week during their 20s have a
significantly lower rate of prostate cancer later in life.
Mood enhancement Orgasms increase estrogen and endorphins, which tend to improve mood and
ward off depression in women.
Longer life Men who have two or more orgasms per week live significantly longer than
men who have fewer
Greater feelings of intimacy The hormone oxytocin, which may play a role in feelings of love and intimacy,
increases five-fold at orgasm.
Less heart disease Studies have shown that men who have at least three orgasms per week are
50% less likely to die of heart disease.
Better sleep The neurotransmitter dopamine, released during orgasm, triggers a stress-
reducing, sleep-inducing response that may last up to two hours.
Younger appearance People who have frequent orgasms in conjunction with lovemaking are judged
to look younger than their less sexually active counterparts.
The female ejaculation debate
Some women claim to ejaculate upon orgasm what is it that women, who do not
possess these anatomical structures, ejaculate?
the debate over the years has been between those who claim that the fluid expelled
by women during orgasm is identical to urine and those who argue that it is not
, urine but something more akin to semen. If it is urine, this leads to the conclusion
that the intense muscular activity during orgasm can, in some women, lead to some
slight incontinence, in the same way that some people will expel a small amount of
urine when laughing too hard or sneezing (referred to as stress incontinence).
However, several other studies have found that female ejaculate actually resembles
male prostatic fluid in chemical composition and that women who report ejaculating
do not appear to be more prone to urinary stress incontinence.
Some research indicates that female ejaculate may be comprised mostly of a fluid
secreted by two paraurethral glands (pare means "alongside") that lie on either side
of the female urethra, known as Skene's glands. used to be small but now larger
and more active in some women. Because these glands may secrete fluid into the
urethra at the moment of orgasm, some researchers are making the case that they
may be thought of as a female variant of the prostate gland in males
Purpose?
fluid is expelled through the urethral opening, not the vagina, and it does not
appear to add significantly to sexual lubrication or enhance the odds of conception.
Other researchers are suggesting that the fluid secreted by the Skene's glands
may serve a reproductive function by inhibiting the growth of bacteria that cause
urinary tract infections (UTIs;)
One study's authors further suggest that the production of these secretions may
exist in women because it has served an evolutionary, survival function.
Resolution
The resolution phase, also sometimes referred to as detumescence ("reduction in
swelling"), is the completion of the cycle, when the body returns to its sexually non-
aroused state. Typically, this process happens fairly rapidly following orgasm but
takes somewhat longer if orgasm has not occurred.
For both sexes, heart rate, blood pressure, and muscle tension drop quickly. The
body may be covered with perspiration. If a sexual flush was present, it now fades.
Both men and women usually feel relaxed, warm, content, and sleepy.
Masters and Johnson (1966) found that if a woman receives additional stimulation
following orgasm, she may be capable of returning to the plateau phase and have
one or more additional orgasms (multiple orgasms) without entering a resolution
phase or refractory period between them.
For women, blood flows back out of erectile tissues throughout the genitals and
breasts. The breasts, nipples, and areolas diminish in size and return to their unerect
state. The clitoris resumes its prearousal position and shrinks slightly. The labia
minora return to their normal size and position over the vaginal opening. The walls
of the vagina relax and fold in on one another. Also, the cervix widens slightly, most
likely to facilitate the passage of semen and sperm into the uterus (assuming
unprotected heterosexual intercourse) and narrows again about a half hour after
orgasm. The uterus drops back down to just above the cervix, where the semen is
pooled if ejaculation has occurred in the vagina.
For men, nipples lose their erection, the penile glans lightens in color, and the penis
becomes softer and smaller, returning to its unaroused, flaccid state. The scrotal skin
relaxes, and the testicles drop down, away from the body.
As mentioned briefly earlier, Masters and Johnson found that, unlike women, when
men enter the resolution phase, they must "take a break" prior to becoming aroused
