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SEXUAL DYSFUNCTIONS

It is very important to note that many of the difficulties that people have in their sexual relationships are not the result of specific sexual dysfunctions, but are rather the result of poor communication. It is very common for couples who otherwise have very intimate, close relationships to never openly discuss sex - their likes and dislikes, etc.

For example, just because a woman does not frequently experience orgasm when making love with a partner does not mean that she suffers from a sexual dysfunction. It may be that her partner is simply unaware of how to bring her to orgasm. In this case some honest, frank discussion about sex can greatly improve the quality of a sexual relationship. However many people do suffer from a specific sexual dysfunction.

SEXUAL RESPONSE

Sexual response has been studied by researchers and divided into stages, with the hope of understanding human sexual response and dysfunction better. The following information has been taken from The Kinsey New Report on Sex . 

SEXUAL AROUSAL

We have already established that the person must be in a state of readiness for sex. The next phase of sexual response is called sexual arousal or excitement (often called feeling horny).

Physical changes accompany mental arousal. The nervous system sends messages to certain centers of the brain, causing measurable changes in the body. For example, blood pressure rises and heartbeat and breathing rates alter. Messages also send blood to the genitals, alter muscle tension, and increase skin sensitivity, among other physical changes. A person's ability to sense and identify these physical changes as signs of sexual arousal actually contributes to the arousal process.

As the level of sexual arousal increases in females, vaginal lubrication begins, the inner 2/3 of the vagina expands, the outer lips of the vulva open, the inner lips enlarge, and the clitoris swells. In males, the penis fills with blood and becomes erect and the testicles draw closer to the body. In both sexes these physical changes are due to increased blood in the tissue of the genitals and the females' breasts. Nipples may also become erect in both sexes. 

PLATEAU PHASE:

Much of the research on sexual responses has been done by Drs. Masters and Johnson. They call the next stage of response the plateau phase. Arousal intensifies, and sexual and muscular tension increases. In both sexes heart rate, breathing rate and blood pressure increases. A "sex flush" that looks like a rash sometimes appears on the skin covering the chest, neck or other areas of the body.

In FEMALES, the 1/3 of the vulva swells and narrows the opening (the physiological reason that penis size is not important; if arousal is high enough, the vagina will grip even a shorter or thinner-than-average penis). The inner 2/3 of the vagina tents or balloons up, lifting the uterus and cervix away from the end of the vagina. The clitoris pulls closer to the pubic bone and is often covered by the enlarged labia. The inner lips may become two or three times thicker than when not sexually aroused and may change to a darker or brighter color. The areolae surrounding the nipples may swell, sometimes making nipples look less erect, and breasts may increase in size.

In MALES, the plateau stage may include an increase in the size of the head of the penis and the testicles. The head of the penis may also deepen in color. The testicles move closer to the body and rotate, so they press close to the area between the scrotum and anus. Clear fluid may appear at the tip of penis (pre-ejaculatory fluid). 

ORGASM:

If nothing interferes with the above process (the phone does not ring or the partners don't start worrying about whether or not they are going to orgasm) and each person feels secure enough to "let go", orgasm will usually occur.

Orgasms last only a few seconds (in contrast to the other stages, which can last for minutes or even hours) and consists of rhythmic muscular contractions. The mind focuses on experiencing these pleasurable sensations and the person may appear briefly to "black out" or lose consciousness; brain-wave patterns have been shown to change during orgasm. Involuntary vocal sounds and changes in facial expression may also occur.

For FEMALES, orgasm consists of three to ten muscular contractions (less than one second apart) of the outer 1/3 of the vagina, the uterus and the anal area. Pleasant sensations may be felt in the clitoris and throughout the genital and pelvic area.

In MALES, orgasms includes two separate and distinct events, even though in many men (almost all) they occur at the same time. First, the prostate and other internal organs contract and force their fluids into the base of the urethra (the inside end); this is sometimes called "emission". Once this has occurred, ejaculation is inevitable and can not be stopped. Several seconds later, orgasm involving contractions of the penis and the urethra force the semen out through the tip of the penis in spurts. As in females, these contractions are less than a second apart, also involve muscles surrounding the anus and may be felt in other genital or pelvic areas. 

RESOLUTION PHASE:

The final phase of sexual response is called the resolution phase. This immediately follows orgasm and consists of the time it takes for the body to return to its un aroused state. Blood leaves the genital area and organs gradually shift back to their original positions, size and color. Any "sex flush" disappears; sweating may occur; the heart rate, slow breathing and blood pressure all return to normal levels. The length of time required for the resolution phase varies. 

MULTIPLE ORGASM:

There are differences between males and females during the resolution phase. If stimulation and sexual interest continue after orgasm, some females have the potential to reenter the plateau stage and have another orgasm. This may happen more than once and is referred to as multiple orgasms. But just because the theoretical capacity for multiple orgasms exists does not mean that trying to have them should be a goal or a measure of "good sex" for either the woman or her partner. In fact, may women find continued stimulation of the genitals after one orgasm uncomfortable.

In contrast, after orgasm most males enter a "refractory period". This may last only a few minutes or much longer. Even though penile erection may remain, another orgasm is usually not possible until the refractory period ends. A very recent study of a small group of men has, however, documented that at least some males may be similar to females and be able to have multiple orgasms, and sometimes multiple ejaculations, if stimulation continues after the first orgasm. The length of the refractory period varies greatly from one person to another, and has been thought to increase to hours and even days as a man ages. The new study also brings this issue into question since half of the men in the study having multiple orgasms (and hence no refractory period) were older than 35. More research is needed on male orgasms.


The sexual responses described above occur in males and females whether the activity that produces them is masturbation, interaction with an opposite-sex or same-sex partner, or stimulation by hand, mouth, tongue or other activity. These stages described should not be used as a checklist. Experiences which do not involve reaching orgasm can be satisfying nonetheless.

Excerpts from University of Toronto study and The Kinsey New Report On Sex


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