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During the 1950s and 1960s, William H. Masters and Virginia E. Johnson conducted many important studies within the field of human sexuality. In 1966, in their book Human Sexual Response, they detailed four stages of physiological changes of humans during sexual stimulation. These phases, in order of their occurrence, are the excitement phase, plateau phase, orgasmic phase, and resolution phase. Together, they make up the human sexual response cycle.

Excitement phase[]

The excitement phase (also known as the desire phase) is the first stage of the human sexual response cycle. It occurs as the result of any erotic physical or mental stimulation, such as kissing, petting, or viewing erotic images, that lead to sexual arousal. During the excitement stage, the body prepares for coitus, or sexual intercourse, in the plateau phase.

Excitement in Both Sexes[]

Among both sexes, the excitement phase results in an increase in heart rate (tachycardia), an increase in breathing rate, and a rise in blood pressure. An erection of the nipples, especially upon direct stimulation, will occur in nearly all females[How to reference and link to summary or text] and approximately 60% of males[How to reference and link to summary or text]. Vasocongestion of the skin, commonly referred to as the sex flush, will occur in approximately 50-75%[How to reference and link to summary or text] of females and 25% of males[How to reference and link to summary or text]. An increase in muscle tone (myotonia) of certain muscle groups, occurring voluntarily and involuntarily, begins during this phase among both sexes. Also, the external anal sphincter may contract randomly upon contact (or later during orgasm without contact).

An exaggerated male erection from Pompeii

Commonly referred to as the sex flush, vasocongestion (increased blood flow) of the skin can occur during all four phases of the human sexual response cycle. Studies show that the sex flush occurs in approximately 50-75% of females and 25% of males, yet not consistently. The sex flush tends to occur more often under warmer conditions and may not appear at all under cooler temperatures. It has also been commonly observed that the marked degree of the sex flush can predict the intensity of orgasm to follow.

During the female sex flush, pinkish spots develop under the breasts, then spread to the breasts, torso, face, hands, soles of the feet, and possibly over the entire body. Vasocongestion is also responsible for the darkening of the clitoris and the walls of the vagina during sexual arousal. During the male sex flush, the coloration of the skin develops less consistently than in the female, but typically starts with the epigastrium (upper abdomen), spreads across the chest, then continues to the neck, face, forehead, back, and sometimes, shoulders and forearms.

The sex flush typically disappears soon after orgasm occurs, but this may take up to two hours or so, and sometimes, intense sweating will occur simultaneously. The flush usually diminishes in reverse of which it appeared.

Excitement in Males[]

In males, the beginning of the excitement phase is observed when the penis becomes partially erect, after only a few seconds of erotic stimulation. The erection may be partially lost and regained repeatedly during an extended excitement phase. Both testicles become drawn upward toward the perineum, notably in circumcised males where less skin is available to accommodate the erection. Also, the scrotum can tense and thicken during the erection process.

File:L'Origine du monde.jpeg

Gustave Courbet's L’Origine du monde (1866) An erect nipple and the redness of the vaginal lips suggest a recent sexual encounter.

Excitement in Females[]

In females, venous patterns across the breasts become more visible and the breasts very slightly increase in size, which becomes more observable if lying on the back. The labia majora become flatter, thinner, and raise upwards and outwards in nulliparous women (those who have not given birth)[How to reference and link to summary or text]. In parous women (those that have given birth), they may increase two or three fold in size[How to reference and link to summary or text]. The labia minora may increase in size and may protrude from the labia majora, depending on the size they are in a normal, relaxed state. The clitoris becomes tumescent, or swollen, like the glans of the penis. After only seconds of stimulation, vaginal lubrication is produced by the vasocongestion of the vaginal walls. They darken in color and become smoother than normal. Also, the uterus elevates, more vertically as time passes, and the inner two-thirds of the vagina expand, usually a total of 7 to 10 cm[How to reference and link to summary or text].

Plateau phase[]

The plateau phase is the period of sexual excitement prior to orgasm.

The plateau phase is the second phase of the sexual cycle, after the excitement phase. Further increases in circulation and heart rate occur in both sexes, sexual pleasure increases with increased stimulation, muscle tension increases further.

During this phase, the male urinary bladder closes (so as to prevent urine from mixing with semen) and muscles at the base of the penis begin a steady rhythmic contraction. Males may start to secrete seminal fluid and the testicles rise closer to the body.

At this stage females show a number of effects. The areola and labia further increase in size, the clitoris withdraws slightly and the Bartholin glands produce further lubrication. The tissues of the outer third of the vagina swell considerably, and the pubococcygeus muscle tightens, reducing the diameter of the opening of the vagina and creating what Masters and Johnson refer to as the orgasmic platform. For the many women who never achieve orgasm, this is the peak of sexual excitement. Both men and women may also begin to vocalise involuntarily at this stage.

Prolonged time in the plateau phase without progression to the orgasmic phase may result in frustration for either partner if continued for too long (see Orgasm control).

Orgasmic phase[]

Main article: Orgasm

Orgasm is the conclusion of the plateau phase in a release of sexual tension. Both males and females experience quick cycles (typically 0.8 seconds apart) of muscle contraction of the anus and lower pelvic muscles, with women also experiencing uterine and vaginal contractions.

Males ejaculate approximately 2–5 mL of semen, with the volume varying considerably depending on the period of abstinence and degree of sustained arousal prior to ejaculation.

Orgasms in both men and women are often associated with other involuntary actions, including vocalizations and muscular spasms in other areas of the body. Also, a generally euphoric sensation is associated with orgasm. Orgasm generally causes perceived tiredness, and both males and females often feel a need to rest afterwards. This is often attributed to the release of endorphins during orgasm causing relaxation and drowsiness, but can also be due to the body's need for a short rest after a bout of vigorous sexual activity.

Orgasms in females may also play a significant role in fertilization. The muscular spasms are theorized to aid in the locomotion of spermatozoa up the vaginal walls into the uterus. Some also hypothesize[How to reference and link to summary or text] that if the woman remains in a horizontal position for some time, due to sexual exhaustion and post-orgasmic pleasure, the chances of impregnation will increase.[How to reference and link to summary or text]

Resolution phase[]

The resolution phase occurs after orgasm and allows the muscles to relax, blood pressure to drop and the body to slow down from its excited state.

Men and women may not experience this refractory period and further stimulation may cause a return to the plateau stage. This allows the possibility of multiple orgasms in both sexes. However, some may find continued stimulation to be painful after the orgasmic phase.

In addition, refractory periods range from human to human, with some being immediate (no refractory) and some being as long as 12 to 24 hours.

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de:sexueller Reaktionszyklus

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