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Handbook On Female Sexual Health And Wellness

Female Sexual Response

There are a variety of opinions, definitions, and theoretical models that describe normal female sexual response. For example, the DSM-IV-TR 2000 describes the sexual response cycle as comprising desire, excitement, orgasm, and resolution. The following additional theoretical models may be useful to your understanding of the female sexual response:



  • Integrates multiple etiologic factors and determinants
    • Biologic (e.g., physical health, neurobiology, and endocrine function)
    • Psychologic (e.g., performance anxiety and depression)
    • Sociocultural (e.g., upbringing, cultural norms, and expectations)
    • Interpersonal (e.g., quality of current and past relationships, intervals of abstinence, life stressors, and finances)
  • The integration and input of all these components are essential for sexual response


  • Sexual satisfaction, and not orgasm, appears to be the focus in some women
    • A woman begins a sexual response experience from a point of relative sexual neutrality but with a goal of emotional intimacy with her partner; she may seek or be receptive to sexual stimuli
    • Goals for sexual activity may be complex and not merely for internal satisfaction of an “innate” sexual hunger
    • Receptivity to sexual stimuli allows the woman to move to a state of physiologic arousal
    • If the mind continues to process the stimuli on to further arousal, sexual desire may encourage the woman to move forward to sexual satisfaction and orgasm fostering intimacy and reinforcing sexual motivation
    • This model reinforces the notion that female motivation for sexual activity is complex and not specifically an innate phenomenon

(Masters and Johnson: traditional model of a linear progression from one phase of the sexual response to the next)

  • Views sex as a natural, biologic phenomenon
    • Sensory stimulation leads to increased peripheral blood flow and vasocongestion
    • With continuing stimulation, increased pelvic floor muscle tension and vasocongestion increase until development of a “plateau” phase that leads to orgasm; physical changes are apparent in the woman
    • During orgasm, there is a brain discharge, widespread genitor-pelvic muscle contraction, and increased cardiac output
    • Resolution follows orgasm with return to the non-stimulated state.
  • The essential components of sexual response depend upon adequate functioning and interplay of hormonal milieux, nerves, veins, arteries, and genitor-pelvic muscles