Sexual Response in Women

What is the normal pattern of sexual response in women?

Sexuality is an important part of a woman's life. A woman's sexual response has stages. They include desire (libido), excitement, arousal, plateau of constant high arousal, peak intensity of constant high arousal, orgasm, possible repeat orgasm, and resolution. The response cycle begins with desire, also called libido, when a woman begins to want sexual intimacy.

The excitement or arousal stage describes the emotional and physical reactions that a woman feels. In this stage, natural lubrication in the vaginal lining, the vulva and vagina begin to swell slightly with blood, and the vaginal smooth muscles begin to relax and prepare the body for sexual activity. This may last from minutes to several hours. The heart rate, blood pressure, and breathing rate all increase.

During the plateau stage, the excitement is stronger and lasts longer. This is the highest level of sexual excitement before orgasm. The heart beats faster, blood pressure increases, breathing is heavier, and muscle tension increases. Increased blood flow causes the vagina to swell.

Orgasm is defined as waves of rhythmic muscle contractions which occur in the vagina and throughout the body. It may last only seconds. In this stage, the heart rate, blood pressure, and breathing are at the highest rate. Some women have orgasms regularly with sex and some women do not. This is normal. Some women have more than one orgasm during the same sex act.

During the resolution stage, the heartbeat and breathing slow down, emotional excitement fades, blood drains out of the swollen genital area, and the whole body sweats. Muscle tension relaxes, and the woman begins to relax and may become drowsy.

What can affect a woman's sexual response?

Many things can affect a woman's sexual response, such as a medical problem (thyroid disorder, diabetes, multiple sclerosis) or mental health problem (depression). Tiredness, age, stress, sexual assault, alcohol, and drugs (legal and illegal) can also affect a woman's sexual response.

When a woman cannot have an orgasm it is called sexual dysfunction. A woman may feel pain during sexual intercourse. The pain may be caused by infection, hormone changes, or other physical conditions, and may decrease sexual response. If a woman feels uncomfortable with sex or has a lack of support from her partner, she may have a much different response than someone who enjoys sex and feels good about herself and her partner. Other women may feel pressured or have a fear of pregnancy that prevents them from enjoying sex. Women who have a history of sexual abuse may have the hardest time with sex. Women with sexual dysfunction should see a healthcare provider to try to find out and treat what is causing the problem, and may also need strong emotional support and counseling.

Definitions of different types of female sexual dysfunction are:

• hypoactive sexual desire disorder: lack of sexual desire for sexual activity; little or no libido
• female sexual arousal disorder: unable to attain or continue to maintain sexual activity until the act is completed
• female orgasm disorder: cannot reach an orgasm, even after excitement phase
• dyspareunia: painful intercourse
• vaginismus: muscle spasms of the outer area of the vagina, which will not allow the penis to penetrate the vagina
• noncoital sexual pain disorder: pain in the genital area with no sexual activity

How can I learn more about this?

Several resources about sexual responses and women are available. You can get books about the emotional and physical aspects of sexuality and the sexual response at stores and libraries. Talking to a friend or family member may also be helpful. If you feel you have a problem, make an appointment with your healthcare provider. While sometimes it is hard to talk about intimate sex concerns, you do not need to be embarrassed. Healthcare providers are skilled at discussing these issues.

Additional information is available from:

• American College of Obstetricians and Gynecologists
  409 12th St., S.W., PO Box 96920
  Washington, D.C. 20090-6920
  Phone: (202) 638-5577
  Website: http://www.acog.org
• American Association of Sex Education Counselors and Therapists
  PO Box 5488
  Richmond, VA 23220-0488
  Website: http://www.aasect.org
• American Psychological Association
  750 First Street, NE
  Washington, D.C. 20002-4242
  Phone: (800) 374-2721
  Website: http://www.apa.org
• Sexuality Information and Education Council of the United States
  130 West 42 Street, Suite 350
  New York, NY 10036-7802
  Phone: (212) 819-9770
  Website: http://www.siecus.org