HUMAN
SEXUALITY
Chapter
Six: Sexual Arousal and Response
The
Role of Hormones in Sexual arousal
The
Brain and Sexual Arousal
The
Senses and Sexual Arousal
Aphrodisiacs
and Anaphrodisiacs in Sexual Arousal
Sexual
Response
Aging
and the Sexual Response Cycle
Some
Differences Between the Sexes in Sexual Response
testosterone is linked to male sexual desire (libido)
castration/orchidectomy
leads to decreased sexual interest and activity
antiandrogens reduce sexual interest and
activity (M & F)
example:medroxyprogesterone acetate (MPA, Depo-Provera)
hypogonadism
a
state of testosterone deficiency
results from certain endocrine diseases
linked to decreased sexual interest
may
be normalized with testosterone replacement therapy
testosterone is linked to female sexual desire (libido)
role of estrogens
in
female sexual motivation and functioning
remains unclear
in
females there is evidence of
a clear causal relationship
between levels of circulating testosterone
and
sexual desire,
genital sensitivity,
and
frequency of sexual activity
[picture of adrenal glands, testicles, and ovaries]
The
Invision Guide to Sexual Health p.23
©2006
by Alexander Tsiaras
Text by Elizabeth R. Boskey, Ph.D., M.P.H.
Male
total testosterone 300-1200 ng/dl
free
testosterone 1.0 - 5.0 ng/dl
Female
total testosterone 20-50 ng/dl
free
testosterone 0.1 - 0.5 ng/dl
the
essential amount (“critical mass”) of testosterone necessary for adequate
functioning
varies from person to person
within both sexes
signs of testosterone deficiency
decrease
desire
sensitivity
- genitals and nipples
arousability
energy
levels / depressed mood
bone
mineral density
body
hair
muscle
mass & strength
increase
fat
mass
testosterone-replacement therapy
testosterone supplements (for men or women)
orally (swallowing)
sublingually (under-the-tongue tablets)
injection
implantation of a pellet
transdermal skin patch
oxytocin – “cuddle hormone”
promotes a feeling of connection, bonding
released when we hug spouses or children
released when mother nurses infant
released at orgasm
treating autistic people with oxytocin
sometimes
helps alleviate symptoms
treating female animals with oxytocin makes
them
act maternal
[picture of prairie voles and cartoon of meadow voles]
the
prairie vole mates for life
asocial promiscuous meadow vole being converted to living monogamous
by
insertion of V1a receptor gene
British
Society for Neuroendocrinology
The
Neurobiology of Social Bonds
Professor
Keith M Hendrick
The
Babraham Institute
http://neuroendo.org.uk/index.php/content/view/34/11/
American
Scientist Online
High
on Fidelity:
What
can voles teach us about momogamy?
Marla
Vacek Broadfoot
http://www.americanscientist.org/template/
AssetDetail/assetid/14756?&print=yes
[drawings of brains showing how the insertion of a gene for
expressing more receptors
causes the same amount of oxytocin or vasopressin
to result in a greater release of
dopamine and more pleasure]
the
brain and sexual arousal
strictly mental events
(such as fantasies)
are
the product of the cerebral cortex
[the thin outer layer of the brain]
the brain and sexual arousal
direct electrical stimulation
in
certain areas within the limbic system
results in sexual pleasure & multiple orgasms
the
limbic system is a region of the brain
associated with emotion and motivation
functional MRI
woman bringing herself to orgasm
through thought and fantasy alone
The
Invision Guide to Sexual Health p.32
©2006
by Alexander Tsiaras
Text by Elizabeth R. Boskey, Ph.D., M.P.H.
the
senses and sexual arousal
touch: primary erogenous zones
-locations
most responsive to tactile stimulation
because of dense concentrations of nerve endings
(genitals, buttocks, anus, perineum, breasts, inner thighs,
armpits, navel, neck, ears, mouth)
secondary erogenous zones
-other
locations of the body
that have become endowed with erotic significance
through sexual conditioning
two-point discrimination
average minimal distance where two points are still felt:
tongue = 1 mm, fingertip = 2-3 mm, palm = 1 cm, back = 4-7 cm
Rapid
Access Guide To the Physical Examination
Donald
W. Novey
©1988
Year Book Medical Publishers
Page
495
If
the area of each body part was proportionate to its sensitivity
people would look very different.
Mapping
the Mind
©1998
Rita Carter
p75
the
senses and sexual arousal
vision
smell
taste
hearing
aphrodisiac
a
substance that allegedly
arouses sexual desire
and
increases the capacity for sexual activity
oysters, bananas, celery, cucumbers
tomatoes, ginseng root, potatoes
ground-up horns of animals such as rhinoceros and reindeer
alcohol, amphetamines, barbiturates
cantharides (“Spanish fly”),cocaine
LSD
and other psychedelic drugs, marijuana
amyl nitrite (“poppers”), L-dopa, yohimbine,
Libido
anaphrodisiac
a
substance that inhibits sexual desire and behavior
opiates (such as heroin, morphine, and methadone)
tranquilizers, antihypertensives,
antidepressants, antipsychotics
nicotine, birth control pills, progesterone
sedatives, ulcer drugs, appetite suppressants,
steroids, anticonvulsants
over-the-counter allergy medicines that cause drowsiness
drugs for treating cancer, heart disease, fluid retention
fungus infections
alcohol and sex
alcohol is not a stimulant
but
a depressant of the brain
alcohol reduces cortical inhibitions such as fear and guilt
with increased levels of intoxication,
both men and women experience:
reduced
sexual arousal (as measured physiologically)
decreased
pleasurability and intensity of orgasm
increased
difficulty in attaining orgasm
alcohol and sex
research has demonstrated a strong association
between the use of alcohol
and
an inclination to participate in
high risk sexual practices (risk of AIDS etc)
Masters
and Johnson’s model
of
the sexual response cycle
(female)
excitement
plateau
orgasm
resolution
(male)
excitement
plateau
orgasm
refractory period
resolution
Helen
Singer Kaplan model of sexual response
desire
excitement
orgasm
three basic patterns in female sexual response
identified by Masters and Johnson
only one male response pattern
identified by Masters and Johnson
two
fundamental physiological responses
to
effective sexual stimulation occur in both women and men
vasocongestion = the engorgement of blood
vessels in particular body parts in response to sexual arousal
myotonia = muscle tension
p.
102 FOR WOMEN ONLY:
A
Revolutionary Guide to Overcoming Sexual Dysfunction
and
Reclaiming Your Sex Life.
© 2001 Jennifer Berman, M.D., and Laura Berman, Ph.D.
excitement phase
duration: less than a minute – several hours
engorgement
penis,
testes
clitoris,
labia minora, vagina, nipples
sex
flush
increased muscle tension
increased heart rate and blood pressure
production of vaginal lubrication
plateau phase
duration: a few seconds - several minutes
heart rate, blood pressure, breathing rates increase
sex
flushes, genital coloration more noticeable
muscle tension increases
involuntary
contractions and spasms (face, neck, hands, feet)
markedly increased engorgement - outer third of vagina
clitoris withdraws under hood
Cowper’s
gland secretes
orgasm phase
duration: a few seconds
series of muscular contractions of pelvic floor muscles
occurring
at peak sexual arousal
male emission phase - seminal fluid gathered in urethral bulb
(sense that
orgasm is inevitable)
male expulsion phase - semen expelled out of penis
female - uterine contractions
resolution phase
if
no additional stimulation occurs
resolution begins immediately after orgasm
all
sexual systems return to nonexcited state
some changes take place rapidly, others more slowly
after orgasm, the male typically enters a
refractory period
a time
when no amount of additional stimulation
will
result in orgasm
duration: minutes - days
factors affecting duration:
age
frequency
of previous sexual activity
degree
of emotional closeness to partner
women generally experience
no
comparable refractory period
they are physiologically capable
of
returning to another orgasmic peak
from anywhere in the resolution phase
Grafenberg Spot (G spot)
area of erotic sensitivity
along
anterior wall of the vagina
stimulation may result intense orgasm
sometimes accompanied by ejaculation (from urethra)
female ejaculate has components similar to prostate secretions
[picture based on MRIs showing
clitoris & G-spot]
The
Invision Guide to Sexual Health p.37
©2006
by Alexander Tsiaras
Text by Elizabeth R. Boskey, Ph.D., M.P.H.
according to Freud
clitoral
orgasm - immature stage of sexuality
vaginal
orgasm - mature stage of sexuality
sexual response cycle of older women
vaginal lubrication
may
begin more slowly
amount
may be reduced
vaginal mucosa - thinner and lighter colored
number of contractions at orgasm may decrease
orgasmic contractions may be painful
resolution typically occurs more rapidly
sexual response cycle of older men
penile erection takes minutes instead of seconds
may
require more direct (manual or oral) stimulation
plateau phase may last much longer
number of contractions at orgasm may decrease
resolution typically more rapid
refractory period lengthens to hours or even days
differences between male and female sexual response
greater variability in female response
Masters and Johnson recognized
three patterns
of
sexual response in females, one in males
the
male refractory period
no
comparable period in women
multiple orgasms
both
women and men have had multiple orgasms
under laboratory
conditions
greater
percentage of women (vs. men)
have experienced
multiple orgasms