Men's Health: Analyzing Cyclic Changes in Sexual Response and Psychological Adjustment

What are the physical changes before and after orgasmic response?

The concept of human sexual response was first proposed in 1966 in the book *Human Sexual Response* by Dr. Masters, an American obstetrician and gynecologist, and the Johnson couple, psychologists, based on their extensive laboratory research over many years. The book details the entire process of male and female sexual response, from the initial arousal of sexual desire to its subsequent subsidence. It broadly divides the human sexual response process into four stages, named: excitement, plateau, orgasm, and resolution. Men and women exhibit different behaviors at each stage. These are described below:

1. Excitement Stage

The excitement stage refers to the period when sexual desire is aroused and the body begins to show sexual tension; it is also called the arousal phase. Sexual arousal is caused by physical and psychological stimulation. The time required varies, ranging from just two or three minutes to over an hour. This difference is related to various factors, including the individual's psychological state, emotions, mood, level of fatigue, and the timing, environment, and effectiveness of sexual stimulation. Generally, men are quicker and more intense, while women are slower and more gradual.

At the onset of sexual arousal, physiological responses include increased heart rate, muscle tension, and genital engorgement.

When men reach the peak of arousal, their muscles are tense and powerful, their anus contracts, their pupils constrict, their heart rate increases, and their blood pressure rises. The penis swells, pulsates, and becomes erect due to engorgement; a small amount of discharge may leak from the urethra; the scrotum lifts and tightens; the spermatic cord contracts; and the testicles move upwards. If intercourse is not immediately performed, the penile engorgement may subside after a while, and the erection may become flaccid, but it can be re-erected with further stimulation, leading to repeated cycles.

During female sexual arousal, the body's muscles contract, the heart rate increases, breathing deepens, hyperventilation occurs, and blood pressure rises. Facial expressions become gentle, the face flushes, and the eyes become alluring, displaying sexual seduction. The breasts enlarge, nipples become erect, and the labia majora and minora swell and become congested. As the vestibular glands on both labia majora secrete more fluid, the vaginal opening becomes moist, and the labia gradually separate. The clitoris hardens and becomes extremely sensitive due to congestion and swelling. The cervix and uterus shift slightly upward, causing the vagina to lengthen and expand to accommodate the penis.

2. Plateau Phase (Pause Phase)

The plateau phase refers to a short, gradual development of excitement before the onset of more intense physical tension. It is also known as the plateau phase or climax phase. There are no sudden physiological changes between the excitement and plateau phases; instead, many physiological responses continue and intensify on the basis of the excitement phase, indicating that the physiological tension, muscle tension, and nerve excitation of orgasm have reached a higher intensity. Intense sexual sensation begins from penile insertion into the vagina. The woman's vaginal walls contract, grip the penis tightly, and the movement of her hips further enhances male pleasure. This phase lasts approximately 2-5 minutes.

During this phase, men experience heightened arousal, muscle rigidity, and localized spasmodic contractions (such as in the face and abdomen). Blood pressure remains similar to that during the excitement phase, and may be higher in some individuals. Breathing becomes shallower, deeper, and faster. A sexual flush appears on the upper abdomen. The penis is thicker and more robust than during the excitement phase, the scrotum tightens, and there is increased secretion from the accessory sex glands.

Women experience similar changes. Locally, the inner two-thirds of the vagina expands further as the uterus rises; the outer one-third of the vaginal mucosa becomes significantly congested and narrows noticeably, forming a "plateau" for orgasm, providing a "grip" effect on the inserted penis. Therefore, the size of the penis has little impact on the physical stimulation felt by the woman. Simultaneously, the vagina produces a large amount of lubricating fluid to facilitate penile thrusting and enhance male pleasure. During this phase, the labia minora stretch and turn a deep purplish-red, correspondingly increasing the length of the vagina. The breasts continue to enlarge, and the nipples harden. The pubococcygeus muscle begins to contract, working in conjunction with the man's thrusting to provide a "grip" to the penis, making it more sensitive. The clitoris retracts, and the uterus rises in position. Sexual flush can spread to the breasts and chest wall, and even to the buttocks, back, and extremities.

3. Orgasm Phase

Reaching orgasm during sexual intercourse is the ultimate expression of sensuality and pleasure. This phase is the shortest of the sexual response, lasting from a few seconds to about 30 seconds. The intensity of the orgasm is closely related to the number and duration of contractions of the sexual organs; it is also related to the method and intensity of sexual stimulation, the psychological receptiveness to sexual stimulation, the feelings between the partners, and their emotional state. The comfort, pleasure, and unparalleled joy of orgasm are inner experiences and feelings that many scholars have attempted to describe in detail but are difficult to articulate, and this sexual experience often varies from person to person.

A common characteristic for both men and women during this phase is that blood pressure rises to its highest point. Breathing becomes rapid, more than twice as fast as usual. The flushing of the chest and abdomen expands, the face becomes flushed, and the muscles throughout the body undergo voluntary or involuntary contractions, including facial contortions and spasms in the hands and feet, contraction of the levator ani muscle, and in some individuals, mild confusion. Some may experience profuse sweating or cold sweats.

In men, orgasm is a unique and pleasurable sensation of the gonads contracting spasmodically and the semen passing through the urethra. The muscle contractions begin at the junction of the ureter and the prostate gland, with all gonads participating in the contraction, allowing sperm and secretions to enter the urethra. Simultaneously, the prostate, seminal vesicles, and ejaculatory ducts contract violently, while the muscles of the ureter and urethra contract in a wave-like motion, creating combined pressure. Semen is expelled from the ejaculatory duct opening, mixed with secretions from the paraurethral glands. These muscle contractions occur 3-5 times at a time, and 8-10 times or even more in strong cases. If there are abnormalities in the seminal vesicles or mental tension, there is often a feeling of weak ejaculation, or ejaculatory dysfunction or retrograde ejaculation. As middle-aged and elderly people age, the intensity of ejaculation decreases, unlike the rapid and powerful ejaculation of younger people. Sometimes, ejaculation may occur only briefly, and the pleasure also diminishes.

In women, muscle contractions begin in the lower vagina, followed by rhythmic uterine contractions that develop from the fundus of the uterus to the cervix. During orgasm, muscle spasms occur more frequently and last longer. Some describe it as a mild electric shock or a warm current flowing from the perineum throughout the body.

Female orgasms are generally diverse. A survey analysis of 936 married women of childbearing age revealed eight common single types of orgasms: vaginal contraction type, warm current type, body shaking type, electric current type, playful and ecstatic type, floating type, moaning and restless type, and intoxicated hazy type. Some women exhibit two, three, or even four types simultaneously. Two or single types are the most common, accounting for about 66%, and the vast majority (about 88%) cling tightly to their partner during orgasm. Of these, about 12% of women have never experienced orgasm, about 5% experience only pleasure without orgasm, and about 7% experience neither pleasure nor orgasm.

In marital sex, often because men reach orgasm relatively quickly, women are often still in the plateau phase when the man ejaculates, failing to reach orgasm. As a result, the sensitivity of the woman's genitals and the tension in her body take a long time to subside. This often leads to sexual dissatisfaction for women, unfulfilled sexual desire, and psychological trauma, resulting in frigidity. Therefore, it is important to try to adjust the speed of sexual response for both partners, striving for simultaneous orgasms to achieve sexual harmony. It is important not to overemphasize this. Furthermore, women cannot achieve orgasm every time; as long as both partners feel satisfied and pleasured, that is sufficient. If the man excessively prolongs his erection time, waiting too long for the woman to reach orgasm, it can cause central inhibition in the man, producing adverse effects. There are also some middle-aged and elderly women who have never experienced orgasm in their lives, yet their marital relationships remain very harmonious. In addition, some women do not necessarily need intercourse to achieve orgasm. Sometimes, stimulation of the clitoris, vaginal opening, breasts, nipples, or lips alone can bring them to orgasm and achieve sexual satisfaction.

4. Resolution Phase

The resolution phase is a period of physiological and psychological relaxation, marking the complete end of sexual activity. After ejaculation, the penis remains partially erect but soon becomes flaccid and slides out of the vagina. Both partners experience a decrease in libido, muscle relaxation, normal heart rate and breathing, and the dissipation of blood flow to the sexual organs.

Generally, male sexual arousal subsides much faster than female arousal, especially the disappearance of penile erection, which is faster than the disappearance of blood flow to the clitoris and vagina. However, muscle tension usually subsides within about five minutes in both sexes. Men often feel tired and sleepy at this time, but female libido subsides more slowly, especially if the woman has not yet reached orgasm. Therefore, husbands should understand the characteristics of female sexual response and take appropriate measures, such as continuing to kiss and hug for a while and providing gentle caresses to satisfy the woman psychologically. After experiencing sexual pleasure, they should express tenderness and love to each other, further deepening their relationship.

Men experience a "refractory period" during the resolution phase. This refers to the period after orgasm. During this time, stimulation of the genitals no longer arouses sexual excitement, the penis does not become erect, and it may even cause physiological discomfort. The refractory period is a necessary relaxation phase before the second orgasm, and it is also a necessary "recharge" period for sperm accumulation and physical recovery. The length of this period is related to physical condition and age. It also varies from person to person. Young, strong men often have a refractory period of only a few minutes, while middle-aged and elderly men may experience it for several hours or even a day before regaining sexual arousal. Of course, if the mood is good and both partners have a strong sexual desire, the refractory period can be shortened accordingly.

It should be pointed out that the four stages of sexual response described above are not clearly defined; they are merely artificial divisions imposed by sex scientists for the purpose of explanation and research.