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Clinical discussion of the outdated sexual response cycle & how it may be hurting your sex life

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The quality of sex education people receive is not consistent and often based in myth and information from friends or nudie magazines. There are pervasive pseudo-science views on sex that get perpetuated by women’s and men’s magazines that are best outdated and at worst wrong and harmful. All these areas of how we arm ourselves with knowledge on sex may be contributing to your less than desirable sex life.


A common misunderstanding is that women’s and men’s sexual response cycle is the same and progresses in the same way. When couples take this view, it is easy for one person in the couple to get labeled with a problem when in fact their body may not be designed to have sex under the conditions it is being placed. People will run into sexual issues after the birth of a child, during high stress times due to work or family crisis or as they get older. People do not realize that their body isn’t designed to have sex when they are tired or are very stressed or in unhappy relationships. It’s important to examine the research on the sexual response cycle.


In assessing which human sexual response cycle allows for greatest experience of intimacy between partners, it is important to consider the validity of the sexual response cycle itself. A feminist critique of the Masters and Johnson four-phase sexual response cycle and Kaplan’s three stages of sexual response reveal that this model is based on biomedical conceptualization of women’s desire and also uses the male response as the standard by which female response are compared (Wood, Barthalow Koch & Kernoff Mansfield, 2006). Both of these models focus on a linear path in which each sequence must occur in a specific order followed by the next act (Wood et al., 2006). These models may not capture the female sexual response cycle.


In assessing female sexuality and response, it has been clearly documented that there has been little research into the many aspects of women’s sexuality (Wood et al., 2006; Hogarth & Ingham, 2009; Fraser, Maticka-Tyndale & Smylie, 2004; Bimbaum, Glaubman & Mikulincer, 2001; Humphries & Cioe, 2009). The connotation of sexual desire, Kaplan’s first stage, and missing from Masters and Johnson, is often based on a male perspective of desire as feelings of sexual thoughts, fantasies, “horniness”, a sensation in the genitals and overall interest in sex and desire to seek out sex (Wood et al., 2006).


Often sexual desire emphasizes feelings in the genitals and in sexual thoughts, which appear to be more common in men than women (Woods et al., 2006). Whereas it has been found in grounded theory studies that women experience sexual desire more in terms of mind and body in which they feel emotional and physical aspects that result in wanting a sexual experience with someone or alone (masturbation) (Bimbaum et al., 2001Fraser, et al., 2004; Woods et al., 2006). Women’s sexual desire seems to be tied more strongly to emotional aspects of a partner than just physical aspects that are often described in men (Bimbaum et al., 2001Fraser, et al., 2004; Woods et al., 2006). 


Another challenge is the linear assumption of both Kaplan’s and Masters and Johnson’s model that assumes just one correct way to proceed through the sexual stages responses.  In a study done by Basson (Woods et al., 2006) she found that women’s sexual desire was not always a precursor to sexual arousal.  Basson (Woods et al., 2006) found that sexual desire results more from a desire of intimacy than an urge in women.  Therefore for the context of the situation in which sex is or will take place is very important for women to feel desire or arousal (Bimbaum, et al., 2001; Fraser et al., 2004).


Context is another important consideration when looking at sex and the possible phases through which a person moves. Men and women have different political and power positions in society and in relationships. Men learn at an early age what is sexual pleasure, orgasms and what sexually pleases them via masturbation before they ever have their first sexual experience (Hogarth & Ingham, 2009). Boys usually start masturbating between the ages of 12 and 15 and some even younger (Hogarth & Ingham, 2009).


Women on the other hand tend to masturbate less frequently than boys and often have mixed and negative feelings about masturbation and their genitals (Hogarth & Ingham, 2009). Women often learn about sex not through their own exploration via masturbation and what pleases them, but from a sexual encounter with a male (Hogarth & Ingham, 2009). Women often cite their first time of sex as unpleasant compared to men that cite their first time as great (Hogarth & Ingham, 2009). Women receive subtle messages through social, moral and religious means that masturbation and female sexuality is wrong, whereas men receive more a message that it’s expected.  These messages about female sexuality and masturbation are evident in the history of female genital mutilation that occurred in the West. Women may be more inhibited to know what pleases them and feel uncomfortable about their own genitals or touching them (Hogarth & Ingham, 2009).


The other aspect of context is the reason why people engage in sex, which may affect desire. Women in particular, may have sex for a variety of reason that has nothing to do with satisfying a sexual desire. Women have sex for self-pleasure via masturbation, security, money, coercion or out of fear (Woods, et al., 2006). The stages of sexual response may not follow in those aforementioned incidents.


Orgasms are another part of the cycle in the finale stages. However, both men or women can engage in sex and progress through the act but one or both may not have an orgasm (Humphries & Cioe, 2009). The other issue of the stages of Kaplan and Masters and Johnson is the view that females have no refractory period after orgasm. However, studies have been done on women find that a significant percentage of women do experience a refractory period in which they have heightened sensitivity of the clitoris and either want no further stimulus or need to wait a period before having further stimulation (Humphries & Cioe, 2009).


Therefore, when considering all the aspects surrounding sex such as gender, context, defining sexual desire, it will vary the level of intimacy that is shared between partners. Sex may be initiated for a variety of reasons that will impact the level of intimacy. Often for women it seems intimacy is expressed in the relational and emotional aspects she shares with her partner outside the bedroom. The women needs to feel loved and respected and cared for and then out of these feelings comes desire that initiates sex. Men apparently feel sexual desire differently than women and may experience intimacy different.


The author worked at Women’s crisis line and received calls from women that are raped by their husbands. These women have sex out of fear with their husband, many times after being beaten by their husband. In such a case, the stages of sexual responsive may not follow either model and the woman may experience no level intimacy.


Another instance is the teenage girl coerced into having sex with her boyfriend. She doesn’t want to but feels she has no choice often feels guilty or bad about herself. Another example is that of a married couple who having been having timed intercourse for over 18 months in the hoping of conceiving a baby. The level of duty and functionality may overtake any level of intimacy experienced in the sex act. Sex becomes about baby making and not about lovemaking. Finally, the person who wants to have a one-night stand may not need to feel any level of intimacy but gratitude at  seeking out to release a feeling a desire.  Bodies and minds will respond differently to these types of sexual encounters.


In assessing intimacy it is important for the counselor to set aside personal biases as well as long held paternalistic bias that still run influence how we diagnosis and treat sexual dysfunction especially in women and more particularly in middle-age women.  Often we need to look at the relationship and the context in which sex is expected to occur. Often the problem is that our bodies are not doing what we demand of them in situations not designed to facilitate the sexual response we need to have sex.


A couple is advised to seek help individually or together to explore their beliefs about sex to see if their beliefs are clinically founded. A trained professional can help a couple look at whether or not their expectations for sex are realistic given what is occurring in their life, for example birth of a new baby, infertility, unhappy and hostile marital relationship or work stress. By properly examining the context sex is occurring one can better assess if it is a medical or relationship issue. Depending on this, the course of treatment will vary.


Tammy Fontana, MS, NCC CTRT


Bimbaum, G., Glaubman, H. & Mikulincer, M. (2001). Women’s experience of heterosexual intercourse-scale construction, factor structure and relations to orgasmic disorder. The Journal of Sex Research, 38(3), 191-205.


Fraser, J., Maticka-Tyndale, E. & Smylie, L. (2004). Sexuality of Canadian women at midlife. Journal of Human Sexuality, 13(3/4), 171-188.


Hogarth, H. & Ingham, R. (2009). Masturbation among young women and associations with sexual health: An exploratory study. Journal of Sex Research, 46(6), 558-567.


Wood, J.M., Barthalow, Koch, P. & Kernoff Mansfield, P. (2006). Women’s sexual desire: A feminist critique. Journal of Sex Research, 43(3), 236-245.

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