An unknown author once used this metaphor to analogize sexual dysfunction: “A chicken and an egg are lying in bed. The chicken is smoking a cigarette with a satisfied smile on its face and the egg is frowning and looking put out. The egg mutters to no one in particular, ‘I guess we answered that question.’” (Unknown Author, n.d.). This might be a tacky illustration of sexual dysfunction, but it does illustrate one important point; namely, that sexual dysfunction can be situational and at times subjective.
The sexual response cycle could be likened to the average American’s work week. The week begins after a weekend which represents the pre-aroused state. On Monday motivation is needed to start the week effectively, symbolizing the excitement phase. Tuesday is a steady day, the plateau phase; really only a precursor to midweek. Wednesday, the orgasm phase, is hump day. It is the climax of the week and it is all downhill from there. Thursday and Friday, the resolution phase, wind down the week before the weekend. At that point, the weekend, or the pre-aroused stage, is started again. As with the average work week, many obstacles may arise during the sexual response cycle which can negatively impact productivity and effectiveness. During the sexual response cycle, these obstacles are referred to as sexual dysfunction. It is important to view sexual dysfunction within the context of the sexual response cycle because many forms of sexual dysfunction are a direct result of dysfunction in one particular step in the sexual response cycle. To that end, the rest of this paper will be devoted to breaking down the sexual response cycle and explaining contextual evidence for the associated sexual dysfunction.
The first stage of the sexual response cycle is the excitement phase. This phase is characterized in men by an erection, thickening of the scrotal skin, and increased size and elevation of testes. Physical changes for women during the excitement phase include swelling of the clitoris, lubrication; flattening and spreading of the vaginal lips, and the inner part of the vagina expands. As per our work week analogy, this phase symbolizes Monday because motivation is needed to reach an aroused sexual state. Some forms of sexual dysfunction are psychological in nature, especially in this phase. Female sexual arousal disorder can be related to anger and resent for the other partner or even sexual trauma and rape. One form of sexual trauma, childhood sexual abuse, is especially common in cases of female sexual arousal disorder. Obstacles to sexual excitement can also be biological as well. The male erectile disorder can be caused by diabetes mellitus, which is a disease that damages blood vessels and nerves. Excess cholesterol in the blood can lead to the plague which can slow down blood flow to the penis. Also, many drugs can lead to male erectile disorder, such as: antidepressants, adrenergic blockers, diuretics, cholesterol-lowering drugs, and anticonvulsants. Both the biological and psychological forms of sexual dysfunction in the excitement phase can be incredibly situational. Certain sounds, smells, or tastes might bring back memories of childhood sexual abuse and impede sexual arousal. Many drugs help curtail the effects of the male erectile disorder. If those drugs are in effect, then an erection is easier to obtain and maintain during sexual intercourse. Also, it is entirely possible that one sexual partner and not the other are suffering from a sexual disorder, making sexual dysfunction incredibly subjective and personal.
The next stage of the sexual response cycle is the plateau stage. For men, this phase is characterized by the increased circumference of the penis and the testes being elevated into position for ejaculation. In women, the plateau phase includes the clitoris shortening and withdrawing behind the clitoral hood, and contraction of the vaginal opening. This phase is exemplified in Tuesday, the lead-up to Wednesday (climax). Men may experience premature ejaculation during this stage. This is ejaculation with only minimal sexual stimulation and can lead to loss of sexual satisfaction in both men and women. Age also plays a substantial part in maintaining an erection during the plateau phase. An NHSLS study discovered that 6% of men 18-24 had difficulty obtaining and keeping an erection and 20% for ages 55-59 (Nevid & Rathus, 2005). This reduction in the ability to maintain an erection can be explained through the drop-off of the male sex hormone testosterone as men age. The example of premature ejaculation highlights the subjectivity of sexual dysfunction in that one partner might reach orgasm without the other partner having sufficient time to reach the climax.
The climax of the sexual response cycle is the orgasm phase. During this phase, men experience two stages of muscular contractions otherwise known in men and women as myotonia. The first stage of male ejaculation entails collection of semen at the base of the penis and blockage of the bladder. The second stage includes muscle contractions which propel the ejaculate out of the penis. In women, orgasm consists of contractions of the pelvic muscles that surround the vaginal barrel. In our analogy, this stage is emphasized on Wednesday, hump day. The orgasmic disorder can keep a person from reaching this stage at all. This disorder is characterized by an inability to reach orgasm or delay in reaching orgasm. In both sexes, pain associated with intercourse can prevent orgasm or even sexual pleasure. Lack of orgasm can also come from a lack of proper stimulation from the other sexual partner. In this case, the orgasm is incredibly situational in that it depends on both the emotion and physical state of both sexual partners.
The last stage of the sexual response cycle is the resolution phase. This phase includes the release of blood from engorged areas resulting in return to pre-aroused size and the return of blood pressure, heart rate, and breathing to normal levels. In our analogy, this phase is Thursday and Friday which symbolize the winding down of the week. There is little dysfunction associated with this phase because it is only the resolution of the entire cycle. One sexual dysfunction associated with age though is that men over the age of 50 may require a one day refractory period between sexual experiences. A refractory period is a time in which it takes for men to become able to be sexually stimulated after the sexual response cycle. As with most of the dysfunction associated with the sexual response cycle refractory periods are situational and can change from one sexual experience to the next.
In conclusion, several types of sexual dysfunction associated with the sexual response cycle are situational in nature and can change from one sexual experience to the next. Many of the sexual dysfunctions are subjective, meaning that they pertain to only one sexual partner and not the other.
Nevid, J.S., Rathus, S.A. (2005). Psychology and the challenges of life: Adjustment in the new millennium. Danvers, M.A.: Wiley.
Unknown Author. (n.d.). Retrieved February 17, 2008, from Quote Garden Web site: http://www.quotegarden.com/sex.html