Women's sexual response

Since the beginning of this century, a great deal of research has been carried out into the subject of female sexual response and whether it can be influenced by medication.
Unfortunately, so far very little has emerged that will help women who have difficulties with enjoying sex or with reaching orgasm.
Indeed, medical science's view of feminine erotic physiology remains today very much what it was over 45 years ago, following the discoveries of the US researchers William Masters and Virginia Johnson.
What Masters and Johnson found was that during sexual activity, women go through the following four phases:

1. Excitement (or arousal) phase. An initial stage in which some erotic stimulus, like kissing an attractive person, starts getting the body ready for sex. This stage is accompanied by a rise in heart rate and blood pressure, erection of the nipples and increased lubrication inside the vagina.
2. Plateau phase. A stage in which the female body starts to prepare itself for imminent orgasm. The clitoris becomes sensitive, and the tissues of the outer part of the vagina begin to swell.
3. Orgasmic phase. This is characterised by immense enjoyment, and by a series of involuntary contractions in the pelvic muscles, plus cries of pleasure, and muscular spasms in various parts of the body.
4. Resolution phase. In this stage, blood pressure and heart rate fall as the woman 'calms down'. However, if sexual stimulation continues, the resolution phase may be very short, and she may proceed to further orgasms.
   
   

These reactions are more fully explained later in this article.

Recent scientific developments

During the period 2000 to 2013, researchers have tried to find ways of influencing female excitement and female orgasm, by developing drugs which were intended (a) to help women get aroused, and (b) to help them climax.
Unfortunately, so far all these efforts have failed. Initially, the use of Viagra seemed to offer a promising avenue. But although Viagra works extremely well on male sexual function, in females it seems at present to do no more than to produce a modest increase in vaginal lubrication.
Similarly, there have been high hopes recently for a medication called flibanserin (Girosa), which was originally developed as an antidepressant.
In September 2012, researchers connected with a US drug company were still claiming that it could improve what is called 'the female sexual function index' (FSFI).
However, the authoritative American Food and Drug Administration (FDA) has refused approval to flibanserin, on the grounds that it has various side-effects, whilst its effects on female sex function seem to be little better than those of a placebo.
So at present, there are no effective pharmacological ways of making women more interested in sex or more orgasmic. However, there's no doubt that various types of counselling or psychotherapy can help females to enjoy their 'love lives' more fully.
In addition, many women have improved their sexual responses by simply learning much more about their bodies and about what works best for them.
Similarly, a lot of females have found that sexual function improves dramatically if you can find a loving partner who knows what he (or she) is doing. 

Do all women have the same sexual responses?

Do all women have the same sexual feelings and responses? No, they don't.
In actual fact, women vary enormously in their sexual drive, and in their ability to have orgasms. Some don't feel very interested in sex at all – whereas others are passionate and wild about it.
Some go through life without ever having an orgasm, whereas others can sometimes enjoy a dozen or more climaxes per night.
But an extraordinary change has taken place in the last 60 years or so. Back in the mid-20th century, it was generally felt by doctors that most women fell into the 'not very interested' group – and that only a few were enthusiastically sexy.
By the 21st century, all that had changed. Today, it is widely assumed by the media – and by many of the public – that most women are easily aroused by sexual stimuli and that only a minority have little interest in sex. In fact, that isn't really true.
Our research indicates that although most modern females are much more 'open' about sex and are keen to enjoy it. It takes them time to learn how to do this.
Indeed, a small study that we completed in 2005 indicated that a considerable proportion of young women just starting at university have thus far developed very little interest in sex (or knowledge about it) and have not even learned to reach orgasm yet.
However, many of them do become very much more 'sexually charged' as the years progress.

Learning how to reach orgasm

We have found that younger females frequently have no real knowledge of the process of sexual arousal. In particular, women often need quite a lot of help to learn how to reach orgasm.
Unlike males – most of whom can 'come' easily from the moment they reach puberty – females will often spend a couple of years experimenting with their sexual feelings before they eventually learn how to climax regularly and reliably.
But once women have learned to cast off their inhibitions and enjoy sex, they tend to respond to sexual stimuli in very much the same way.

What exactly are women's sexual reactions?

A woman's first response to sexual stimulation is usually a nice, warm feeling all over her body – as she begins to let herself go.
At the same time her pulse rate starts to go up, and the pupils of her eyes get bigger. Incidentally, this widening of the pupils makes her more attractive sexually. In the olden days, drugs like belladonna ('beautiful woman') were used to produce this effect.

What happens to her sex organs as she gets aroused?

Laboratory studies carried out in Holland in 2004 show that as s soon as a woman even starts thinking with interest about sex, her vagina begins to moisten. This is the female equivalent of erection in men.
The reason for this moistening is to lubricate her vagina, in preparation for possible sexual activity.
At the same time, various other things happen:

• her clitoris – the most erotically sensitive part of her body – swells up
• her labia (the lips of the opening of her vagina) also swell up. The effect of this is to open up her vaginal opening slightly, in preparation for intercourse
• inside her, her vagina lengthens – making room for the possible entry of a penis.
  
  

What happens next?

As she gets more and more aroused, her breasts will swell a little and her nipples will become more prominent. Her breathing gets faster and she starts to gasp. Her eyes tend to become glazed and she is likely to lick her lips – probably making them even more attractive to her partner.
If she is fair-skinned, a faint pink 'rash' will develop at the base of her neck and over her breasts.

And finally?

And finally, she climaxes. What generally happens here is that she experiences a series of waves of ever-increasing pleasure, till eventually the last one is so mind-blowing that she nearly passes out.
At that moment, nearly all women cry out – sometimes very loudly. The muscles of their faces and bodies contract violently (but very enjoyably) – and then after a while everything relaxes.

So that's the end?

No, not really. These days, most women can – if they want to - go on to have further climaxes. But this will only happen if:

• they are happy and relaxed
• they are being skilfully stimulated
• they have actually learned how to have multiple orgasms.

This is of course, a dramatic difference between the sexual response of females and males. Most men have no chance whatsoever of enjoying multiple climaxes

Written by Dr David Delvin, GP and family planning specialist  and Christine Webber, psychotherapist