Models of Sexual Response

By OBOS Sexuality & Relationships Contributors | October 1, 2011

Various sex researchers have developed models that attempt to describe women’s sexual responses. In the 1960s, William Masters and Virginia Johnson observed and measured women and men engaging in sexual activities in a laboratory setting, and reported their research in the book “Human Sexual Response.” The Masters and Johnson model outlined four stages of physiological arousal: excitement, plateau, orgasm, and resolution.

It can be helpful to understand the Masters and Johnson model, not because it fits all women or is a standard you should try to follow, but because aspects of it may fit your experience and because so many clinicians still use it. Here’s a breakdown of the four stages.

Excitement. During the first stage of arousal, the whole pelvic area may feel full, as erectile tissue in the pelvis, vulva, and clitoris swells with blood, and nerves in that area become more sensitive to stimulation and pressure.1 In the vagina, this increased blood circulation produces the fluid (transudate) that makes the vaginal walls and inner lips wet—often an early sign of sexual excitement. Women produce different amounts of lubrication; for some, there may not be much lubrication, or it may come later, after sufficient sexual stimulation. Sexual tension affects the whole body as muscles begin to contract. Women may breathe more quickly or experience little shivers. Nipples may become erect and hard, and a flush or rash may appear on the skin.

Plateau. If stimulation continues, one moves into the plateau stage. The responses may continue to intensify as the vagina becomes more sensitive and the glans of the clitoris retracts under the hood.

Orgasm. With enough stimulation of or around the clitoris—and, for some women, pressure on the cervix or other sensitive areas such as the G‑spot—a woman may build up to a peak, or orgasm. This is the point at which all the tension suddenly releases in a series of involuntary and pleasurable muscular contractions. Contractions may be felt in the vagina, uterus, and rectum. Some women experience orgasm as a total-body contraction and release.

Resolution. Unless stimulation continues, the resolution stage occurs. During the half hour or more after orgasm, the muscles relax, and the clitoris, vagina, and uterus return to their usual positions (except in the rare disorder known as persistent genital arousal disorder).

Masters and Johnson’s work was valuable for women in exploring and asserting the role of the clitoris in sexual response. But by focusing their study on people who were very experienced with orgasm during masturbation and intercourse, they reinforced a belief that orgasm and intercourse are necessary to women’s sexual response and pleasure. And by offering only one model for human sexual response, Masters and Johnson missed the fact that women who do not orgasm with penetration, for example, also experience pleasure.

In the 1970s, the feminist researcher Shere Hite polled more than three thousand women and discovered that most of them did not experience orgasm through intercourse alone. In the 1970s and 1980s, several researchers and clinicians such as Harold Lief, Helen Singer Kaplan, Bernie Zilbergeld, and Carol Rinkleib Ellison expanded the Masters and Johnson model to include emotional aspects like desire and satisfaction.

In 1997, Beverly Whipple and Karen Brash-McGreer developed a circular model of women’s sexual responses, suggesting that if a sexual experience resulted in pleasure and satisfaction, then it could lead to another sexual experience. But if the experience was not pleasurable and satisfying, it might not lead to another sexual experience. In 2001, Rosemary Basson published a nonlinear model of female sexual response that incorporated the importance of emotional intimacy, sexual stimuli, and relationship satisfaction. Basson argues that, contrary to what the linear model suggests, women have many reasons for engaging in sexual activity other than desire.

The best part is the afterglow, when we’re both limp and glowing with satisfaction, wrapped around each other. I love the way he knows my body, where to touch, how to touch. The feeling of being so full of him and so full of pleasure that I could explode. The climax of orgasm, whether it’s an intense eruption of physical pleasure or an overwhelming emotional sense of being so completely in love with him, brings tears to my eyes.

Despite the limitations of even the revised Masters and Johnson model, psychiatric and medical clinicians, along with pharmaceutical companies, continue to use it to create definitions of sexual health and sexual problems. For instance, a key resource used by U.S. mental health professionals, the Diagnostic and Statistical Manual of Mental Disorders (DSM), bases its definitions of sexual dysfunction on the Masters and Johnson sexual response cycle. For a critical alternative, see NewViewCampaign.org and the book “A New View of Women’s Sexual Problems,” edited by Ellyn Kaschak and Leonore Tiefer, which includes the relational aspects of women’s sexuality and allows for a wide range of differences among women’s experiences.