Let’s Talk about the Sexual Response Cycle


I see women and men who come into my practice every day because their doctor told them their sexual dysfunction all in their head or their partner gave them an ultimatum.

The origins of their dysfunction vary, from sexual abuse to situational. They all have different stories but one question:

Am I normal?

For so long, people who suffer with sexual disorders or functions suffer in silence due to embarrassment and judgment. When they finally get up the courage to see a physician, some go through further embarrassment with exams and questioning. By the time some of my clients get to me, they just want validation, to prove that they are not crazy and it’s not all in their head.

So, what is healthy sexual functioning?

Sexual functioning involves the mind and the body. I know the study of biology may not thrill, but knowledge is power. The nervous, circulatory and hormonal systems all work together to help us with the sexual response. So just think, behind that look or touch you have a whole system preparing you for sex.

The sexual response system is not only found in our genitals. Our sexual response cycle has four stages:

  • Desire – the wish to have sexual activity. This is triggered by those sexual thoughts and fantasies you get in your head, by verbal cues from a partner, through whispers or erotic talk, and by visual stimulation, by looking at something you find attractive. This is also the phase that some say they lack. Nothing seems desirable to people with a low libido. With education and exploration desire can be found again!
  • Arousal – this is when your body gets excited. The blood starts flowing to your genitals causing erection for men and enlargement of the clitoris for women. This phase sometimes has complications due to poor health and diet, causing inflammation in the body. Some surgeries and medicines also can interfere with this stage, and it changes with age. What excited you in your 20s may not do it for you in your 30s or even 40s. Everything changes, even what gets you excited. Many seek therapy to find their arousal but together we figure out its not gone it’s just in a different form of touch or thought.
  • Orgasm – The Big “O”. It is the peak of climax of sexual excitement. Both men and women experience muscle tension and contractions of the pelvic muscle. By the sounds of it you would think it was painful, but many find it pleasurable. Orgasms are a myth to some and plentiful in others. All sexual excitement doesn’t have to end orgasm. Many have good sex lives without ever experiencing orgasms. A few people can experience pain during this phase and so try to avoid it. Even a smaller few can orgasm by force of their thoughts. Women come into therapy ready to experience orgasm after trauma, lack of education and self-neglect. Men can seek therapy to assist in transition with aging, medications, or after surgery.
  • Resolution – When I hear this I think of it meaning the answer to a problem, but in fact it is the feeling that follows orgasm, which is also called the refractory period. Your muscles start to relax, you regain all your senses and a sense of wellbeing washes over you. It’s the goal of many after sexual excitement. Some may drift to sleep while others curl up and don’t want to be touched; it can vary with each person. Men may need some time in between this phase and erection again, while women are able to respond right away with additional stimuli to reach orgasm once more.

Sex therapy works well in dealing with sexual dysfunction as it relates to possible psychological stressors and conflicts:

  • Depression
  • Guilt
  • Performance anxiety
  • Religious beliefs
  • Anger
  • Sexual trauma
  • Lack of sex education

A doctor may want to rule out any medical factors causing sexual dysfunction and a good sex therapist can help you deal with a possible disorder. Sex therapy has its benefits.

I love when clients breathe a sigh of relief to find out they are in fact normal and very unique!

Author: Renelle Nelson LMFT

Renelle E. Nelson is a Licensed Marriage and Family Therapist and an AASECT Certified Sex Therapist who has been providing therapy for over 10 years.

About Renelle Nelson LMFT

Renelle E. Nelson is a Licensed Marriage and Family Therapist and an AASECT Certified Sex Therapist who has been providing therapy for over 10 years.