since the work of Masters and Johnson, researchers have talked about sexual activity as consisting of four sequential phases. Desire, arousal, orgasm, and satisfaction (sometimes called resolution) are considered to constitute the female sexual response cycle.
Many women worry that when they do not feel sexual desire, they will not be a good sexual partner and will not experience personal pleasure. They believe that desire is the window to having and enjoying sex. However, in 2000, Dr. Rosemary Basson showed that arousal can come before desire or afterwards. In other words, arousal can prompt desire.
Results of studies show that for many women, the genitalia respond to sexual stimuli, even though their minds seem to be “stuck in neutral.” This explains why a woman with cancer may feel no desire, yet her body is responding.
It may alleviate some women’s anxiety on this issue to know that the mind and the body can play different tunes where sexuality is concerned. Good loving takes time, because the woman needs to be brought to a point of sexual receptivity and arousal. As a woman gets older, or experiences sexual effects of cancer treatment, she may need more foreplay to come to a point where she desires sex and is aroused. Many of the physiological effects of arousal, such as feeling warm and sensing some stirring in the genitals, are the same sensations a woman has during desire.
As she goes through the normal sexual cycle, a woman experiences physical changes in her breasts and genitals. During the arousal phase, and sometimes when she feels desire, her nipples are likely to swell, and she may feel some wetness and enlargement of the vagina, preparing her for intercourse. Her heart rate increases because more blood is pumping to certain areas of her body, especially her pelvic area. She may feel flushed as more blood is pumping to her face.
During the height of the arousal phase and before orgasm, a woman reaches a plateau. According to Masters and Johnson, the feelings that occur during excitement and arousal reach their peak in the plateau phase. The woman feels more sensitivity in her genital area. Her heart rate increases and the clitoris becomes engorged, ready for further stimulation so that she can reach orgasm.
Orgasm is the culmination of excitement. At this time, the woman often experiences contractions of the muscles in the pelvic area, especially the vaginal and rectal sphincter areas. Her muscles go into a recurring series of contractions, sometimes leading to a spasm in other muscles in her body.
The last phase, now named satisfaction, is the release. This is complete relaxation, where the heart rate, breathing rate, and muscle tension all gradually return to normal.
Not all women experience all the phases or all of the sensations in any of the phases. In addition, chemotherapy, surgery, and radiation can each change the way a woman’s body responds. For example, many women who have gone through chemotherapy get upset when they realize they have little or no sense of sexual desire. This is sometimes a temporary condition, but it may be long lasting.
Because desire can come before arousal or arousal can come before desire, if a woman does not have any desire, she might still be able to respond to her partner initiating love-making. Since research shows that female desire is driven by emotional attachment, her partner’s advances could “turn her on” sexually.
Desire is partly emotional and partly physical. Feeling desired is a strong component of the emotion. Thirty or forty years ago, researchers and others such as sexuality therapists believed that a woman’s sexuality was independent of what went on outside of her. However, subsequent research shows that a woman is strongly responsive to her partner’s feelings for her. Even if she already feels desire, her level of arousal increases if she feels wanted by her partner.
People undergoing treatment for cancer have experienced the change Dr. Basson presented in her research. Many people, both men and women, who go through various therapies become aware that they have little or no sexual desire. However, after the partner begins caressing, kissing, and touching, they can become aroused. The keys to arousal and then the desire to continue the sexual activity are receptivity to the partner’s actions, sensitivity, and emotional responsiveness.
Not a “Non-Stop Trip” to Intercourse
Some women may be concerned that beginning a sexual event means that they must go on to sexual intercourse. Often, women have a greater desire for hugging, stroking, and kissing, as those give them comfort and the feeling of being appreciated and wanted. Intercourse may not even be possible or wanted. This concern can lead to being reluctant to get started, even though they may want part of the sexual activity.
Actually, a woman has several choices as to how far she wants to go after becoming a partner in a sexual encounter. Although many people think about sex being the same as intercourse, sex can be seen as the overall term for physical intimacy, whereas intercourse is one of several possible end points.
Assume that a woman’s starting point of sexual arousal is zero on a scale of zero to five. After some foreplay, she may get to a two or three. Now she has an emotional connection with what is happening at the moment and with her partner. She also feels desire. At this point, the woman has three choices. She needs to remember that she has a choice and is not on a non-stop trip to intercourse. Other options include having a sensual interaction or manually bringing each one or even just one of the partners to a climax.
Keeping a sexual event at a sensual level involves a lot of touching, kissing, and hugging. Touching, caressing, and stroking are cornerstones of sensuality. There are also massage techniques such as sensate massage if either partner wants it.
Manual stimulation can be satisfying to both partners, as this allows them orgasms without intercourse. Partners may stimulate each other, or masturbate with the support of the other partner. They do not have to climax, but this outcome is available to them.
A woman has a choice anywhere along the way to decide how far she wants to go depending on how she feels at the moment. The challenge for a woman is to feel free to exercise her right of choice without feeling guilty or believing that her partner will be upset. Being comfortable with what she wants is based on good communication with her partner. A woman can stop at caressing or manual stimulation for herself, and still bring her partner to orgasm in many different ways - manually, orally, or with a vibrator.
Lifestyle Choices and Sexual Function
Lifestyle choices can harm sexuality. These include smoking, drinking alcohol, and using street drugs. For example, alcohol has a sedative effect that often dampens sexual interest and energy. In addition, a high-fat diet can block arteries and also clog pelvic blood vessels that aid the arousal cycle. The three major lifestyle causes of dysfunction in both women and men are:
Alcohol: People talk of going out to eat and drink, and then making love. Alcohol is perceived as “loosening people up” and making them more receptive to engaging in sex because it reduces inhibition. While it is true that a little alcohol, such as a glass of wine or a beer, can decrease anxiety and inhibition and generally relax a person, it can also depress sexual function and mood. Several drinks are likely to make someone sleepy and less able to actively participate in sex. In many men, alcohol may reduce the ability to have an erection and a climax.
Street and Prescription Drugs: Many prescription drugs available today lessen the ability and the energy to make love. Some drugs (both prescription and street drugs) increase desire and a sense of sensuality, but decrease sexual response.
Prescription drugs with sexual side effects include those prescribed to control cardiovascular problems (such as hypertension and angina) anxiety, depression, psychosis, and other conditions.
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