B8.074 Female Sexual Response and Pleasure (Pre-work and Formative Answers) Flashcards
Masters and Johnson
first model of sexual response
based primarily on males
-did not include desire
-did not include multiple types of orgasms
Helen Kaplan Singer
criticized Masters and Johnson because it did not address the importance of desire
placed desire at the beginning of the sexual response
Basson
looked at first large scale study of viagra in women
critical of mountain peak imagery
-could be rolling hills
-could be multiple mountain peaks
Kellogg-Spadt
researched when women in long term relationships feel intense desire
found that women often only feel desire in the moment right before an orgasm
Gina Ogden
research on sexual fantasy
- mental rehearsal for mastery of other skills
- greatly impacts sexual confidence and positively impacts sexual self-esteem
- helps individuals create an idea of what they need concerning healthy sexual relationships
- helps relieve shame (visualize non-shaming sexual encounter)
- heightens spiritual connection with a lover
- improves love making
Emily Nagoski
lemon lab rat experiment dual control system for arousal > sexual brakes and accelerators which are very individualized *sexual context is very important* important clinical contexts: -wifes/mothers = not sexy
Sheri Winston
importance of having a complete female erection prior to penetration
Freud
women deeply long to have a penis and see their bodies as insufficient
theorized that clitoral organisms = neurosis and vaginal orgasms = mental and emotional maturity
in order to accept womanliness, move sexual excitement from clitoris to vagina
what goes on during a female erection?
increased blood flow to genitals twitching PC muscles lubrication/transudation upper 2/3 of the vagina balloons uterus and cervix shift as the round ligaments contract clitoris enlarges lower 1/3 of vagina gets narrow labia minora engorge bulbocavernosus stretch and widen the vestibular bulbs beneath clitoral gland retract muscles throughout body tense HR and respirations quicken nipples, earlobes, and nostrils erect
what causes the lower 1/3 of the vagina to narrow
vestibular bulbs, urethral sponge, and perineal sponge become erect
erectile network of women
clitoris
vestibular bulbs
perineal sponge
urethral sponge
what can happen if a woman is entered prior to a green light (doesn’t have an erection)
pain disorders (dyspareunia, vaginismus) touch can feel irritating urge to urinate deep penetration hits the uterus (sheri winston)
dyspareunia
lack of education
physical origin
vaginismus
involuntary muscle spasm
- penetration may be difficult or impossible
- typically “ripping” or “burning”
- body is protecting woman from something
treatment for vaginismus
MD, PT, therapist
rule out medical causes
work on biofeedback to help relax muscles
work on mental narrative surrounding sexual encounters
biochemical components of sexual happiness
oxytocin
phenylethylamine (PEA)
endorphins
dimethyltryptamine (DMT)
oxytocin
stimulates orgasm and inspires attachment
stimulates contractions of labor and breast feeding
allows mom to fall in love with new baby
components of an orgasm
stimulation of the clitoris, cervix, vaginal walls, g-spot, or “u-spot”, perineal sponge and/or nerves around the anus lead to a climax
rhythmic contractions of the uterus occur
part of the vagina and the anal sphincter expel blood flow back into circulation
role of the uterus in the orgasm
work as a “suction cup” and contract to facilitate sperm movement during orgasm
hysterectomy impact on sexual function
women with hysterectomies report qualitative shifts in their orgasm
discuss this prior to the procedure
why can women have multiple orgasms
erectile network (capillaries) works independently, allowing the maintenance of engorgement of erectile tissue after orgasm in a male > capillaries that trap blood for engorgement work in concert to expel ejaculate, so you can't orgasm again
where do orgasms originate from in women?
any part of the erectile network
don’t stimulate this area until a woman is already aroused
why don’t all orgasms feel the same
sensations depend on nerve endings being stimulated clitoral - pudendal vaginal - pelvic cervical - vagus, pelvic or BLENDED
how does pelvic floor strength impact orgasm?
women w vaginal and clitoral orgasms have the strongest PC muscles
only clitoral = intermediate
no orgasms = weakest
what % of women never have a vaginal orgasm?
10%
what % of women typically dont have orgasms during vaginal orgasms?
> 50%
what % of middle aged women report never or infrequently feeling desire
40%
sexual outcomes that are associated with poor body image
low arousal low desire less orgasms increased # of partners less sexual assertiveness increased use of alcohol and drugs during intercourse more unprotected sex
why do women masturbate?
feels good (85%) physical urge (85%) to have orgasms (70%) no partner (48%) to relax (39%) sleep (32%) etc.
role of fantasy in pleasure
improve love making
deepen emotional and spiritual connection with partner
relieve shame, fear, fatigue
heal past wounds by visualizing healthy, loving relationships
alter sexual self image without fear or consequences
most commonly picked word to describe a positive sexual experience
loved
sources of sexual satisfaction in ongoing relationships
emotional closeness
feeling loved
feeling safe
orgasms
knowing partner is accepting of desires, preferences, and responses
knowing the partner is having a good experience
(carol rinkleib ellison)
framework of sex therapy
we can develop sustainable, hot, and steamy intimate connections with others when we can be authentic with ourselves and others
genital response of women to sexual stimuli
“automatic reflex”
more expansive than men
non dependent on sexual orientation, some respond to even non-human encounters
(chivers, laan, and val lunsen)
masters and johnson (quick)
first model
male focused
basson (quick)
rolling hills, not mountain peak
singer (quick)
desire @ beginning of encounter
nagoski (quick)
acceleration and breaks
sexual context
lemons
moms aren’t sexy?
ogden (quick)
fantasy
kellogg-spadt (quick)
desire only right before orgasm
laundry
winston (quick)
green light
it hurts if you go in too soon
health professionals who are aware of their own feelings and attitudes about sex are less likely to
be judgemental and imposing about patients’ sexual encounters
