Sexual arousal Flashcards
The human sexual response cycle
Desire phase
Arousal phase
Plateau phase
Orgasm phase
Resolution phase
–> cycle can repeat itself after
Desire phase
Sexual urges occur in response to sexual cues or fantasies
Arousal stage
A subjective sense of sexual pleasure and psychological signs of sexual arousl: in males, penile tumescence; in females, vasocongestion leading to vaginal lubrication and breast tumescence
Plateau phase
Brief period of time befor orgasm
Orgasm phase
In males, feelings of the inevitability of ejaculation, followed by ejaculation; in females, contractions of the walls of the lower third of the vagina
Resolution phase
Decrease in arousal occurs after orgasm
- in men particularly
Vasocongestie
Wanneer er veel bloed naar een gebied stroomt als gevolg van de verwijding van de bloedvaten
Myotonie
Wanneer de spieren samentrekken, niet alleen in de geslachtsorganen maar ook in het hele lichaam
Masters and Johnson
three stages of sexual response
- excitement
(- plateau)
- orgasm
- resolution
Arousal
Various erotic thoughts and physical stimulation trigger parasympathetic reflexes that cause an erection
–> Release of NO, dopamine, serotonin, exytocin
- cognitive factors involving visual stimuli and high levels of activity in the amygdala and hypothalamus contribute to sexual arousal and sexual response in males
Erection neuron initiation phase
Stimuli: imaginary, ausio-visual, tactile
Inhibition: depression, stress, fear
–> Paraventriculaire nucleus ‘ereto-motoric area’
Dopamine –> dopamine receptoprs –> NO, Oxy –> neuronal erectil signal
ERECTION
Excitement
During arousal increases in heart rate, blood pressure, skeletal muscle tone, and hyperventilation occur
- bulbourethral glands start working
Erection
Occurs when neurons release nitric oxide (NO) at their synaptic endings
- NO causes smooth muscles of the penile arteries to relac, vessels to dilate, blood flow to the erectile tissue increase
- the vascular channels engorge with blood, resulting pressure causes the penis to become stiff
–> erection is obstructed bloodstream
Penile anatomy
slide 36 idek
What happens during plateau stage
Changes that begin during arousal are sustained at an intense level
- head of the penis increases in diameter and the testes swell
- toward the end of the plateau stage, emission occurs
Emission
Sympathetic stimulation causes peristaltic contractions of the internal urethral sphincter, ampulla of vas deferens, seminal vesicle, prostate gland and external urethral sphincter
Ejactulation
Sympathetic stimulation of the ischiocavernosus and bulbospongiosus muscles causes powerful rhytmic contractions that push the semen out of the penile urethra
Orgasm
Intensely pleasurable sensations associated with ejactualion
- other physiological changes include a pronounced increase in heart rate and blood pressure
- a serie of rhythmic contractions of the pelvic organs t 0.8 second intervals
- sharp increase in pulse rate, blood pressure, and breathing rate during orgasm
- for males, ‘ejaculatory inevitability’ is a sensation that ejaculation is just about to happen and cannot be stopped
Resolution
Sense of profound relacation- genital tissues, heart rate, blood pressure, breathing, and muscle tone return to normal
- during the early period of resolution, males enter a refractory period during which a second ejaculation and orgasm are physiologically impossible
- Post Orgasmic Refractory Period 3 - 30 min. post orgasm
- brain activity in men suggest a de-arousal neural network
Criticisms of Masters and Johnson’s model
Focused almost entirely on the physiological aspects of the response
- ignored what the person is thinking and feeling emotionally
- desire and passion are not a part of the model
Research exclude anyone whose pattern of sexual response did not include orgasm
- model cannot be generalized to the entire population
Kaplan’s three stage model of sexual repsonse
Three relatively independent phases
- sexual desire
- vasocongestion of the genitals (excitement)
- reflex muscular contractions of the orgasm phase
Brancroft’s Dual Control model
Sexual response is controlled by two processes:
- excitation: responding with arousal to sexual stimuli
- inhibition: inhibiting sexual arousal
Both processes can be adaptive or distractive
Propensities towards both processes vary widely from one person to the next
Early learning and culture are critical factors
Sex hormones
Interact with nervous system to influence sexual response
- organizing effects either activate or deactivate certain behaviors
Receptoren
Detectoren stimuli en sturen de boodschap door naar het ruggenmerg of brein
Transmitters
Ontvangen de boodschap, interpreteren deze en sturen een boodschap om de juiste respons te produceren
Effectors
Neuronen of spieren die reageren op de stimulatie
Gräfenbergspot –> vrouwelijke ejaculatie
G-spot mondt uit in de urinebuis
Sekshormonen
Interacteren met het zenustelsel om seksuele respons te beïnvloeden
- testosteron
Testosteron
Heeft effecten op het libido. Het lijkt een activerend effect te hebben in het behouden van seksueel verlangen in mannen
- hypogonadisme
Hypogonadisme
fname/laag testosteron. en neemt af met de jaren
- bij burn-out
- geen zin in seks
- bothuishouding
Men are more into:
- sex
- genital pleasure
- orgasm
- penetration
–> more assertive
–> bad ‘antenna’
Women are more into:
- the relation
- contact
- sensuality
–> more submissuve
–> sensitive for partner
–> more feelings of guilt
Erogenous zones
Erectile dysfunction
Responsible for loss of quality of life in 12-24% of the population
- age related
- related to physical and mental condition
- comparable with infertility, angina pectoris, and rheumatoid arthritis
Prevalence erectile dysfunction in NL
BOXMEER: 12% (1233) - 40-70 yr
KRIMPEN: 35% (1688 urological department) - 50-80 yr
ENIGMA: 17% (2117) - >18 yr
Organic cause diagnosis erectile dysfunction
Onset is gradual
Course is consistant
Reason: no conflict
Situation is always
No morning erection
No erection with masturbation
Psychological cause diagnosis erectile dysfunction
Onset is acute
Course is situational
Reason: conflict
Situation is situational
Normal morning erection
Good erection with masturbation
Impact of erectile dysfunction
The sexual function and sexual identity fall away and there is no sexual activity as result
Morbus peyronie
After baron François de la Peyronie
- fibrous tissue formed in the tunica albuginea
Nesbit
Curve in the penis
Retrograde ejaculation
Internal urethral sphintcter fails to contract, semen can enter the bladder
- sometimes happens after prostate surgery
- some medications can also cause
- neurological innervation problem
- not harmful but impairs fertility
Medical treatment options erectile dysfunctions
- medication (PDE-5 inhibitors)
- intra urethral medication (MUSE and vitaros)
- vacuum penis pump
- injection therapy
- penile implant
PDE-5 inhibitors
- Sildenafil: 1 hour before activity (4-6 hrs)
- Tadalafil: 30 min before activity (24 hrs)
- Vardenfil: 30-60 min before activity (4-6 hrs)
Vacuum penis pump
Pump erect with vacuum
Intra urethral medication
- vitaros and MUSE
Alprostadil (Pg E1) vasodilatation
Injection therapy
Papaverine/fentolamin (Androskat)
–> Cave priapism (erection> 4 hrs)
Prothese
Malleable penile prothesis
- inflatable penile implant
