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To gain a better understanding of the causes of sexual dysfunction, it is imperative that one fully comprehends the sexual response cycle. For both males and females, this response cycle is similar. When males and females become sexually aroused, obvious physical changes take place to prepare them for intercourse. The cycle of changes experienced by both genders has been described by Masters and Johnson (1966) as the excitement, plateau, orgasm, and resolution stages.

During the excitement stage, vasocongestion takes place. Several areas of the body including the nipples and earlobes become swollen and sensitive, and the male will experience an erection. In females, the same changes will occur, as well as a swelling of the vaginal area. Vasocongestion means that these areas have become engorged with blood. Various muscle groups of the body also become tense and spasmodic. This causes the scrotum to expand in size, while the female will experience an enlarged clitoris as the vagina begins to lubricate. This process of muscle tension is known as Myotonia. During this first stage of the sexual response cycle, both males and females with have elevated blood pressure and heart rates. The lubrication process and the erection are involuntary responses which signal the readiness of both parties to become sexually active.

The plateau stage is somewhat similar to the excitement stage; the physical changes of the excitement stage remain as they were, with the clitoris and scrotum contracting in readiness for ejaculation. The heart rate of both male and female can heighten to around 160 beats per minute, and breathing becomes more rapid as both parties come closer to orgasm. This orgasmic phase differs from male to female. Semen pools at the base of the penis ready for ejaculation, and the muscle spasms of the vaginal wall become more intense as the female reaches her sexual climax. As she experiences the orgasm, the pulsing spasms of these muscles release sexual tension and provide the woman with pleasurable feelings. The orgasm can be very intense for both parties; the male experiencing around 5 contractions every 4 seconds, and 3-15 contractions for the female as she has an orgasm. (Meston & Frohlich, 2000). It is interesting to note at this stage, that the heartbeat of both parties can be elevated as high as 180 beats per minute.

After sexual intercourse, the parties enter the resolution stage. The heart rate begins to slow and return to normal, as does the blood

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