Abstract
Changes induced by human sexual arousal serve reproductive and recreational functions. The current sexual phase model (desire, excitation, orgasm, and resolution) conveys little about this duarchy. Lack of spontaneous sexual desire in a third of nonclinic females indicates that the D phase needs splitting into D1 (the spontaneous endogenous activation of desire) and D2 (desire activated by sexual excitation at and during the E phase). Attempts to link D1 with reproduction by studies monitoring it over the menstrual cycle revealed a D1 peak just before or at ovulation, but its reliability is criticized because of the poor identification of the time of ovulation. Sexual arousal initiates enhanced genital blood flow, leading to the formation of a neurogenic transudate, lubricating the vagina, partly buffering its acidity, and increasing its oxygen tension all features that enhance spermatozoal function and survival. Orgasm occurs with vaginal and uterine contractions. The latter have been misinterpreted as powering rapid sperm transport to facilitate fertilization, but such fast transport would lead to the tubal deposition of noncapacitated, incompetent spermatozoa. Vagino–cervico elevation, however, delays rapid sperm transport and allows the initiation of decoagulation and sperm capacitation before the elevation resolves. The fastest transport of spermatozoa from cervix to the fallopian tubes occurs in the nonaroused female by uterine/subendometrial smooth muscle peristalsis. There is some evidence that even this may be reduced for a time after coitus, adding to the transport delay. If a number of the changes induced by sexual arousal are inadequately expressed, sexual as well as reproductive dysfunctions could arise.
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REFERENCES
Abramovitz, J. S., & Archer, D. F. (1990). Uterine endometrial peristalsis: A transvaginal ultrasound study. Fertility and Sterility, 54, 451–454.
Baker, R. E., & Bellis, M. A. (1995). Human sperm competition: Copulation, masturbation and infidelity. London: Chapman and Hall.
Bancroft, J. (1980). Endocrinology of sexual function. Clinics in Obstetrics and Gynaecology, 7, 253–281.
Beck, J. G., Bozman, A. W., & Qualtrough, B. A. (1991). The experience of sexual desire: Psychological correlates in a college sample. Journal of Sex Research, 28, 443–455.
Bickers, W., & Main, R. J. (1941). Patterns of uterine motility. Journal of Clinical Endocrinology, 1, 992–995.
Birnholz, J. C. (1984). Ultrasonic visualisation of endometrial movements. Fertility and Sterility, 55, 157–158.
Boivin, J., Takefman, J. E., Brender, W., & Tulandi, T. (1992). The effects of female sexual response in coitus on early reproductive processes. Journal of Behavioral Medicine, 15, 509–518.
de Blok, S. (1982). The connective tissue of the adult female pelvic region: Amusculo-fibrous apparatus. Acta Morphologica Neerlandia Scandinavica, 20, 347–362.
Eisenbach, M. (1995). Sperm changes enabling fertilization in mammals. Current Opinion in Endocrinology and Diabetes, 2, 468–475.
Faix, A., Lapray, J. F., Courtieu, C., Maubon, A., & Lanfrey, K. (2001). Magnetic resonance imaging of sexual intercourse: Initial experience. Journal of Sex and Marital Therapy, 27, 475–481.
Garde, K., & Lunde, I. (1980). Female sexual behaviour: A study in a random sample of 40-year-old women. Maturitas, 2, 225–240.
Grimes, D. A. (1999). Role of the cervix in sexual response: Evidence for and against. Clinical Obstetrics and Gynecology, 42, 972–978.
Hoch, Z. (1986). Vaginal erotic sensitivity by sexological examination. Acta Obstetrica et Gynaecologica Scandinavica, 65, 767–773.
Hutchinson, K. A. (1995). Androgens and sexuality. American Journal of Medicine, 98(Suppl. 1A), 111S-115S.
Kaplan, H. S. (1979). Disorders of sexual desire. New York: Simon and Schuster.
Komisaruk, B. R., Gerdes, C. A., & Whipple, B. (1997). "Complete" spinal cord injury does not block perceptual responses to genital self-stimulation in women. Archives of Neurology, 54, 1513–1520.
Krantz, E. K. (1958). Innervation of the human vulva and vagina. Obstetrics and Gynecology, 12, 382–396.
Kunz, G., Beil, D., Deininger, H., Wildt, L., & Leyendecker, G. (1996). The dynamics of rapid sperm transport through the female genital tract: Evidence from vaginal sonography of uterine peristalsis and hysterosalpingoscintigraphy. Human Reproduction, 11, 627–632.
Lavoisier, P., Aloui, R., Schmidt, M. H., & Watrelot, A. (1995). Clitoral blood flow increases following vaginal pressure stimulation. Archives of Sexual Behaviour, 24, 37–45.
Leffler, C. W., & Amberson, J. I. (1982). Intravaginal prostaglandin E1 increases vaginal blood flow. Prostaglandins Leukotrienes and Medicine, 9, 587–589.
Levin, R. J. (1992). The mechanisms of human female sexual arousal. Annual Revue of Sex Research, 3, 1–48.
Levin, R. J. (1998a). Sex and the human female reproductive tract-What really happens during and after coitus. International Journal of Impotence Research, 10(Suppl. 1): S14-S21.
Levin, R. J. (1998b). Actions of spermicidal and viricidal agents on electrogenic ion transfer across human vaginal epithelium in vitro. Pharmacology and Toxicology, 81, 219–225.
Levin, R. J. (1999a). The impact of the menopause on the physiology of genital function. Menopause Review, 4, 23–31.
Levin, R. J. (1999b). Measuring the menopause genital changes: A critical account of laboratory procedures past and for the future. Menopause Review, 4, 49–57.
Levin, R. J. (2000a). Sexual desire and the deconstruction and reconstruction of the human female sexual response model of Masters and Johnson. In W. Everaerd, E. Laan, & S. Both (Eds.), Sexual appetite, desire and motivation: Energetics of the sexual system (pp. 63–93). Amsterdam: The Royal Netherlands Academy of Arts and Sciences.
Levin, R. J. (2000b). Normal sexual function. In M. Gelder, N. C. Andreasen, & J. Lopez-Ibor (Eds.), New Oxford textbook of psychiatry (Vol. 1, pp. 875–882). Oxford: Oxford University Press.
Levin, R. J. (in press). Do women gain anything from coitus apart from pregnancy? Changes in the human female genital tract activated by coitus. Journal of Sex and Marital Therapy.
Levin, R., J., & MacDonagh, R. P. (1993). Increased vaginal blood flow induced by implant electrical stimulation of sacral anterior roots in the conscious woman: A case study. Archives of Sexual Behavior, 22, 471–475.
Levine, S. B. (1988). Intrapsychic and individual aspects of sexual desire. In S. R. Leiblum & R. C. Rosen (Eds)., Sexual desire disorders (pp. 1–44). New York: Guilford.
Masters, W. H., & Johnson, V. E. (1966). Human sexual response. Boston: Little, Brown.
Matteo, S., & Rissman, E. F. (1984). Increased sexual activity during the midcycle portion of the human menstrual cycle. Hormones and Behavior, 18, 249–255.
McLean, J. M. (1999). Anatomy and physiology of the vulva. In C. M. Ridley & S. M. Neill (Eds.), The vulva (pp. 37–63). Oxford: Blackwell Science.
Meuwissen, I., & Over, R. (1992). Sexual arousal across phases of the human menstrual cycle. Archives of Sexual Behavior, 21, 165–173.
Michael, R. T., Gagnon, J. H., Lauman, E. O., & Kolata, G. (1994). Sex in America: A definitive survey. London: Little, Brown.
O'Connell, H. E. (2001). Editorial comment. Journal of Urology, 166, 1184.
Overstreet, J. W., & Katz, D. F. (1977). Sperm transport and selection in the female genital tract. In M. H. Johnson (Ed.), Development in mammals (Vol. 2, pp. 31–65). Amsterdam: North-Holland.
Palle, C., Bredkjær, H. E., Fahrenkrug, J., & Ottesen, B. (1991). Vasoactive intestinal peptide loses its ability to increase vaginal blood flow after menopause. American Journal of Obstetrics and Gynecology, 164, 556–558.
Pfaus, J. G. (1999). Revisiting the concept of sexual motivation. Annual Review of Sex Research, 10, 120–157.
Regan, P. C., & Berscheid, E. (1999). Lust: What we know about sexual human desire. Thousand Oaks, CA: Sage.
Robinson, P. (1976). The modernization of sex. London: Paul Elek.
Schultz, W. W., van Andel, P., Sabelis, I., & Mooyaart, E. (1999). Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal. BMJ, 319, 1596–1600.
Settlage, D. S. F., Motoshima, M., & Tredway, D. R. (1973). Sperm transport from the external as to the fallopian tubes in women: A time and quantitation study. Fertility and Sterility, 24, 655–661.
Shafik, A. (1993). Vaginocavernosus reflex. Gynecology and Obstetrical Investigation, 35, 114–117.
Shafik, A. (1995). Vagino-levator reflex: Description of a reflex and its role in sexual performance. European Journal of Obstetrics and Gynecology and Reproductive Biology, 60, 161–164.
Shuttle, P., & Redgrove, P. (1987). The wise wound. London: Paladin Grafton.
Sobrero, A. J., & MacLeod, J. (1962). The immediate post-coital test. Fertility and Sterility,13, 184–189.
Symons, D. (1979). The evolution of human sexuality. NewYork: Oxford University Press.
Wagner, G. (1974). Physiological responses of the sexually stimulated female in the laboratory (motion picture 16 mm). Copenhagen, Denmark: University of Copenhagen, Panum Institute, Institute of Medical Physiology.
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Levin, R.J. The Physiology of Sexual Arousal in the Human Female: A Recreational and Procreational Synthesis. Arch Sex Behav 31, 405–411 (2002). https://doi.org/10.1023/A:1019836007416
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DOI: https://doi.org/10.1023/A:1019836007416
- human female sexual arousal
- sperm transport
- coitus
- sexual desire
- hormones
- menstrual cycle
- genital arousal