Physiological responses Sexual arousal causes various physical responses, most significantly in the
sex organs (genital organs). Sexual arousal for a man is usually indicated by the
swelling and
erection of the
penis when blood fills the
corpus cavernosum. This is usually the most prominent and reliable sign of sexual arousal in males. In a woman, sexual arousal leads to increased blood flow to the
clitoris and the rest of the
vulva, as well as vaginal transudation - the seeping of moisture through the vaginal walls, which serves as
lubrication. In both sexes, pupil dilation is an involuntary physiological response to sexual arousal. However, the degree of pupil dilation varies with individuals, as does the degree of maximal pupil dilation.
Male It is normal to correlate the
erection of the
penis with male sexual arousal. Physical or psychological stimulation, or both, leads to
vasodilation and the increased blood flow engorges the three spongy areas that run along the length of the penis (the two
corpora cavernosa and the
corpus spongiosum). The penis grows enlarged and firm, the skin of the
scrotum is pulled tighter, and the
testicles are pulled up against the body. However, the relationship between erection and arousal is not one-to-one (arousal non-concordance). After their mid-forties, some men report that they do not always have an erection when they are sexually aroused. Equally, a male erection can occur during sleep (
nocturnal penile tumescence) without conscious sexual arousal or due to mechanical stimulation (e.g., rubbing against the bed sheet) alone. A young man—or one with a strong libido—may experience enough sexual arousal for an erection to result from a passing thought, or just the sight of a passerby. Once erect, his penis may gain enough stimulation from contact with the inside of his clothing to maintain and encourage it for some time. As sexual arousal and stimulation continues, it is likely that the
glans or head of the erect penis will swell wider and, as the genitals become further engorged with blood, their color deepens. As the testicles continue to rise, a feeling of warmth may develop around them and the
perineum. With further sexual stimulation, their heart rate increases, blood pressure rises and breathing becomes quicker. As sexual stimulation continues,
orgasm begins, when the muscles of the
pelvic floor, the
vasa deferentia (between the testicles and the prostate), the
seminal vesicles and the
prostate gland itself may begin to contract in a way that forces sperm and semen into the
urethra inside the penis. Once this has started, it is likely that the man will continue to
ejaculate and orgasm fully, with or without further stimulation. Equally, if sexual stimulation stops before orgasm, the physical effects of the stimulation, including the
vasocongestion, will subside in a short time. Repeated or prolonged stimulation without orgasm and ejaculation can lead to discomfort in the testes (corresponding to the slang term "
blue balls"). After ejaculation, men usually experience a
refractory period characterized by loss of their erection, a subsidence in any sex flush, less interest in sexual activity, and a feeling of relaxation that can be attributed to the
neurohormones
oxytocin and
prolactin. The intensity and duration of the refractory period can be very short in a highly aroused young man in a highly arousing situation, perhaps without even a noticeable loss of erection. It can be as long as a few hours or days in middle-aged and older men. There have been studies to find the degree of correlation between these physiological responses and the woman's subjective sensation of being sexually aroused: the findings usually are that in some cases there is a high correlation, while in others, it is surprisingly low. Further stimulation can lead to additional vaginal wetness and further engorgement and swelling of the
clitoris and the
labia, along with increased redness or darkening of the skin in these areas as blood flow increases. Further changes to the internal organs also occur including to the internal shape of the vagina and to the position of the
uterus within the
pelvis. A
sex flush may extend over the chest and upper body. If sexual stimulation continues, then sexual arousal may peak into
orgasm. After orgasm, some women do not want any further stimulation and the sexual arousal quickly dissipates. Suggestions have been published for continuing the sexual excitement and moving from one orgasm into further stimulation and maintaining or regaining a state of sexual arousal that can lead to second and subsequent orgasms. Some women have experienced such multiple orgasms quite spontaneously. While young women may become sexually aroused quite easily, and reach orgasm relatively quickly with the right stimulation in the right circumstances, there are physical and psychological changes to women's sexual arousal and responses as they age. Older women produce less vaginal lubrication and studies have investigated changes to degrees of satisfaction, frequency of sexual activity, to desire, sexual thoughts and
fantasies, sexual arousal, beliefs about and attitudes to sex, pain, and the ability to reach orgasm in women in their 40s and after
menopause. Other factors have also been studied including socio-demographic variables, health, psychological variables, partner variables such as their partner's health or sexual problems, and lifestyle variables. It appears that these other factors often have a greater impact on women's sexual functioning than their menopausal status. It is therefore seen as important always to understand the "context of women's lives" when studying their sexuality.
Psychological responses Psychological sexual arousal involves appraisal and evaluation of a stimulus, categorization of a stimulus as sexual, and an affective response. The combination of cognitive and physiological states elicits psychological sexual arousal. Some suggest that psychological sexual arousal results from an interaction of cognitive and experiential factors, such as affective state, previous experience, and current social context.
Male The relationship between
sexual desire and arousal in men is complex, with a wide range of factors increasing or decreasing sexual arousal. Physiological responses, such as
heart rate,
blood pressure, and
erection, are often discordant with self-reported subjective perceptions of arousal. This inconsistency suggests that psychological or cognitive aspects also have a strong effect on sexual arousal. The cognitive aspects of sexual arousal in men are not completely known, but the state does involve the appraisal and evaluation of the stimulus, categorization of the stimulus as sexual, and an affective response. Research suggests that cognitive factors, such as sexual motivation, perceived
gender role expectations, and sexual attitudes, contribute to sex differences observed in subjective sexual arousal. Specifically, while watching heterosexual
erotic videos, men are more influenced by the sex of the actors portrayed in the stimulus, and men may be more likely than women to objectify the actors. There are reported differences in brain activation to sexual stimuli, with men showing higher levels of
amygdala and
hypothalamic responses than women. This suggests the amygdala plays a critical role in the processing of sexually arousing visual stimuli in men. suggests that women's need for
intimacy prompts them to engage with sexual stimuli, which leads to an experience of
sexual desire and psychological sexual arousal. Psychological sexual arousal also has an effect on physiological mechanisms; Goldey and van Anders showed that sexual cognitions impact hormone levels in women, such that sexual thoughts result in a rapid increase in
testosterone in women who were not using
hormonal contraception. In terms of brain activation, researchers have suggested that
amygdala responses are not solely determined by level of self-reported sexual arousal; Hamann and colleagues found that women self-reported higher sexual arousal than men, but experienced lower levels of amygdala responses. ==Models of human sexual response==