Arousal and the sexual response cycle

The models, and what replaced what

Masters and Johnson (1966) described a four-phase linear cycle from direct laboratory observation of several hundred participants: excitement, plateau, orgasm, resolution. It documented real physiology — vasocongestion, myotonia, the sex flush, vaginal tenting, testicular elevation — but assumed a universal sequence beginning with spontaneous desire.

Helen Singer Kaplan (1979) added desire as a first phase, producing desire–arousal–orgasm.

Rosemary Basson (2000, 2001) proposed a circular model after observing that the linear model did not describe most women in long-term relationships. In Basson's model, many people begin from sexual neutrality, choose to be receptive for reasons including intimacy and connection, and experience desire after arousal begins — responsive rather than spontaneous desire. This model is now standard in sexual medicine and underpins the DSM-5 merger of desire and arousal disorders in women.

Dual control model (Bancroft and Janssen, 2000) frames response as the balance of a sexual excitation system and a sexual inhibition system, with large stable individual differences in both. It explains why the same stimulus arouses one person and not another, and why removing brakes (stress, distraction, shame, fear of pregnancy, pain anticipation) is often more effective than adding accelerators.

Spontaneous and responsive desire

Roughly speaking, spontaneous desire arrives unprompted; responsive desire emerges once something pleasurable is already happening. Both are normal. Survey and clinical data indicate responsive desire is more common in women and becomes more common in everyone as relationships lengthen — a change frequently misread as loss of attraction.

The practical implication is significant: waiting to feel like it before starting will work poorly for a responsive-desire person. Deciding to start, in conditions that are actually pleasant, and letting desire follow, works better.

Arousal non-concordance

Genital response and subjective desire are only loosely coupled. Chivers et al.'s meta-analysis (2010, Archives of Sexual Behavior) of 132 studies found a correlation of about r = 0.26 in women and r = 0.66 in men between measured genital response and reported arousal.

Consequences that matter:

• Wetness or erection does not mean wanting.
• Absence of wetness or erection does not mean not wanting.
• Physiological response during unwanted or coerced sex, including orgasm, is documented and does not imply consent (Levin and van Berlo, 2004).
• Lubricant addresses a mechanical problem, not a motivational one.

What happens physically

Arousal is parasympathetic: vasodilation, engorgement of clitoral or penile erectile tissue, vaginal transudation, labial and testicular changes, nipple erection, raised heart rate and blood pressure, and rising muscle tension. Attention narrows. The orgasmic threshold is reached through summation over time, which is why interruption is costly and why duration matters more than intensity for many people.

Brakes

Anything sympathetically arousing in the threat sense suppresses sexual response. Documented contributors: stress and cortisol, performance anxiety, distraction and self-monitoring during sex (spectatoring, described by Masters and Johnson and repeatedly confirmed as a predictor of dysfunction), body shame, relationship resentment, pain anticipation, fear of pregnancy or infection, fatigue, alcohol above modest amounts, and medication — SSRIs most prominently, with sexual side effects in an estimated 40–65 percent of users.

Removing brakes usually does more than adding stimulation. This is the single most practically useful finding of the dual control literature.

Time

Laboratory and clinical work consistently finds most people, especially those with vulvas, need considerably longer for full arousal than typical foreplay allows — often 15–20 minutes or more of building stimulation. Inadequate arousal time is the most common mechanical cause of painful penetration and of reported anorgasmia.

Sources

• Masters WH, Johnson VE. Human Sexual Response, 1966.
• Basson R. "The female sexual response: a different model." Journal of Sex & Marital Therapy, 2000; "Human sex-response cycles." 2001.
• Bancroft J, Janssen E. "The dual control model of male sexual response." Neuroscience & Biobehavioral Reviews, 2000; Graham CA et al. on the female version, 2006.
• Chivers ML et al. "Agreement of self-reported and genital measures of sexual arousal: a meta-analysis." Archives of Sexual Behavior, 2010.
• Levin RJ, van Berlo W. "Sexual arousal and orgasm in subjects who experience forced or non-consensual sexual stimulation." Journal of Clinical Forensic Medicine, 2004.
• Nagoski E. Come As You Are, 2015 (dual control model, applied).
• Montejo AL et al. "Incidence of sexual dysfunction associated with antidepressant agents." Journal of Clinical Psychiatry, 2001.

Last reviewed: August 2026.