During the 1950s and 1960s, William Masters and Virginia Johnson
conducted many important studies within the field of human sexuality.
In 1966, in their book Human Sexual Response, they detailed four
stages of physiological changes of humans during sexual
stimulation. These phases, in order of their occurrence, are the
excitement phase, plateau phase, orgasmic phase and resolution
phase. Together, they make up the human sexual response cycle.

The excitement phase is the first stage of the human sexual response
cycle. It occurs as the result of any erotic or physical or mental stimulation,
such as kissing, petting, or viewing erotic images, that lead to sexual
arousal. During the excitement stage, the body begins becoming prepared
for coitus, or sexual intercourse, in the plateau phase.
- Heart rate and blood pressure increase, body muscles tension,
sexual flush occurs, nipples become erect, genital and pelvic blood
vessels become engorged, and involuntary and voluntary muscles
contract.
The vagina lengthens and widens, the clitoris swells and enlarges, breasts
increase in size, the labia swell and separate, the vagina becomes
lubricated, and the uterus rises slightly. Vaginal lubrication is the key
indicator of sexual excitement.
The plateau phase is the highest moment of sexual excitement before
orgasm, may be achieved, lost, and regained several times without the
occurrence of orgasm.
- Breathing rate, heart rate, and blood pressure further increase,
sexual flush deepens, and muscle tension increases. There is a
sense of impending orgasm.
The clitoris withdraws, the Bartholin’s glands lubricate, the areolae around
the nipples become larger, the labia continue to swell, the uterus tips to
stand high in the abdomen, and the “orgasmic platform” develops (that is,
the lower vagina swells, narrows, and tightens).
The orgasm phase occurs at the peak of the plateau phase. At the
moment of orgasm, the sexual tension that has been building throughout
the body is released, and the body releases chemicals called endorphins,
which cause a sense of well-being. Orgasm can be achieved through
mental stimulation and fantasy alone, but more commonly is a result of
direct physical stimulation or sexual intercourse.
- Heart rate, breathing, and blood pressure reach their highest peak,
sexual flush spreads over the body, and there is a loss of muscle
control (spasms).
The uterus, vagina, anus, and muscles of the pelvic floor contract five to
12 times at 0.8-second intervals.
The resolution phase occurs after orgasm and allows the muscles to
relax, blood pressure to drop and the body to slow down from its excited
state. Women experience no refractory period—they can either enter the
resolution stage or return to the excitement or plateau stage immediately
following orgasm.
- Heart rate and blood pressure dip below normal, returning to normal
soon afterward; the whole body (including the palms of hands and
soles of feet) sweats; there is a loss of muscle tension, increased
relaxation, and drowsiness.
Blood vessels dilate to drain the pelvic tissues and decrease
engorgement; the breasts and areolae decrease in size; nipples lose their
erection; the clitoris resumes its pre-arousal position and shrinks slightly;
the labia return to normal size and position; the vagina relaxes; the cervix
opens to help semen travel up into the uterus (closing 20–30 minutes after
orgasm); and the uterus lowers into the upper vagina (location of semen
after male orgasm during penile-vaginal intercourse).
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