Sexual Response in Men

What is the normal pattern of sexual response in men?

A man’s sexual response has several stages:

• desire
• excitement
• plateau
• orgasm
• resolution.

Your sexual response starts with a desire for sexual intimacy. This is also called libido. Sexual stimuli—either thoughts or physical actions—start the excitement phase. In the excitement phase:

• The heart beats faster.
• Blood pressure gets higher.
• Skin becomes flushed (filled with blood).
• The testicles get larger.
• The skin of the scrotum pulls closer to the body.
• More blood flows into the penis, creating an erection.

The plateau is the phase between excitement and orgasm. It is usually short, but a man may be able to make it last longer by holding off ejaculation. What normally happens in the plateau phase is:

• The head of the penis gets bigger and more purplish in color.
• The glands secrete semen into the urethra.
• A point is reached where it is hard to stop from having an orgasm.

If you continue the sexual activity, you will often have an orgasm and ejaculation. Orgasm is a total-body response. It triggers a series of muscle spasms in the legs, stomach, arms, back, and penis. The feelings are intense and pleasurable. Ejaculation is the term for the time when semen comes out of the penis.

After ejaculation, your body starts to go back to the state it was in before the sex began. During this resolution phase:

• Blood flows out of the penis and the erection goes away.
• You have an overall feeling of relaxation.
• The testes and scrotum return to their normal size.

What happens if you become aroused but do not have sex?

If you become aroused but do not have sex, your body will slowly go back to its normal, unexcited state.

How does age affect male sexual response?

Young men tend to get full erections very quickly. As men get older, it usually takes a longer time for a full erection. With aging, erections may not get as firm as they were at a younger age. This is normal.

What are common misunderstandings about the male sexual response?

Some common myths about the male sexual response are:

• An erection always means a man wants to have sex.
• Lack of an erection means a lack of sexual interest.
• All touching is sexual.
• A real man is always interested in and ready for sex.
• Satisfying sex just happens—without any discussion or planning.
• A man who has a regular sexual partner will not want to masturbate.
• Real men do not have sex problems.

Are sexual problems common?

All men will have some type of sexual problem at some time. For example:

• You may have problems getting erections.
• You may get erections when you do not want one.
• You may feel like you either reach orgasm too soon or that it takes too long.
• You may feel that you or your partner is not getting enough enjoyment out of sex.
• Your ideas about good sex may be different from your partner's.

How can I learn more about this?

You can get books about the emotional and physical aspects of sexuality and sexual response at stores and libraries. Talking to a friend or family member may also be helpful. You need not worry about occasional sexual problems. However, if you keep having problems that concern you or that affect your relationship with your partner, talk to your healthcare provider about it. While sometimes it is hard to talk about intimate sex concerns, you do not need to be embarrassed. Many healthcare providers are skilled at discussing these issues. Your provider can help you determine whether your problem is physical or psychological. In either case your provider can refer you to someone who specializes in problems with sexual function.

Additional information is available from:

• American Association of Sex Education Counselors and Therapists
  Web site: http://www.aasect.org
• American Psychological Association
  Phone: (800) 374-2721
  Web site: http://www.apa.org
• Sexuality Information and Education Council of the United States
  Phone: (212) 819-9770
  Web site: http://www.siecus.org