Aah, Aaah, Aaaah, AHHH - The Four Stages of the Female Sexual Response

Misinformation has surrounded the female orgasm for decades. From the incorrect notion that vaginal lubrication originates from the cervix (it doesn’t, it originates from two pea-sized glands near the entrance to the vagina called the Bartholin’s glands). To Cosmopolitan magazine making a public apology in 2020 about championing the G spot back in the early 80s when actually, it doesn’t exist [1]

It’s little wonder The Big O is surrounded in mystery.

Even where the female orgasm originates from is contested. Vaginal penetration or external clitoris stimulation? The simple truth is that there are no distinct ‘vaginal’ orgasms and ‘clitoral’ orgasms. Just orgasms. Plain and simple.

However, there isn’t anything remotely plain or simple about the female orgasm. It’s far from two minutes of vaginal penetration with a penis, fingers or a traditional penis-shaped sex toy, which has long been the view of the female orgasm, though the lens of a male-centric vision.

In fact, it had previously been posited that an inability to achieve orgasm through “enough penetrative thrusting through intercourse to simulate the clitoris” was a sign of female sexual dysfunction. Thrusting?

However, there isn’t anything remotely plain or simple about the female orgasm. It’s far from two minutes of vaginal penetration with a penis, fingers or a traditional penis-shaped sex toy, which has long been the view of the female orgasm, though the lens of a male-centric vision.

Social media ‘two pumps and a squirt’ memes might serve to make women feel part of a club that they can roll their eyes at and go off to the bathroom to ‘sort themselves out’.

But is this really empowering? Should we make jokes about simply shrugging off a poor sexual experience that’s focused on male pleasure and the male orgasm, leaving women unsatisfied or having to fake it?

The Four Stages to Orgasm

The female sexual response occurs in four distinct phases, ultimately ending in orgasm, for some, as a result of external stimulation of the female orgasmic platform – more commonly known as the vulva, which itself is the collective term for the inner and outer labia (lips) and the clitoris.

In 1966, researchers William Masters and Virginia Johnson conducted one of the most ground breaking studies into the sexual response and discovered the four distinct phases [2] to female orgasm:

  1. Excitement – An increase in heart rate, flushed skin, erect nipples, fuller breasts, blood flow increases to the clitoris and labia causing them to swell and vaginal lubrication.
  2. Plateau – An increase in intensity in the changes happening in the excitement phase, increased muscle tension, the clitoris becomes increasingly sensitive.
  3. Orgasm – A significant increase in heart rate, breathing rate, muscle tension and blood pressure and involuntary, rhythmic muscles spasms in the vagina, uterus and anus.
  4. Resolution – Increased heart and breathing rates, muscle tension and swelling all return to normal.

This study (albeit intentionally) focused on the physiological changes in the body that lead to orgasm, and as such, it was criticised for not also taking into account psychological factors. By default therefore, it was taking a male view of things, rather than also considering a female emotional approach. So, ground breaking it might have been, and it certainly led the way, but there was more to be understood…

Females Want Orgasms Too!

As a result of the criticism of the Masters and Johnson model, in 1979, another researcher, Helen Kaplan, took desire into account, [3] and came up with her three step model:

  1. Desire
  2. Excitement
  3. Orgasm

Stages two and three remain the same as the Masters and Johnson model, but the additional phase of desire results in the initial increase in heart and breathing rates, often as a result of physical stimulation or psychological stimulation such as sexualised thoughts or the presence of a new or exciting partner.

Adding desire into the mix was seen as revolutionary – that a woman would require an emotional response to reach the excitement stage is something that’s well understood (if not always practised) now. That is, a requirement for a psychological response – desire – is needed in order to reach a physiological one - orgasm.

This was an obvious flaw of the Masters and Johnson model - that it was male biased. It went a long way to explaining the male sexual response, but not the female. It’s now generally accepted that a female will require around 20 minutes of external stimulation, in a safe and relaxed environment, in order to reach orgasm. And she’ll need desire.

Which leaves us to return to the ‘female sexual dysfunction’ notion. The Masters and Johnson four stages of the sexual response was male biased and didn’t take into account the need for initial desire.

Because of this, the Masters and Johnson model assumed that sexual desire could be switched on spontaneously, something that many females simply don’t experience. It then naturally led to the assumption that women were sexually ‘dysfunctional’ if they didn’t reach orgasm, simply because their crucial initial stage had been overlooked.

More Sex Please, We’re British

In more recent years, it’s become more accepted that desire isn’t always spontaneous, especially so in women. Instead, desire occurs as a response to a sexual stimulus, which then leads to sexual action to continue this feeling of desire and arousal. In other words, the anticipation of a sexual event, actually leads to desire.

This is the circular model for sexual arousal in females, which is better suited than the male, linear, model first recognised by Masters and Johnson.

A virtuous cycle, if you will, that begins with feelings of safe intimacy and sometimes, love. (It obviously also applies to some men, but primarily, women, who were undeserved by the linear model.)

This is the most accepted set of stages of the sexual response in women in the UK – work carried out in 2000 by Rosemary Basson. [4]

Therefore, the most up to date theory includes the following four stages of the female sexual response:

  1. Anticipation/desire – An increase in heart rate and breathing rate, stimulation leads to more desire, the vagina becomes lubricated and starts to widen and the clitoris and labia begin to swell.
  2. Tingle – Blood flow increases to the vulva, causing more swelling and a deepening in colour. The changes at the desire stage continue to increase in intensity.
  3. Orgasm – The muscle spasms continue until the muscular walls of the vagina, anus and uterus contract rhythmically leading to intense feelings of pleasure and the release of feel-good hormones. At this stage, it’s possible for a women to go on to experience multiple orgasms. Unlike males, who have a recovery, or refractory period during which they cannot orgasm, females can continue to orgasm.

You’ll note that orgasm is the final stage, with resolution left to the history books, as it has been since Helen Kaplan [5] in 1979.


[1] Kiefer, E. M. (2021, January 22). The G-spot doesn't exist. Cosmopolitan. Retrieved July 7, 2022, from https://www.cosmopolitan.com/interactive/a32037401/g-spot-not-real/

[2] Rowland, D., & Gutierrez, B. R. (2017). Phases of the sexual response cycle - Valparaiso University. Phases of the Sexual Response Cycle. Retrieved July 7, 2022, from https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1061&context=psych_fac_pub

[3] Perelman, Michael. (2012). Helen Singer Kaplan's Legacy and the Future of Sexual Medicine. Journal of Sexual Medicine. 9. 138.

[4] Rosemary Basson (2000) The Female Sexual Response: A Different Model, Journal of Sex & Marital Therapy, 26:1, 51-65, DOI: 10.1080/009262300278641

[5] Helen Kaplan https://en.wikipedia.org/wiki/Helen_Singer_Kaplan