Sexual arousal occurring during sexual anxiety stimuli was compared to sexual arousal occurring during sexual pleasure stimuli in 19 sexually functional women. Stimuli were individualized narratives based on descriptions given by each subject. Sexual arousal was measured by monitoring vaginal blood flow with a vaginal photoplethysmograph. Results showed significant increases in vaginal blood flow in response to both sexual anxiety and sexual pleasure. However, increases in the pleasure condition were significantly greater than those in the anxiety condition. Analysis of the blood flow across time showed a significant linear increasing trend in the pleasure condition and a lack of such a trend in the anxiety condition.