Married for months and years and yet no intercourse? You are not alone! (This should be the heading) Mr. and Mrs. S. were married for over 2 years now. It was an arranged marriage and the couple were getting along well. The only issue bothering them was that despite trying in many different ways, sexual intercourse has not taken place between them. It appeared that initially the wife was afraid of penetration, has experienced pain when the husband tried to penetrate, avoided sex as much as possible, consulted several doctors and gynecologists and followed their suggestions.
Finally, when Mrs. S was mentally and physically ready for intercourse, the husband, Mr. S started experiencing erectile dysfunction. He says his erections are good when he is alone, or even when he indulges in foreplay, but loses erection the moment he tries to take the penis near the vagina.
The result? The marriage is unconsummated, that is, intercourse has not yet happened between the couple.
Unconsummated marriage is not a rare thing. Quite a few couples experience it, though the exact prevalence is not known. Usually it is expected to be more prevalent in cultures with no or limited sex education / premarital guidance. For some, the problem resolves in a few weeks, for others it takes years on end. I have seen several couples who were unconsummated for 6-8 years and at least one couple who were married for 18 years. It does not mean that the problem is so complex! It only means the couple have taken so long to pluck up the courage to seek professional help and to strictly follow the therapist's suggestions.
Whether a couple is married or not, when they are unable to accomplish vaginal penetration, the relationship may be impacted in profound ways. It depends on how much each one loves, cares and supports the other, or how much each distrusts and finds fault with the other.
- Some try every position, lubricant, anesthetic, tranquilizer or the advice of a well-wisher and rate the outcome as success or failure.
- Some may altogether avoid intercourse or even other sexual activities.
- Some engage in all other intimate sexual activities including mutual masturbation or superficial sex (sex between the thighs) but preclude attempts to penetration.
- Yet others resort to the blame game, accusing the other for the failure. - Nevertheless, all unconsummated couples feel distressed, except those who enjoy satisfying sexual life, albeit without intercourse. Marital distress may in some cases lead to disputes between the couple, their families, and eventual annulment of marriage.
- Some people seek immediate consultation when they notice the problem, but many delay it for weeks to years out of embarrassment. Many a time, the couples seek professional help only when their urge to conceive surmounts embarrassment. Yet others consult only when their relationship comes under threat.
Why does it happen?
Unconsummated marriage can result from physical problems as well as psychological causes.
Causes in women:
2) Past painful experiences
3) Sexual pain disorders such as localized vulvodynia (vulvar vestibulitis syndrome), which is characterized by pain with touch at the entry to the vagina, which can prevent intercourse.
4) Some women have a very thick hymen, or a septate hymen, which vertically separates the vagina into two sides.
5) Vaginismus - a condition in which the muscles surrounding the vaginal opening contract involuntarily and close the opening tightly, making the penetration impossible. This is a psychosexual condition requiring counseling and behavior therapy.
In the male:
1) Erectile dysfunction can prevent intercourse. If it has a physiological basis, it may be treated medically.
2) Too early ejaculation (ejaculating before penetration)
3) curvature of the penis (if the curvature is mild, it can be dealt with through creative positioning. In more severe cases, medical or surgical treatment may be needed).
4) Severe anxiety and being over protective.
1) Lack of knowledge about sexual anatomy, physiology and sexual positions & techniques may contribute to the inability to penetrate.
2) One or both of the partners may have mobility problems or difficulty getting in to or maintaining a position.
How is the problem treated?
Most of these conditions can be addressed with appropriate information, guidance, counseling and physical therapy, including use of vaginal dilators. A septate hymen needs surgical repair. Anxiety and fear have to addressed. Pain due to infections or deformities need to be treated. Male erectile dysfunction and premature ejaculation require treatment.
Couples in unconsummated relationships of long duration, may need couples-therapy. Premarital education and counseling can go a long way in reducing the number of unconsummated marriages and the resulting distress and marital problems.