Saturday, April 12, 2014

The unconsummated marriage

The unconsummated marriage is a surprisingly common course of childlessness . If you notice , I did not say infertility , because infertility refers only to couples who have failed to conceive after having regular intercourse for at .least one year.

So why are couples unable to achieve vaginal intercourse  ?

While the fact that this is a common problem comes as a surprise to many of these couples ( who feel they are incompetent freaks , because they cannot even manage to perform such a natural biological activity) , what’s even more surprising is how often the diagnosis is missed by their doctors.

Most doctors naively assume that in this day of sexual permissiveness , all couples know how to have intercourse . They blithely assume that the couple is having normal intercourse , and have come to them for resolving their fertility issues . These couples are often very reluctant to volunteer the fact that they have not been able to achieve intravaginal ejaculation, because this is something they are ashamed of.

This is a tricky situation, and doctors need to be extremely patient , if they want to make the right diagnosis . This is not something which can be diagnosed by ultrasound scans or blood tests ! It’s hard to get to the truth in the first few minutes of a hurried consultation , and requires a lot of gentle and careful probing. Patients need to be able to be trust the doctor, before they are willing to volunteer such sensitive information.

An unconsummated marriage could occur because of many reasons . Often it's because of erectile dysfunction or because of vaginismus. Sometimes it’s because of plain ignorance - if both partners are virgins, they may not have an idea as to how to have sex.  The only way they can get this information is from the net, but a lot of this sexual information  comes from unreliable pornographic sites, which often end up confusing the couple even more.

The good thing is that this is a relatively easy problem to solve, because it doesn't require much medical intervention . Of course, this makes it harder to treat for some doctors, who prefer writing a prescription rather than sitting down and educating to the patient what they need to do to consummate the marriage.

Not only does it require a lot of counseling , it also requires an empathetic doctor, so that patients know that they are not being judges as incompetent nincompoops, who do not even know how to have sex !

Some doctors will make a bad situation worse by coming to the “ diagnosis “ that the reason for the failed penetration is a very tight vagina, which can be treated by a primitive operation called a Fenton’s where the vagina is cut in order to make it bigger ! Others will fob off the patient to a psychiatrist, as they aren’t interested in handling these “mental” problems.

Doctors can prescribe information therapy, by encouraging these couples to buy books, so they can educate themselves as to how intercourse is normally performed . This can go a long way towards helping them to resolve their issues. Couples should be encouraged to explore their own sexuality , by performing mutual masturbation ; and using sexual toys such as vibrators and liquid paraffin . Once they are comfortable with their own sexuality , many of these couples are able to get pregnant in their own bedroom, without any further assistance from the doctor.

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