Unconsummated marriage & Infertility - Dr. Sharmila Majumdar, Sexologist
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Unconsummated Marriage – one of the leading causes of infertility

unconsummated marriage

Unconsummated marriage (UM) is a condition where the couple in spite of being married and living together is unable to engage in sexual activity and have successful intercourse. This condition may exist among a couple for a variable duration. While medical and therapeutic intervention is available, many people still suffer in silence and feel embarrassed about their condition.

UM can have detrimental effects on the psyche of the individual partners, it can lead to low self-esteem in individuals, blames games can result in frequent fights among partners, extra marital affair, fights within family or both the families. Also in a place like India predominantly for not being able to conceive and give birth to a child, frustration, depression, and if appropriate help isn’t available, it may lead to annulment of marriage and divorce.

Various factors are responsible for this condition, many a times individuals may not seek help at the right time from appropriate person due to lack of awareness and taboo to talk about sex life and shame it will result in after discussion.

There can be several reasons for UM: psychological, organic or even both at the same time.

In a developing country like India, most individuals have nil or inadequate (may not know ‘how to proceed’) or even negatively presumed knowledge about sex (especially in females that intercourse will be very painful); so many individuals are unable to have sex after marriage. 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. Some may have a negative image about sex (based on the early teachings by their family or religion, but fail to understand that it’s an important and integral part of marriage), hence may not indulge in and nor allow the partner to proceed.

Women rose to place most of their self-esteem and identity in virginity can have a tough time.For them taking on a new role as a married woman and a new identity as a sexual human being, is difficult. In the conservative middle-Eastern societies and in the developing countries, couples are strongly prevented by religious rules and cultural taboos from sexual experiences before wedding.

For some the performance anxiety; the intense social pressure to accomplish hasty coitus with an unfamiliar woman (some men having had no social contact with their new bride), and in the presence of relatives waiting nearby for evidence of the bride’s virginity and confirmation of coitus; may lead to unsuccessful attempts. Sources of performance anxiety includes fear of sexual failure, fear of mistakes, sexual myths about sexual performance, demand for sexual performance, fear of being rejected by the partner, living in the same house with family/ lack of privacy and misconceptions and beliefs about sexuality. Unreasonable expectations, traumatic early sexual experiences, restricted foreplay, impaired self-image and poor communication, also may contribute to performance anxiety.

The current competitive lifestyle, working couples are under constant tremendous work pressure to meet deadlines leading to excessive mental stress and fatigue. They are practically available for each other only on weekends and that too, if one of them has different work schedule then it’s really difficult to spend time together. This results in “no mood tonight”, “have had a hard day, want to sleep”, “am tired, have to complete project, and get back to work early” and such other excuses and situations, affecting their sex-life. This also increases performance anxiety and later due to avoidance behaviour, partners enter a vicious cycle where they lose sexual interest altogether.

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.

Sexual dysfunction like erectile dysfunction, premature ejaculation, performance anxiety in males and vaginismus in females has been predominantly reported in several studies and reviews over the years. Vulvodynia, an often unbearable pain when the genitals are touched is also one possible reason.

Little research has been conducted about UM. A trend that is seen in these studies is that in western countries lately there have been lesser reported cases of unconsummated marriage compared to eastern developing countries. Also a positive trend visible is: increased reporting among people in developing countries, this could be attributed to the fact that discussing or seeking help for sexual problems may no longer be a stigma.

It’s essential to assess and evaluate both the partners and their sexual history along with their current relationship & psychiatric history well in combination with physical examination and diagnostic testing. The socio-cultural and psychodynamic factors pertaining to the failure to consummate the marriage should be investigated in detail and addressed. An empathetic attitude by Qualified Sexologist is required, so that patients know that they are not being judged as incompetent nincompoops. Educating a couple to take their time, experience sexuality and intimacy rather than view it as a performance or a test, or as a task you either pass or fail, often takes the pressure off.

Premarital sex education can prevent UM arising due to wrong/inadequate knowledge of sex. Frequent meetings during courtship can lead to better understanding and comfort level between couples, thus preventing the condition. Couple counselling on sex and physical relationships including sex education can be availed after marriage.

Marital therapy is done to resolve interpersonal issues, make each other understand faulty behaviour, to work hard to strive the relationship, develop trust and emotional bonding, to spend quality time together eventually to save the relation. Behaviour therapy where first couple should be encouraged to explore their own sexuality. Once they are comfortable with their own sexuality, gradually they can progress to having intercourse.

Sexual dysfunctions like Vaginismus & low desire in females & Erectile Dysfunction and premature ejaculation, low desire in males and infertility due to UM should be treated.

In conclusion, identification of the etiological factors of UM may be essential for the proper management to achieve a successful outcome. In addition to proving explicit sex education and behavioural counselling, Sexologist often find prescription medicines useful.

Conclusion
It’s time for unconsummated marriages to come of the closet!

Dr. Sharmila Majumdar

Make an Appointment at the Sexual & Mental Health Clinic, Avis Hospital, Jubilee Hills, Hyderabad

doctorsharmila
doctorsharmila
Dr. Sharmila Majumdar is the First Female Sexologist in India, who specializes in Female & Male Sexual Dysfunction & Mental Health. Her professional experience comprises of National and International Consultations, co-authoring a Medical Handbook on “Male Infertility and Andrology”, Journal Publications, Presentations as a guest faculty at National & International Conferences on Sexology, Endocrinology, Gynecology & Psychology. She is also a Guest lecturer in several medical colleges in India. Dr. Sharmila Majumdar has also won an award for the best Presentation in Female Sexual Dysfunction in the National Conference of Sexology in 2008. She is also a columnist in leading local newspapers. She is a guest editor and a contributor in several medical portals and magazines. Dr. Sharmila Majumdar has rich experience of 11 years in the area of Sexual & Mental Health. She has successfully treated hundreds of patients globally. Her primary motto is optimal Sexual & Mental Health in Men and Women. She is up-to-date with the latest advancement in the emerging field of Sexual & Mental Health for the well-being of her patients. She strongly believes in the right to Physical, Sexual and Mental wellness. DR. SHARMILA MAJUMDAR IS AVAILABLE FOR CONSULTATION AT AVIS HOSPITAL, SEXUAL & MENTAL HEALTH CLINIC, HYDERABAD – 500033, TELENGANA, INDIA

1 Comment

  1. Chayan Das says:

    Informative and helpful post

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