Definition Inability or absence of successful peno- vaginal intercourse in a couple. Prevalence About 15% of couple have problem of non consummation though they can have orgasm by masturbation or by oral stimulation of the genitals. It is not so common in thewest, be for social and cultural reasons. The longest duration of non consummation seen was for 9 years.
Etiology The Commonest cause of unconsummated is ignorance about the sexual act, thoughsexual aversion, rigid hymen, atresia of vagina, trauma, infection and sexual dysfunctions like impotence, premature ejaculation vaginismus, dyspareunia,etc. and up in non consummation of marriage.
Attention is mainly focused here on the unconsummation due to ignorance about the sexualact. The other conditions responsible for unconsummation are managed by treating the cause.
Why unconsummation?1. sexualityis a basic instinct in the animals for reproduction and propagation life.Unlike the other animals, sexual behavior in the human being is the outcome of learning and conditioning. Sex being a very private issue and considered as taboo, there is hardly any opportunity for learning the intercourse . therefore ignorance, myths and misconceptions about sexual act prevail.
2. the actis done in the dark. 4. thevaginal opening and its direction are not visible externally.How the problem presents?Unconsummationis more common in urbanized and well- educated clients. They are normal in every respect except for their ignorance about the sexual act.1. the client complaint may come for the guidance saying, I don’t know how to dointercourse. Please help me.
3. the chief complaint may be, I can’t penetrate. Perhaps he tries at the wrong site or in a wrong direction; or she may be having vaginismus. 3. some men may not know that they have to do pelvic movements after penetration.
4. woman keeps her legs straight This can bean important statement by the client giving a clue to the diagnosis. Thisciotal position there is no proper alignment between the direction of penis andvagina; therefore penetration is not possible.
5. my penisis not hard enough for penetration this could be the complaint. The female might not have been sufficiently stimulated through foreplay. Nature has designed the structure of the vagina in such a way that man gets maximum rigidity of penis in the vagina and then only he can ejaculate.
6. man may lose erection after trying at a wrong site ( at urethra or at clitoris) for along time and blame himself. In such case, woman may complain of pain during the coital act.
7. If the women has vaginismus, man may not be able to penetrate. He may lose erection and label himself as impotent.
8. all these men comes out This is the complaint by the women when the man ejaculates on the vulva instead of in thevagina.
9. women complaint of primary infertility. To the surprise of the examiner, the hymenmay found to be in fact proving non consummation. Till this fact is brought their notice, they feel that they are doing the coitus in a perfect way.
Consequences:1. thecouple may countinue to do intercoursein a wrong way without being aware about unconsummtion.
2. women may complain of pain during the intercourse
3. man waylose the erection after trying intercourse unsuccessfully at a wrong site for sufficient length of time. He may think himself suffering from impotence.
6. marital conflict/ divorce
7. suicide Diagnosis: