A newlywed couple came to me yesterday after their return from honeymoon. She is a doctor.

Problem: They could not do sexual intercourse in the Bahamas where they spent seven days.

What do we see?

Unfortunately, this is not uncommon in our practice. Couples come 3 days, 3 months, 3 years, even 6 years or later after marriage.

The couple who came last month was from a metro city. She was in tears narrating her experience with two Gynecologists whom she visited.

What's the bloody problem?

Vaginismus leads to unconsummated sex.  Both words, 'vaginismus' and 'unconsummated' are uncommon. Vaginismus is the involuntary contraction of pubococcygeus muscles that happens at the attempt of insertion of the penis. If you are a couple who has not been able to do sexual intercourse see the two animated pictures at mydoctortells dot com. You will know precisely what's happening.

Unconsummated sex is wherein penis has not gone inside the vagina.

Earlier, Gynecologists used to do Fenton's operation in an attempt to widen the vaginal introitus in a woman who had painful intercourse.  This surgery is outdated and does not serve the purpose as the basic mechanism of reflex contraction of the pelvic floor muscles persists.

Doc, I have ED

Interestingly, the couple often comes to us with a different scenario.

The newly married husband does online search for treatment of erectile dysfunction or/and premature ejaculation. The female passage is so well hidden that many a man doesn't realize that his inability to insert penis is owing to the passage. He labels himself as having ED. 

There have been cases where the couple earlier met a Urologist from a highly reputed hospital. After due examination and necessary reassurance, the urologist prescribed PDE-5 inhibitor (Viagra or similar medicine). Back home when the husband discovers even this does not work he is shattered.

Happy outcome

Treatment of painful sex requires sensitivity and experience on the part of the health care professional. There is a definite, systematic, step by step method of therapy by which insertion is accomplished. (Note: I am not using the word 'penetration' or 'penetrative sex'. These words subtly indicate forceful entry.) Actually, the penis has to glide in the vaginal passage in a sublime experience of awesome bliss, 'trupti'.  

For the simple reason that we see such couples on regular basis (for over 20 years), it is best to meet a Sex Therapist who is experienced.

I have never had to use vaginal dilators nor refer a case to a Gynecologist.

With commitment and cooperation from the couple, the treatment has a happy outcome.