Understanding Unconsummated Marriage: Causes and Treatment

The lack of sexual relations in a marriage (known as an Unconsummated Marriage) can be extremely painful, perplexing, and isolating for a couple. It is an intimate personal situation that may be clouded in silence and result in guilt, shame and anxiety.

It is important to accept the fact that this is, first and foremost, a medical and psychological condition. It is not a failure to fulfill your spouse's desires or an indication that you love your spouse less than they love you. You are not alone - this is a common problem, and more importantly, it is treatable. There is an empathetic, confidential, and thorough approach to Unconsummated Marriage Treatment. Getting help gives you a timely, confidential, and non-judgment space to begin to identify the root causes of the issue and eventfully provide you with a plan for achieving a location of emotional and physical intimacy.

What is an Unconsummated Marriage?
An Unconsummated Marriage refers to a marital relationship where no penetrative vaginal intercourse (coitus) has occurred. This situation can last, often for extended periods, from months to years - creating a strain in their relationship.

The underlying reasons are often complicated, as there are often physiological, psychological, and emotional factors involved - therefore, they most often cannot be attributed to one cause alone and it can create a clinical picture requiring a holistic approach for diagnosis and treatment.

Understanding the Common Causes
Identifying the root cause is the most important step in successful treatment. The difficulty might originate with a primary issue in the female partner, the male partner, or a combination of psychological factors that influence both partners.

Factors in Women
The most common cause of an unconsummated marriage is a condition in the female partner:

Vaginismus: This is usually the main reason in most cases. Vaginismus is the involuntary, reflexive tensing or contraction of the pelvic floor muscles at the thought or attempt of vaginal penetration. This makes intercourse painful (dyspareunia) or impossible. This is a protective, subconscious reflex often originating in fear.
Physical Barriers: Sometimes a physical issue can be the cause, like a rigid or thick hymen, a septate hymen, or other anatomical variations making penetration difficult or painful.
Past Trauma: A history of sexual abuse or a history of a pelvic exam that were traumatic can trigger a fear response deep in the subconscious.
Fear and Anxiety: This may vary from fear of pain, fear of pregnancy, or anxiety rooted in a lack of sexual education.

Factors in Men
Difficulties with intimacy are not exclusive to female partners. Male factors can also contribute significantly:

Erectile Dysfunction (ED): The inability to develop and maintain an adequate erection for penetration. The reasons can be psychological (performance anxiety) or physical (for example, diabetes, vascular problems).
Premature Ejaculation (PE): While unpleasant at times, it does not prevent penetration, but if the problem is severe enough, avoidance occurs, and the couple then begins to have issues.
Performance Anxiety: A psychological cycle where a fear of "failure" when engaging in sexual activity ultimately leads to a self-fulfilling prophecy; typically leading to erectile dysfunction or avoidance.

Psychological and Relational Factors

Fear-Pain-Anxiety Cycle: Often an initial painful episode (due to Vaginismus or lack of lubrication) generates fear. This fear initiates anxiety with the next attempt which leads to more muscle tensing which leads to more pain. This cycle is at the root of the diagnosis.
Lack of Sexual Education: Many couples enter marriage with little to no good sexual education which can lead to a great deal of misunderstanding, anxiety, and unhelpful techniques.
Cultural/Religious Upbringing: Very strict cultural or religious adherence may instill guilt, sin, and/or fear about sex and can be hard, if not impossible, to overcome even after you are married.
Relationship Issues: Prominent relationship conflict or lack of emotional connection can show up as a physical barrier in the bedroom.

Our Approach: Unconsummated Marriage Treatment
We feel that successful treatment means addressing all contributing factors that lead to the solutions of the issues explored (the physical, the psychological, and the relational). Our approach is not a simple "fix," rather we offer a complete, multi-disciplinary program tailored to the couple.

Step 1: The Confidential Consultation
It all begins with a private and in-depth consultation. This is a space for you and your partner to tell your story without judgement. A full medical and psychological history will be taken to paint a complete picture.

Step 2: Gentle and Thorough Evaluation
In order to identify the specific cause, a gentle and respectful examination is frequently required.

Women: This is done with a great deal of care and sensitivity. The goal is to diagnose conditions related to Vaginismus or identify any physical barriers to penetration. In more severe cases of Vaginismus, an examination is either not possible in the beginning or is delayed.
Men: There will be an evaluation for erectile dysfunction or other andrological issues.

Step 3: A Customized Treatment Plan
Based on the diagnosis, a personalized Unconsummated Marriage Treatment plan is created. This may include:

1. Treating Vaginismus and Physical Barriers:

Education: The first and most important step is to think of Vaginismus as an involuntary muscle spasm, not as a failure on your part.
Progressive Desensitization (Dilator Therapy): This treatment will be reviewed with a medical professional, to help your muscles learn to relax and accept penetration in a slow, controlled, painless fashion.
Botulinum Toxin (Botox) Treatment: For cases of severe and resistant Vaginismus, this is a very successful, modern treatment. A small amount of Botox is injected into the spastic pelvic floor muscles, which temporarily relaxes the muscle, breaking the cycle of pain and spasm and allows the patient to proceed with dilator therapy and eventually achieve intercourse successfully.
Hymenectomy: In very rare instances, if a rigid or septate hymen is discovered, a simple and minor surgical procedure can be performed to remove the physical barrier.

2. Treating Male Factors:

Medical Treatment: Oral medications are very effective for erectile dysfunction.
Counseling: Individuals suffering from performance anxiety or PE can receive targeted treatment that creates strategies to modify anxiety and enhance control.

3. Psycho-Sexual Counseling:
This is a cornerstone of treatment for both partners. A qualified therapist helps the couple:

Address and overcome underlying fears and anxiety.
Communicate better about intimacy.
Restore emotional and physical intimacy.
Understand appropriate sexual facts and techniques.

Your Journey to Intimacy Can Begin Today
The emotional burden of an Unconsummated Marriage is significant but it’s not a burden that couples have to bear alone anymore. This is a solvable situation, and with expert and compassionate care, a satisfying intimate relationship can be achieved.

Our trained medical providers are committed to helping patients find a way to heal and have successfully assisted countless couples through this intimate and serious matter. Do not let confusion or shame prevent you from reaching out for help. The first step is always the hardest.

Contact us today
We want to encourage you to think about engaging in a private consultation to talk about your specific situation. Schedule your appointment today to learn more about Comprehensive Unconsummated Marriage Treatment programs and take the first step to the intimacy you deserve and should be having with your partner.