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Advice on how to decrease phobia of penetrative sex in wife and advice on semen analysis report.

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Psychiatrist
Practicing since : 2004
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hi,i am 29yrs male with juvenile diabetes from last 11yrs,got married 4yrs back. till date i was not able to make complete intercourse with my wife because of her panicness towards penis insertion in her vagina. Now i am planning for kids and she is also been briefed and ready for complete intercourse. recently i had my sperm analysis and following r the results - Macroscopic - volume: 3 ml;colour - pearly white; Reaction-Alkaline; Viscocity-Normal; Liquefaction time-25 min; Microscopic - Sperm count - 60 millions/ml; Motility- Active - 35%; Sluggish - 25%; Non Motile: 40%. Please advice how to make a easy insertion without her apprehension towards pain once penis is inserted and advice on reports if any and cares to be taken
Posted Sun, 15 Apr 2012 in Sexual Problems
 
 
Answered by Dr. Ashish Mittal 22 minutes later
Hello,

Thanks for your query.

Important points of your query:
•     Known case of diabetes
•     Chief complaint: Pain and Phobia from penetrative Sex in wife
•     Good support from husband

Your semen report is not problematic at this point of time. For child birth penetrative sex is needed. So currently you need to focus to identify and solve this issue.

Your wife appears to suffering from the condition called vaginismus in which patient has severe pain in intercourse leading to lack of enjoyment and phobia from sex. This is the result of a reflex spasm of the muscles around vagina. The reflex causes the muscles in the vagina to tense suddenly, which makes intercourse—painful or impossible.

Following steps need to be done for treatment:
•     Proper sex education for wife: read about physiology of sex and watch sex educational video to decrease anxiety related to sex.
•     Enjoy foreplay and physical intimacy regularly without sex.
•     Involve in gradual stepwise penetration: with small to large finger or use of vaginal dilators with increasing size according to your comfort. You can also use local anaesthesia with xylocaine during dilation
•     Improvement may take time so never hurry.

During these steps your wife also need treatment assessment and treatment of anxiety or phobia from psychiatrist.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Regards,
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