Dr. Chadi Ibrahim, LebMASH executive board member, and Dr. Sandrine Atallah, LebMASH partner, presented at the Lebanese Society of Family Medicine 13th annual conference on Gender, Health and Sexuality held at The Crowne Plaza in Beirut on Nov. 15, 2014.
Dr. Ibrahim presented on “how to take a sexual history in a primary care setting”. His talk stressed on the necessity of taking a sexual history in order to gather information to guide risk reduction counseling, to identify patients at risk of developing a sexually transmitted disease and to detect a sexual dysfunction that justifies treatment. He also detailed the clinical interview when taking a sexual history and emphasized on two specific populations, teenagers and LGBT individuals, with whom addressing the subject of sexuality is essential in order to enhance patient provider relationship and to screen, detect and prevent conditions that might be more common in these specific populations.
Dr. Sandrine Atallah presented on unconsummated marriages, the “one area in medicine which still remains in the closet”. Many health professionals are truly shocked to hear that such a phenomenon even exists. While statistics regarding the prevalence of unconsummated marriage aren’t documented, it has been estimated that 1% of all couples presenting to infertility clinics had not consummated their marriage.
The causes of an unconsummated marriage can be varied, and complex. The reasons that a married couple have for never having intercourse range from simple lack of sexual education and actual inability to determine how, to sexual dysfunction of the man (erectile dysfunction, premature ejaculation), woman (vaginismus, sexual aversion), or both spouses. Some partners may not be sexually active at all, whereas others do everything but actual penetration and find satisfying ways to be intimate without intercourse.
Some couples may be perfectly satisfied with this arrangement, and may have even purposefully sought out a likeminded partner. Most couples, however, are dismayed to find they are unable to have sexual intercourse, whether their first attempts to do so were prior to, or after the marriage. Often, simple embarrassment prevents them from confiding in or consulting with anyone, thus perpetuating the condition, often for several years.
Unconsummated marriage is common however its treatment and management are simple. Proper medical and sexual history and a focused general examination are the keys to the diagnosis. Sex Education, PDE5-I and Sex therapy are mainstays for treatment.