Erectile dysfunction, vaginismus prevent marriage consummation in couples

Unconsummated marriage (UCM) among heterosexual couples is typically caused by erectile dysfunction (ED) and vaginismus, according to a study, noting however that a strong psychological component plays a major role in many of these cases.

“UCM is the inability of the heterosexual married couple to have penovaginal sexual intercourse,” said the researchers, who did a bibliographic search on Medline, Scopus, Web of Science, and Cochrane databases in June 2023.

Included studies described married couple who never had sexual intercourse in case report or case series evaluating the related causes and/or management and reporting data with qualitative, quantitative, or mixed methods.

Twenty-seven studies with 1,638 male and 1,587 female participants met the eligibility criteria. Of these, eight (29.6 percent) were case reports involving a single couple and 19 (70.4 percent) were case series. The mean age of married couples varied between 24.2 and 37.6 years.

Overall study quality was low to intermediate (mean Murad score 4.1), and all articles had evidence level of 4. Most of these studies were carried out in Egypt (18.4 percent), Israel (14.9 percent), and the US (14.9 percent).

Inability to consummate (23 studies, 85.2 percent) was the most common reason for the medical visit that led to a UCM diagnosis. Other reasons were inability to conceive (one article, 3.7 percent) and mixed (three articles, 11.1 percent). The mean UCM duration ranged from 7 days to 3.5 years.

In eight studies involving both men and women, the most common causes of UCM were vaginismus (8.4 percent to 81.0 percent) and ED (10.5 percent to 61.0 percent). Moreover, the articles reported that 16.6 percent to 26.0 percent of all UCM cases were caused by both male and female factors.

Various treatment modalities were used to achieve consummation, as reported in 27 studies. These included sildenafil, tadalafil, intracavernosal injection, penile plication, female genital reconstructive surgery, vaginal dilators, lubricants, psychosexual therapy, and sex education. The consummation rate achieved stood at 66.6 percent to 100 percent.