One of the common causes of childlessness is sexual dysfunction. But this is often the elephant in the room, which no one talks about, for multiple reasons.
Most gynecologists who treat these couples for their “ infertility “ don’t even bother to take a proper history because they don’t have the time or the inclination. They would much rather order a routine battery of tests mindlessly, as they do for everyone who comes to their clinic.
And because most couples who have sexual problems are very reluctant to share this information with their doctor, because they are so ashamed about this, that they often hide this until asked about it explicitly.
There are many different ways how sexual dysfunction contributes to childlessness.
Some women may have a lot of pain during intercourse, which is called dyspareunia, as a result of which she is scared to have penetrative sex. Or she may have what is called vaginismus, which is an involuntary spasm of the vaginal muscles, which means he cannot have sex, because she will not allow him to , because it’s too painful for her. Similarly, for some men, the problem is erectile dysfunction as a result of which they cannot get an erection and cannot penetrate into the vagina. Whereas for others, there is a problem of premature ejaculation, which means they ejaculate outside the vagina even before they can penetrate. And for some men, the problem is called anejaculation, which means they get an erection, and can penetrate, but they cannot ejaculate inside the vagina.
The point is that these are surprisingly common causes for childlessness, but partly because patients are ashamed and do not discuss these bedroom difficulties with their doctor on the first visit, and partly because doctors don’t have enough time to take a proper history, they fail to identify what the underlying cause of the childlessness is. As a result of this , many of these patients are subjected to unnecessary medical procedures, such as artificial insemination or even IVF, where they could actually just get pregnant in their own bedroom by using simple techniques such as self-insemination using a Malpani self-insemination kit.
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