In India, sex is associated with marriage. People expect that a couple after marriage should have babies and raise a family as soon as possible. It is also taken for granted that couple knows everything about sex and should have no problem with having babies . The expectations are high from the parents of the newly married couple that everything will be alight and the couple will have babies. But not all couples have a smooth journey from sex to parenthood, but everything is not so easy.

The sexual attraction between male female may be instinctive, but the process of sexual behaviour and act has to be learnt. Couples may experience difficulty in performing the sexual act on the first day or night after the marriage due to various reasons. But in some cases, the problems may continue due to various physiological and psychological issues among the male or female or both. In some cases, the problems may arise even later in life leading to serious psychological, social and physiological problems. Sometimes such problems may even lead to break down of relationship.

The Masters-Johnson Study Of Male and Female Fertility Treatment

The management of sex issues is complicated and taxing, mainly due to lack of knowledge and communication between couples and the health professionals. Hence even qualified medical doctors were reluctant to prescribe remedies to such problems.

The ground breaking work in understanding of physiology and psychology of human sexual response by Master’s and  Johnson’s was instrumental in improving our understanding of sexual problems to great an extant. This also made possible to take up this work by professionals to carry forward management of sex problems on full time basis, thus paving the way for the emergence of sexual medicine.

Common Sexual Problems In Men

• Low libido or Lack of sexual desire.
• Erectile dysfunction or the inability in obtaining the erection during sex.
• Problems associated with ejaculation or inability to deposit sperms in the vagina to obtain proper transportation of sperms in to female reproductive tract.
• Such as premature ejaculation, retrograde ejaculation, inability to ejaculate during intercourse, the absence of sperm in the ejaculate.
• Lack of pleasure during intercourse.
• Pain during or after intercourse or both due to lack of lubrication.

Common Sexual Problems in Women

• Lack of or reduced sexual interest.
• Inability to get aroused (Dry Vagina).
• Orgasmic dysfunction (unable to reach orgasm (climax) during sex).
• Vaginismus- Tightening of the vaginal muscles, preventing intercourse
• Pain during or after intercourse or both.

Problems That Both Sexes May Face

• Problems of Sex orientation such as: Homosexuality, Lesbianism, Transsexual or inter sex.
• Body Image due to poor development of secondary sex characters.
• Faulty sex techniques leading to infertility.
• Paraphilias – abnormal sexual behavior due to incorrect sexual identity.

Role of Mind in Sexual Orientation

The psyche or mind also plays an equally important role in gender differentiation.

Sexual behaviour is not purely instinctual but mostly learnt. The learning process is important in the life of a couple as the sexuality also changes with ageing. Hence, it is very important to understand that, besides body organs, several other factors, (including socio-cultural) are also involved in the sexual act

In order to understand Sexual problems, we have to talk to patients singularly and collectively to understand various issues involved.

sometimes we have to take the help of diagnostic tools:

State-of-the-art diagnostic tools are available nowadays to identify the causative factors Some of these are:

• Biochemical Tests
• Hormone Assays
• Penile Haemodynamic Studies
• Nerve Conduction Studies
• Ultrasound Scans
• Doppler Studies
• Rigiscan
• Psychological Assessment Tests

Once the Causative Factor is Identified, The Appropriate Treatment Strategy is Offered to The Patients.

Treatment Strategies

The treatment strategies include:

• Sex Therapy
• Sex Counseling
• Medication (treatment with medicines).
• Surgical (Corrective) Therapy
• Hormone Replacement Therapy
• Vacuum Suction Devices
• Penile (Intracavernous) Injections
• Penile Implant Surgery
• Behavior Modification Therapy
• Supportive Psychotherapy
• Marital Therapy.