After pregnancy, many times couples report that they don’t experience the pleasure that they used to. Can this be helped?

After normal delivery often-vaginal walls become lax and the penovaginal contact reduces. Thus some people do report less pleasure. This can be helped. While doing the episiotomy, the gynecologist should take one more stitch known as husband’s stitch to ensure adequate apposition that helps in increasing the peno-vaginal contact, thus giving more pleasure.

What are the most common causes of lax vagina? How can it be prevented?

This may occur following childbirth. Proper management of labor with perineal support and an adequate and timely episiotomy can best prevent it.

What is the treatment for a lax vagina?

Kegel’s exercises for contracting the perineal muscles by holding the urine and releasing it, 20 such contractions and relaxations three times a day, may help increase the muscle tone. If this does not work, one may go in for vaginal reconstructive surgery.

What are women’s misunderstandings about men’s sexuality that many lead to sexual dysfunctions?

Often when a man is a premature ejaculator, many women may consider him a poor lover or the woman may make an attempt to reach orgasm early also. At times, this leads to a shortening of periods of intimacy. In cases of retarded ejaculation, where there is a delay in reaching orgasm, the woman starts getting a feeling that her partner does not love her or she is not attractive to him any more which may disturb the intimate relationship. Also most women consider it improper to actively participate in intercourse and prefer to remain completely passive or only minimally responsive leaving the onus on the male who is now under pressure to perform. This may create a situational anxiety that may impair his response and performance. Even if the male is able to perform properly in these circumstances, the minimal or deliberately subdued response of his partner due to traditional misconceptions will leave him with the feeling that the encounter has not been mutually satisfying. If this occurs repeatedly, it instills a sense of inadequacy and frustration in him that may affect his performance and his sex drive may decline.

How should a physician deal with a sexual problem?

Alter an adequate history taking the physician should try to determine exactly where the problem lies misconceptions, unrealistic expectations, disturbed interpersonal relationships, hostility towards a partner. The physician should counsel the couple as a unit, clarify and explain the situation to them, and clear misconceptions. He may offer specific therapy if and when the situation demands.