Brief Answer: Hi Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. There may be following causes for lack of sexual relation in your wife case: -Low sexual desire -Phobia from sex (vaginismus) Many female has sexual phobia called vaginismus in which patient has anticipated severe pain, anxiety and phobia in intercourse. In several cases this is the result of a reflex spasm of the muscles around vagina. The reflex causes the muscles in the vagina to tense suddenly, which makes intercourse—painful or impossible. Due to that these female avoid sexual relationship by giving some reasons. It may be associated with anxiety, excessive worry, restlessness or sleep problem. Following steps will help you in management: • Do not be in hurry while deciding about future of relationship. • Proper sex education: make her read about physiology of sex and watch sex educational video to decrease anxiety related to sex. • Get her examined by gynecologist to rule out any structural problem. Female with vaginismus also have phobia and anxiety while while getting examined by gynecologist. She may also need some investigation like ultrasound and hormonal investigation. • Meet nearby psychiatrist in case of sexual phobia. • If there is some other problem after examination and investigation, then consultation should be taken accordingly. • Enjoy foreplay and physical intimacy regularly without sex. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards,

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