Abstract Introduction An unconsummated marriage (UCM) is defined as the inability of a married couple to achieve penile–vaginal penetration despite repeated attempts. Common in non-Western societies, it represents both a medical and a social issue. Its prevalence in sexology consultations ranges from 2% to 24% according to the international literature. It results from a combination of physical, psychological, social, and cultural factors, requiring a multidimensional approach. Objective This study aims to evaluate the management strategies for UCM and to identify factors influencing prognosis among couples consulting for unconsummated marriage Methods This is a retrospective analytical study conducted in the outpatient sexology clinic between 2010 and 2020. All couples consulting for UCM were included. Sociodemographic, clinical, and sexual data were collected using a standardized form inspired by the Derogatis Sexual Function Inventory (DSFI). Results A total of 229 couples consulting for UCM were included. The mean age was 29.8 ± 5 years for women and 34 ± 5 years for men. Vaginismus was the main cause (65%), followed by erectile dysfunction (35%). Both disorders coexisted in 11.8% of cases, and severe premature ejaculation was observed in 10.9%. A decrease in sexual desire secondary to unsuccessful attempts at consummation was reported by 10.5% of women and 11.8% of men. Twenty-five women (10.9%) had undergone hymenotomy before consultation. A psychiatric disorder was identified in 28.8% of patients, mainly mood and anxiety disorders. From a therapeutic standpoint, 47.2% of patients received pharmacological treatment: antidepressants were prescribed in 29.3% of cases and PDE5 inhibitors in 21.4% of men. Vaginismus was managed through sex therapy, Kegel exercises, and muscle relaxants when necessary. Sex therapy was recommended for all couples, but was effectively completed by 214 couples; the others refused or discontinued follow-up. Factors associated with successful consummation included the man’s prior sexual experience, persistent attempts at consummation, social motivation to consummate the marriage, and good marital harmony (p 0.05). Conclusions Unconsummated marriage, mainly related to vaginismus and erectile dysfunction, benefits from a combined approach integrating sex therapy and pharmacological treatment. Better outcomes are observed when couples maintain non-penetrative sexual activity, show strong social motivation, and have good marital harmony. Disclosure No
Kaabia et al. (2026) studied this question.