Q: I am 27 years old and have been married for the past 1.5 years. I love my husband a lot, but I am not able to have sex with him. Even when I force myself to have sex trying to be interested, I don't get aroused and feel the process to be extremely painful. I also tend to divert my mind by thinking about some other thing and try to be mentally absent in the situation. However, I enjoy first and second degree sex. It's the last stage that creates an inhibition and fear in me. We would have hardly had sex for 5 or 6 times in the past year and a half. I came to know about the facts of sex only during my college days and thought the process to be dirty. I haven't even come to terms with my periods and have severe vomiting on the first day. The doctors say it is psychological disturbance. How can I get rid of this problem?

A:Sexual response involves both psychological and bodily processes, and any dysfunction may be secondary to any factor. It is sometimes difficult to ascertain the causation of such lack of interest/ dysfunction. In fact, lack of sexual desire is a known diagnostic entity, as well as fear and anxiety for sexual activity. At times there can be pain during sexual intercourse or dryness or spasms associated which can lead to anxiety regarding intercourse leading eventually to lack of interest. Exploration regarding any sexual abuse, correct understanding/ myths about sex, sexual arousal during fantasy, masturbation, sexual orientation may be necessary to rule out a few other factors. The specific management plan needs to be formulated based on the understanding of the causes. Although discussion about sexual issues can be quite anxiety provoking, I would strongly recommend you to visit a medical college psychiatrist, possibly of the same gender (may help psychologically), possibly having an interest in sexual disorders for planning out strategies for help. Further on the Psychiatrist may be able to help you by referring you to a Psychologist who would be experienced in sex therapy and also individual counselling.