When Jill (not her real name) married Boris, she was a 22 year old virgin.  She had saved herself for the one man she loved and was proud of it.  Yet, the wedding night proved to be unexpected.  She had put candles everywhere in their beautiful spacious hotel room.  The atmosphere was very romantic.  The maître d’hotel had brought a bottle of champagne with two glasses, strategically placed on a small table at the foot of the bed.  Jill was happy the moment was finally there when she could give herself completely to the man she loved.  No more saving her virginity.  Now she had a husband and he would have the best of her as well as the most intimate part of her.  She was looking forward to the moment when he would dive into her and bring her to the ecstasy she had heard of.  Finally, that moment was now.  As he got on top of her, taking her beautiful gown off, kissing her, telling her how much he loved her, he began to make love to her. 

The searing pain was immediate. Jill feared she was literally being torn apart.

Screaming, Jill did nothing to stop Boris as she waited for the pain to turn into pleasure.  Unfortunately, it didn’t.  She had heard that sex can be painful the first few times but that afterwards it becomes pleasurable.  Yet, as days and weeks went by, vaginal sex never became pleasurable.  Boris wanted sex every day, sometimes twice a day but she never reached vaginal orgasm because pain always came first.  After having two children with Boris, she decided she didn’t want intercourse any more.  Consequently, one year after the last child was born, Boris had an affair with a work colleague and left Jill with her two children.  Ultimately Jill and Boris got divorced.

A few years later, Jill met Brett.  After a few dates, they had sex.  Jill expected sex to be painful as it used to be with Boris.  Yet, it wasn’t.  As a matter of fact, not only did she not have pain, she didn’t feel anything.  Was he inside of her?  She wasn’t sure.  As she looked at the size of his erection, she realized Brett’s penis was a quarter of the size of Boris’s.  She was astonished.  She didn’t know there were different sizes in men.  She thought all men had a penis about the same size.  After a few months with Brett, she still couldn’t feel much.  Since her relationship with Brett wasn’t great on other levels, she broke up with him.

Could she find a man who could be compatible with her on a sexual level?  Could she discover vaginal orgasms?

A few months later, she met Jack.  Not only were they emotionally, intellectually, spiritually and financially compatible, they were also sexually compatible.  Jack’s sexual organ was smaller than Boris but bigger than Brett.  Sex was not painful and she could feel him inside.  Little by little she experienced more and more pleasure as she learned to relax more and more.  Finally, after one year with Jack, she had her first vaginal orgasm and many after that.  They are now happily married.

Studies show that Jill isn’t alone. 

Melissa Farmer and Cindy Meston published their studies in the Archives of Sexual Behavior in 2007. They showed that out of close to 1,000 women between 18 and 25 years old, of sexually active women, 63 percent reported any history of genital pain during intercourse.  Of sexually active women, 40 percent of women reported genital pain “occasionally” and 23 percent of women reported experiencing pain during sexual intercourse “always” or “most of the time.”

Also Laumann, Paik and Rosen in JAMA 1999 did a survey on 1749 women and 1410 men aged 18 to 59 years.  They found that sexual dysfunction was prevalent in 43 percent of women and that number increased after menopause.  Sexual dysfunction was also present in 31 percent of men.

In my medical practice, over the years, I found that sexual compatibility is important not only for happiness but also for health.

Three sex questions are important when looking for a life partner:

1) How often do each of you need sex?

Some people are more sexual than others.  Some need sex once or twice a day while others need sex only once a month, the average being two or three times a week.

While this shouldn’t be important in theory (“we are very compatible on other levels: emotional, spiritual and intellectual levels”), in practice it is really important when looking for a life partner.  Especially if children are created.  At the beginning of a relationship, both people will do their best to accommodate each other but as time goes by, their basic need will take over.  The one that needs sex once or twice a day will be increasingly unhappy whereas the one that needs sex once a month will not understand the other’s needs.  The one who needs more frequent sex might end up having a lover which ultimately will destroy the family.

2) Size and shape-wise, how compatible are you?

Some men have a large and long erect penis while others have a small and short erect one.  Some women have a large and long vagina while others have a narrow and short one.  Some men have a bent forward penis while others have a bent backwards one or one bent to one side.  Some women have a bent forward uterus while others have a bent backwards one.

All those details shouldn’t be important and yet, they are!  If a man with a large and long penis marries a woman with a short and narrow vagina, which could have been the case of Jill and Boris, intercourse will tend to be painful at times for her, which means that as years go by, the woman might want less and less sex.  When menopause will hit and her vagina will be dryer and less lubricated, she might not want sex any more whereas her man will still need sex.  He might then look for a lover and the family will be destroyed.

If a man with a small and narrow erect penis marries a woman with a long and wide vagina, both of them might have trouble getting orgasms.  He will be swimming in a large ocean while she will be wondering if there is anything inside of her.

If a man with a bent-forward penis marries a woman with a bent backwards uterus, his penis will hit the bent backwards uterus which will then hit the back of her pelvis which might be painful in the missionary position. Other positions will then have to be explored so that intercourse can be pleasurable to both partners.

Fortunately, instead of vaginal sex, a couple may be very compatible for oral sex, manual sex and/or sex using toys which will give intense pleasure to both and save the relationship.

3) How long does it take for each of you to reach orgasm?

Some people need 20 to 30 minutes to reach an orgasm while others need six seconds or less.

Yes, there are medications that people can take to increase the time to orgasm.  Those will triple or quadruple their time to orgasm.  This means that instead of having an orgasm in six seconds, they will manage to delay orgasm 18 to 24 seconds.  This will still be hard to match the 20 to 30 minute others need.  Sometimes, with time, some people will reach orgasm faster or slower.

But if they don’t, while at the beginning of the relationship, both people will do their best to make the other happy, as years go by, they will tend to accommodate the other less and less.  If a more compatible sex partner shows up, this might destroy the relationship.

Does that mean that sex before marriage is needed to make sure both people are sexually compatible?  Well, maybe yes and maybe no.

Arranged marriages historically work very well.  And those people only have sex after marriage.  Family is important to them and they respect their husband or wife.  As for sexual happiness, it is probably a gamble but they play “the cards they are dealt” and do the best they can.  Those marriages are very often successful ones because sexual fulfillment isn’t the primary focus of the marriage.  Family is!

So that shows how complex and multifactorial, having a happy relationship with a life partner is, especially if people want children.  Couples need not only to be emotionally, spiritually, intellectually and financially compatible, they also benefit from being sexually compatible.

But all this can change with time.  After giving birth to children, some women will be less interested in sex.  After menopause, a lot of women will also have more vaginal dryness and want less frequent sex.  Antidepressants will decrease their sex drive.  For men, diabetes, heart disease, stress and medications might affect their ability to have erections. 

So, if you have a perfectly compatible life partner, enjoy the present moment because such a relationship is hard to find and could change as age progresses and diseases pass by.


Castelo-Branco C, Blumel JE, Araya H, et al. Prevalence of sexual dysfunction in a cohort of middle-aged women: influences of menopause and hormone replacement therapy. J Obstet Gynaecol. 2003 Jul;23(4):426–430. [PubMed]

Frank E, Anderson C, Rubinstein D. Frequency of sexual dysfunction in “normal” couples. N Engl J Med. 1978 Jul 20;299(3):111–115. [PubMed]

Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. Jama. 1999 Feb 10;281(6):537–544. [PubMed]

Hisasue S, Kumamoto Y, Sato Y, et al. Prevalence of female sexual dysfunction symptoms and its relationship to quality of life: a Japanese female cohort study. Urology. 2005 Jan;65(1):143–148. [PubMed]

Rosen RC, Taylor JF, Leiblum SR, Bachmann GA. Prevalence of sexual dysfunction in women: results of a survey study of 329 women in an outpatient gynecological clinic. J Sex Marital Ther. 1993 Fall;19(3):171–188. [PubMed]

Davies S, Katz J, Jackson JL. Sexual desire discrepancies: Effects on sexual and relationship satisfaction in heterosexual dating couples. Archives of Sexual Behavior. 1999;28:553–567. [PubMed]

Melissa A. Farmer and Cindy M. Meston, Predictors of Genital Pain in Young Women, Arch Sex Behav. 2007 Dec; 36(6): 831–843.

Laumann, Paik and Rosen in JAMA 1999 A national probability sample of 1749 women and 1410 men aged 18 to 59 years at the time of the survey.

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