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| First Night Failure: |
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 INTRODUCTION
The first night or 'honeymoon night' of the marriage traditionally means the first sexual encounter for an Indian couple. It is the moment when society legally permits the consummation of the union of man with woman. The first night is the most awaited night in one's life.
Unfortunately, as sexologists, we come across a large number of clients failing on their first night. The 'first night failure' often results in sexual dysfunctions, social maladjustments, marital disharmony and even divorce.
WHY FAILURES?
The first night has been given special importance from ancient days. Our Sanskrit
literature gives detailed descriptions and exotic fantasies woven around the first
night. In the 'Kumar Sambhava', Kalidasa takes liberty in describing the love
dalliance of the newly wedded Shiv and Uma.
Our cinema has glorified the first night. The entry of the bridegroom in the
decorated bedroom, flower bedecked beds, the bride, veil, glass of milk, sweets
and the magic moment begins!!
 Today, a large number of novels in vernacular languages are available under
erotic titles glamourising the sexual raptures of the first night. So the first night becomes the most special night^of a young couple's life i.e. the 'golden night'. In our culture, till today in many parts of India, adolescent boys and girls are not allowed to interact with each other socially (except in some tribal societies) once the girl attains puberty. Marriages are fixed by elders. There is hardly any chance of courting. The first night in reality becomes the 'first encounter' to know each other.
Some young individuals are scared to death about their performance on the first night. Their fear is doubled by misguiding friends, yellow books, white self-advertised pamphlets by quacks and blue films. They have a feeling of sexual inadequacy, 'kamjori' or believe that they have become impotent and life has come to an end.
One of the most worrying questions on a man's mind is whether on the 'First Night' he will succeed in breaking the 'virginal seal' with a bang, as this is supposed to make a successful marriage. Because of this fear, many eligible bachelors avoid marriage.
 Sometime they end up buying so called sex tonics advertised in lay press or even rejuvenators even prescribed by consultants. To avoid 'first night' Failures some of them even visit prostitutes to test their potency!! A woman enters into the 'first night' with anxiety, tension,- fear and a variety of other emotions. The greatest worry on the mind of the bride is how she will fare in the 'virginity test'.
Virginity is considered a virtue. It is a sign of purity. In some societies, the couple is expected to show the bed cover stained with blood after first night as proof of virginity!
Thus, the bedroom, instead of being the foundation for developing tenderness, care, warmth, affection, life long love, pleasure bond, trust," intimacy and relationship, turns into a laboratory for testing potency and virginity. The West has got over its honeymoon problems i.e. first night failures. One does not even find a mention of first night failure in any standard text book of sexual medicine or in Diagnostic and Statistical Manual (DSM-IV).
WESTERN VIEWS
 Dr Wadell B Pomeroy, Co-author of the Kinsey's report, describes premarital intercourse as a training ground for marriage. Lessons learnt without feelings of guilt and fear and the knowledge of good techniques, go a long way in developing relationship. Urge to have intercourse is like any other urges, e.g. playing tennis, swimming or dancing, riding a horse or doing anything which gives pleasure. Premarital intercourse, unlike masturbation, is a means of interaction with another human being and consequently is a means of learning how to live with people. Sometimes, it is learnt too late after marriage that they are not suited to each other sexually.
PREVALENCE
The word 'first night' is described by various terms in vernacular languages (Table 1). This list can be easily doubled, if all India survey is carried out. It shows first night performance as still an important event in one's life. Failure can lead to disaster! |
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TABLE 1
FIRST NIGHT |
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| PRATHAM RATRI |
| SUHAG RAAT |
| MADHU RAJANI |
| PRASTHA |
| BED CEREMONY |
| MILAN-KI-RAAT |
| GOLDEN NIGHT |
| AADHYA RATRI |
| VATHAL |
| BASAR |
| NISHAKHER |
| SHOBHAN RAXRI |
| SHOBHANA |
| CHOTHI RATRI |
| MUDHAL ERAVU |
| MODALA RATRI |
| MUKABALE WALI RAAT |
| KATLA KI RAAT |
| LAGAN NI RAAT |
| MADHU CHANDRA CHI RAAT |
|
| (HINDI) |
| (GUJARATI, HINDI) |
| (HINDI) |
| (KANNADA) |
| (ENGLISH) |
| (HINDI) |
| (ENGLISH) |
| (MALAYALAM) |
| (KASHMIRI) |
| (BENGALI) |
| (KANNADA) |
| (TELEGU) |
| (KANNADA) |
| (ORIA) |
| (TAMIL) |
| (KANNADA) |
| (URDU) |
| (URDU) |
| (PARSI) |
| (MARATHI) |
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 It is difficult to quote statistically because of want of actual reporting and documentation. One can say 20% to 30% of couples who seek sex therapy have failure on their first night or at the time of first sexual contact.
AETIOLOGY
The sexual behaviour in human being is the outcome of learning and conditioning.
Sex being considered a taboo, there is hardly any opportunity for learning.
Therefore, ignorance, myths and misconceptions about sex prevail.
The most common aetiological factor for first night failure in marriage is ignorance about male and female anatomy and facts of sex act. Some couples have unrealistic expectations of sex act.
Other causes of first night failure are tight foreskin in male, tough hymen in female and dyspareunia, etc.
A list of probable causes of first night failure either due to organic, psychological or miscellaneous causes are given in Table
2. In reality these factors can be overlapping.
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TABLE 2 FIRST
NIGHT BLUES |
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 Psychological
- Inadequate sexual information
- Restrictive upbringing
a. Sex is dirty
b. Women who enjoy sex are disreputable
- Unreasonable expectation
- Performance anxiety
- Guilt
- Traumatic early sexual experience
- Comparison with past sexual experience
- Sexual myths
- Fear of pain
- Fear of failure
- Fear of not satisfying partner
 Impaired self image. Size of penis/breast - Fear of pregnancy
- Feeling angry, bitter or resentful towards partner
- Expectations of spontaneous erection
- Fear of STD/HIV/AIDS
- Contraception
- Stimulus
- Masturbation
- Voyeurism
- Group sex
- Pornographic material
- Knowledge of sex act by female - can create suspicion in
Organic
- Dysfunction in the partner e.g. vaginismus
- Psychiatric disorder
- Tight foreskin
 Tear of frenulum/small blood vessels - Tough hymen
- Health problems
Miscellaneous
- Random failure
- Too tired
- Sexually not attracted. Bad breathe, clothes, nails
- Poor communication
- Restricted-Forepiay
- Sex positions
- Tricks - to prolong sex act
- Stranger - many meet for first time after marriage
- Unsuitable environment
a. Too cold
b. Too hot
c. No Privacy
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 If failure occurs on the first attempt, the first thing which strikes a man is "Am I impotent?" The more he tries, the more he fails. He feels something is terribly wrong with him. He feels that due fo his past habit of masturbation, he has lost his vitality, vigour and potency. He stops further sexual advances. It starts « vicious cycle of performance anxiety and 'spectatorating' and failure.
CONSEQUENCES
- They may avoid sexual activity.
- They may continue to have only foreplay.
- They may have good relationship in other aspects of life.
- Some may suffer from anxiety/depression.
- Impotency
- Infertility
- They may make allegations at each other leading to marital conflicts, separation or divorce.
 CLINICAL PRESENTATION
There is no standard picture that either an individual or a couple will present. It may differ from one situation to another.
It depends upon the couple's education, social, environment, economic background, religious up-bringing and their knowledge about sexuality.
They can be grouped in following categories:
- Early Bird
A couple or an individual may contact a doctor/specialist/ sexologist even before actual failure has occurred. Invariably, the young man had the habit of masturbation. They believe in various myths surrounding the first night. They can be helped with reassurance, education and counselling. Sometimes antianxiety or antidepressant drugs may help. They remain worried till die actual event happens. Prognosis is good.
- After Marriage
A couple may contact on the very next day of the failure or in a few months after the honeymoon is over. Sometimes, they end up with surgeons or gyneacologist and unnecessary circumcision of male or hymenectomy of female is done to help them out, but it does not work. They form around 30% to 35% of total cases of first night failure. Prognosis is good.
- Fertility Concerned
Our society accepts if the couple has no issue for about one and half year, thinking that they are planning their family. After that period pressure starts from all concerned - relatives, friends, particularly on the woman to have issue as  soon as possible. Sometimes a couple may come with a bunch of reports of hormone studies, sonography, D&C operation, semen analysis, operation for varicocele and it is discovered that it is case of first night failure followed by non consummation of marriage. Their major concern is fertility and not the success of sex act. They invariably request that once wife conceives, they will be relieved of social pressure. Even if they have no sex for life time, it is okay for them. They contribute about 20% to 30%" of cases. Prognosis is good.
- Resistant Cases
Problem starts with first night failure, but the couple learns to live with the situation. Sometimes there may be an undercurrent of marital disharmony. They form around 10% of cases. Prognosis is not good.
- About to Divorce
One of the partners approaches for legal purpose, to certify the condition. Other partner is not willing to come forward for treatment. They form around 5% to 10% of cases. Prognosis is bad.
- Divorced and.Planning Remarriage
Sometimes they need a certificate that they are okay together with reassurance, counselling and, if required, intracavernosal injection. They are worried till they are successful. Prognosis is good.
PREVENTION
It is good preventive medicine to ask recently, married couples whether they have any sexual difficulties and if yes, whether they would like to discuss with
them.
 PREMARITAL COUNSELLING CENTRES
Sexuality education and premarital counselling for about to marry adolescents can act as a vaccine to prevent many first night failure. Premarital counselling services should be rendered by family physicians at their clinics as a service centre.
MANAGEMENT
The management includes detailed history, physical examination, sexuality education, counselling and in selected cases therapy. It helps most of the clients. Male and female should be separately interviewed. Their medical, psychological and sexual history should be taken.
HISTORY
History.of sexual awareness, sexuality education, masturbation, first sexual encounter, sex with prostitutes or others, sexual trauma, exposure to pornographic material, watching of blue films, incest, homosexual encounter and fantasies, expectation of sex act on first night are noted.
 After detailed history both should be interviewed for description of first night or first sexual attempt after marriage Where was it? Was there privacy? Whether both were tir$d after the whole days ceremony? What were their expectations? What really happened? Whether contraceptives were used? If condom was used, did he know how to use it correctly? What advice was received by bride from her friends or experienced family members like elder married sister or sister-in-law? What were their sexual preferences and what really happened.
The couple should be asked about how they feel about themselves, their body and their attractiveness.
EXAMINATION
Then male should be examined for tight foreskin, hypospadias, epispadias, large hydrocele or hernia, size and shape of penis.
In case of female client, she should be examined in presence of female attendant or her husband. She should be examined for tough hymen or vaginismus. If no abnormality is detected, it is better to explain to the client and reassure him/her. That itself can be therapeutic.
EDUCATION/COUNSELLING AND THERAPY
 Every couple presenting a sexual problem should be provided with information about sexual anatomy and physiology and the wide range of human sexual behaviour.
The aim of providing this type of information is to dispel myths and create realistic expectations.
ln some cases 'permission giving' by a respected authority, figure such as a doctor, may displace longstanding negative attitude.
In selected cases some anxiolytics or antidepressants can be used along with sex therapy.
Even intracavernosal injection (chapter 10) can be given just to build up confidence and to consummate marriage.
Thus, education, counselling and sex therapy can be very useful to treat First night failure.
PROGNOSIS
The success rate is very high if couple come in initial period. If they come after Otte or two years, if both are interested in fertility aspect and if there are no marital conflicts then results are good.
A small percentage of couples, who have deep rooted psychological problems, have come to terms with their lifestyle and move happily in society. They are difficult cases to treat but they may not seek medical help.
ANCIENT WISDOM
 In fourth century, Vatsyayan in 'Kamasutra' under chapter on 'How to Win Bride's Confidence* gives detailed account that how the newly; wedded couple should sleep on the floor for the first three nights observing celibacy.
For the next seven days they should continue their celibacy as before but time should be spent in cresting confidence in the bride, removing her fear and distress and suspicion.
On the night of 10th day, in privacy, a bridegroom should approach a bride. It is step by step sensuous approach, without any hurry or flurry or crude genital oriented performance pressure.
It is what Masters and Johnson have recommended in their 'sensate focus' or pleasuring regime of sex therapy after their pioneering research. By suitable combination of sage Vatsyayan's wise guidelines with new sex therapy techniques and judicious use of drugs many couples who are in marital distress due to first night failures can be helped. |
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