Speaking openly about sexual relations remains largely taboo in Egypt, even within marriage. Reham El-Adawi meets a woman who is trying to break down the wall of silence around pleasure "I am the saddest man on earth," said the young man. An Egyptian who works as a teacher, he had agreed to speak on condition of anonymity. Eight years ago, he married one of his college students. They love each other very much. Yet he has never had full sexual intercourse with his wife, because she is very shy and remains frightened of the whole process. However, instead of just submitting to their suffering and allowing it to continue indefinitely, he and his wife decided to seek professional help. One person who knows how difficult a decision this can be is Dr Heba Kotb, who specialises in sexuality and marital consultations. "At the beginning, married couples tended to stumble into my clinic looking slow and confused," Kotb recalls. "But today, they can talk to me openly about this very sensitive part of their private lives." As a student of forensic medicine, Kotb had to deal with many cases of sexual assault and rape. It was this experience which gave her the idea of a clinic that would specialise in sex counselling. When she set up five years ago, she discovered that a great number of married couples in the Arab world knew very little about the intimate and private dimension of the relationship between man and wife. "Hence, they tend to concentrate on the functional aspect of sex [procreation], rather than on the sensual, which is the source of real pleasure," Kotb explains. According to specialists, this state of affairs represents a serious social problem, affecting not just the quality of individual lives, but productivity and social interaction generally. Despite this, you can search the universities of the Middle East in vain for a department of sexology, even though the discipline was first introduced into the US educational system as early as the 1960s. As a result, Kotb was obliged to travel as far afield as Florida in order to study sexuality and marital consultations at Maimonedes University for Clinical Sexology. In the past, gynecologists tried to fill this gap as best they could, by providing sex counselling as part of their work, or referring patients to psychiatrists. According to professor of obstetrics and gynecology Dr Mohamed Abul- Ghar, "We still suffer from the lack of sex and marital consultation clinics. They are a good idea and can alleviate the burden that currently falls on the shoulders of gynecologists." After her return to Cairo, Kotb converted her clinic into a centre for teaching married couples and those on the verge of marriage "the art of making love". A recurrent problem is that encountered by the young teacher and his wife whom we cited above. "Girls who are brought up in a very conservative and religious environment suffer these kinds of problems. They are taught by their mothers that it is totally impolite to ask questions about sex," Kotb explains. She advises the husband to be more patient and to do all he can to persuade his wife that her deeply- rooted beliefs are meaningless now, and that there is no place for fear or shyness between a wife and her beloved husband. "Remind her that the Prophet Mohamed's dearest wife -- Al- Sayeda Aisha -- used to call him to bed," she adds, to underline her point. The clinic offers sex counselling, marriage counselling, sex therapy and personal interviews. "First, I talk to each member of a couple separately, then I bring them together in a shared session. That way, neither of them is embarrassed and they can both talk freely about what really bothers them. I also give out homework for them to do in between sessions." Kotb has designed three curriculums, providing sex education for teenagers, for couples on the verge of getting married, and for those already married who have sex problems, or are simply looking for a better and more enjoyable sex life. Kotb says that around ten years into a marriage most couples suffer from lassitude and sex tends to be reduced to a routine devoid of any passion. "This is a sign that everyday occupations and the hassle of life have begun to absorb the couple and dispossess them of their private life," she warns. Further, many husbands complain that their wives stop making love to them both during and after the menopause. These women often claim that sex is not "appropriate" anymore. For Kotb, one lesson that she has to give over and over to women is that there "are no restrictions that prevent love-making between married couples at any age, and that Islam has never confined the husband-wife sexual relationship to a certain period of time". One 56-year-old woman walked into the clinic after 33 years of marriage, to complain that her husband -- who had recently retired -- had become insanely jealous. "Any man who talks to me, even the doorman or the grocer, is suspect. And now we only have sexual intercourse three times a year. But I am a woman who also has desires and needs!" she told Kotb. Another couple explained that they were on the verge of divorce. Only one month into their marriage they had begun to exchange accusations, as the wife was still a virgin. They were unaware that all she required was a simple surgical intervention. Since the husband was not patient enough to complete sexual intercourse, his wife accused him of impotency. "One of our relatives recommended us to go to Dr Kotb's clinic," this satisfied customer recalls. "She convinced my wife to have this simple operation, and explained to her that there was nothing wrong with me." "In the very beginning, I used to receive two cases a week," Kotb recalls, "but now the number is increasing and I have a full schedule every week. Thanks to the media and the higher profile sex education is getting, I have far more business." Kotb has been careful in basing the logic of her therapy on religion. "I knew from the beginning that I should base my discussions on Al-Sunna and Islamic jurisprudence, because these provide a guaranteed reference. I took the veil a long time ago, and as I am a woman doctor, it has been easy for a lot of women to come to me and talk about their marital problems." For those who want to go to her centre, but can't afford the standard LE150 fee, Kotb extends her sympathy. "I'm sorry, but I can't cure every Egyptian! After all, I am myself a wife with children." Take it from the pros: * Don't talk about your sex problems with friends or relatives: every one's experience is different and unique. * Be brave in facing any sexual or marital problem and discussing it with your partner. * The selfishness of husbands and the stubbornness of wives can destroy their sexual relationship; flexibility and consideration are key. * Open and sincere pillow-talk helps a husband and wife in developing crucial understanding and empathy. * Allocate at least one day a week when you forget all about work; go to a nice place and exchange "words of love". In short, work at rejuvenating your emotional life.
