Mrs S. was a favourite with the doctor. She was a bubbly woman, confident and attractive, who had worked hard to educate herself and had achieved an Open University degree and a post as a legal executive after an upbringing in a working class family. She rarely consulted except for contraception and the doctor felt her husband, a professional man whom the doctor knew socially was a lucky man to have snapped up such a peach. The doctor was disappointed when Mrs S. failed to attend for a contraceptive consultation and sent in a request for a prescription to tide her over until she could make another appointment. When she next attended, she looked rather strained and said she was thinking of changing from the oral contraceptive she had been on for some time. Could she have some leaflets to think about what would be the best for her? The doctor enquired why she wanted to change from a method that had suited her for several years. She said, rather distantly that she was not so sure that it had been suiting her but declined to expand on her statement saying only that she would return when she had made up her mind what to do. The doctor felt excluded and baffled.
He was pleased when she returned and told him that she did not know what to do. He had the bright idea that perhaps she wanted a pregnancy (she was now 34 years old) and wanted a less certain method so that she could become pregnant by accident rather than making a definite decision about a family. She shot him down. There was no question of her wanting a child. Her husband, she reminded him, had three rising teenagers by his previous wife, quite enough to cope with. And for herself, she had never wanted children, and was pleased to find a partner who would not put any pressure on her in that direction. The Pill was so convenient and reliable, all the other methods seemed so hit and miss. What did he think her chances of being sterilized were? Perhaps, she rushed him onwards, she could have it done privately. The doctor struggled to regain the initiative. Why did she want to stop the Pill? She was healthy with no risk factors and could continue on for several years yet if she wanted. He waited and rather wished he had not confronted her, as the silence became very uncomfortable. Just as he was thinking perhaps he should just agree to refer her for sterilization, she seemed to make up her mind to confide in him. She told him that she had never had any satisfaction making love with her husband. Mr S. thought that she did not reach orgasm because she was on the Pill, but, blushing, she was able to tell the doctor that she had been orgasmic with other partners before her husband, and had been on the Pill then. She told him that she had not minded at first, she had thought it was just that he was so ardent and passionate that he came so quickly and could not hold back. She had thought that as their relationship became more mature and less urgent he would slow down, but he always came as soon as he was inside her, and sometimes before.
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