Premarital Exam

7 things you should know before you get married

Now that you’ve found true love and set the date, it is important to take the time to prepare for the wonderful journey that awaits you. Here are 7 things you should know before you get married.

1. HOW TO AVOID PREGNANCY.

The vast majority of couples will get pregnant without using contraception so just “seeing what will happen” is not prevention. There are many methods and options available to help you plan your family. Condoms are quite effective when used correctly and consistently. Withdrawal and the rhythm method will decrease the chance of pregnancy but are not reliable for many women.

Hormonal contraception (like “the pill”) is 99 percent effective when used as directed and taken at about the same time every day. Hormones often take a month to be effective but ideally should be started three months before getting married. This allows time to adjust to the medication, solidify the habit of taking the pill regularly, allows for some manipulation of when your period will start in order to avoid bleeding on your honeymoon and often improves acne, decreases cramps and lessens the flow.   There are a variety of types of pills and hormones available and most are well-covered by insurance. Finding the contraception that works for you is important.   When looking online for options, be sure to look at reputable sources like bedsider.org or womenshealth.gov. You may have heard stories or rumors associated with certain types of contraception or pregnancy. Please discuss your concerns with us.

2. HOW TO AVOID PAINFUL SEX.

If you’ve never had intercourse before, it may be helpful to stretch the hymen before your wedding night. They hymen is basically a membrane of skin at the vaginal opening that may cause pain or bleeding when having intercourse for the first time.   Gradual stretching of this membrane before getting married is helpful for women with a tight hymen and good option for women who have concerns about this.

DIRECTIONS FOR DILATORS:

Apply a water-based lubricant to the smallest dilator and slowly insert into the vagina. Hold the dilator in place for about one minute then remove and repeat this process two more times. Do this three times in the morning and three times in the evening. If the hymen (membrane of skin) is tight, this may be a little uncomfortable but shouldn’t cause significant “pain”.   Once the diameter of that dilator is tolerated without discomfort, move to the next larger size. Continue this process until the largest dilator can be inserted without pain or discomfort.   This process will be a little uncomfortable but shouldn’t be painful. If you have questions or this isn’t working for you, please contact our office.

Intercourse when the vagina is dry and not well-lubricated may also cause discomfort, burning or bleeding. The body creates a natural lubricant with sexual arousal via specific glands located near the vagina but if you are worried or nervous, it is helpful to have extra lubricant with you. There are several commercial brands and types available (KY Lubricating Jelly or Astroglide, just to name a few. There are oil-based, water-based, silicone and hybrid forms available.) These are typically found in any pharmacy or department store near the pads, home pregnancy tests or condoms.

Semen is the fluid made by a man in order to facilitate movement of the sperm into the uterus in an attempt to fertilize an egg. It is released during ejaculation. The fluid (semen) often pools in the vagina while laying down but will leak out with gravity and changing your position. It may be helpful to bring along some small towels for easier clean up.

3. HOW TO AVOID A BLADDER INFECTION.

Some women are prone to getting a bladder infection when they become sexually active because of the close proximity of the vagina to the urethra. Symptoms of a bladder infection include painful and frequent urination, the need to urinate urgently and in small amounts and possibly pelvic or back pain. In order to avoid these uncomfortable symptoms it is helpful to drink plenty of water which will require more trips to the bathroom but hopefully avoid the pain associated with an infection. The more you drink water, the more you urinate and hopefully this will help flush the system and avoid a urinary tract infection (UTI).

You may also find it helpful to urinate after having intercourse.

4. WHAT TO DO WHEN I WANT TO GET PREGNANT?

If you are trying to have a baby, it is important to PLAN for pregnancy. Preconception health focuses on things you can do before and between pregnancies to increase your chance of a healthy pregnancy and newborn. You should focus on getting in shape nutritionally, physically, financially and emotionally. 85 percent of couples become pregnant within the first year of stopping contraception. This means after stopping birth control you could get pregnant that first month or it may take a little while, but caring for yourself like it could happen at any time is important in giving yourself and your baby the best chance of maximal health. When you are ready to start your family, it is a good idea to come in for an examination to evaluate your health and talk more specifically about what you should do to get in shape for pregnancy.

Some important tips are:

• Focus on good NUTRITION. Eat a healthy diet and start taking a prenatal vitamin or folic acid supplement three months before trying to get pregnant.
• Get in shape PHYSICALLY. It doesn’t matter if you are 2, 22 or 82, pregnant or not, everyone should be exercising! If you have special health conditions or questions about exercise and weight loss, please talk to us.
• Control any chronic MEDICAL CONDITIONS. (like high blood pressure, asthma, diabetes, etc.)
• Talk to your provider about any prescription or over-the-counter MEDICATIONS you are taking.
• Get VACCINATED if necessary.
• Eliminate any HABITS that may affect the health of your unborn child (tobacco, alcohol, any illicit drug use, even excessive caffeine consumption).
• Make sure EMOTIONALLY & FINANCIALLY you are stable… so you can adapt to changes that accompany pregnancy.

5. HOW TO LIVE HEALTHY.

This is a perfect time to evaluate how you are regularly taking care of yourself and make the necessary changes to improve your longevity and quality of life. The habits you create when you’re 20 or 25 make a big difference when you are 40 and 60 years old. Here are some tips to living a healthy lifestyle:

• Get regular annual examinations. These visits are important to enable you to live a healthier lifestyle, prevent behavior-related disease and ailments and conduct the appropriate screening for your age and specific risk. Prevention is the best medicine!
• Exercise approximately 30 minutes most days of the week. Include aerobic, strength and flexibility training. Take this opportunity to spend time with your spouse and work out together. If your schedules don’t allow for training and physical activity at the same time, asking about how each other’s workout was or what your spouse did for his workout that day should be a part of your everyday conversation.
• Keep up to date on vaccines.

(HPV, ages 11 to 26; Tdap every 10 years, flu vaccine annually, Hepatitis A, Hepatitis B, meningitis vaccine, Varicella. For more information go to immunizationforwomen.org)

• Maintain a normal weight. Body Mass Index (BMI) gives you a relative idea of how appropriate your weight is for your height. Typically, the older we get, the harder it is to maintain a normal BMI. Make sure your food selection, cooking and meal planning are foods that support a normal weight. Avoid processed foods which are typically striped of nutrition, calorie-laden, create cravings and promote overeating and weight gain.
• Learn to manage stress in healthy ways. Getting married is wonderful but certainly causes stress. Look for therapeutic ways to manage stress (like muscle relaxation, deep breathing exercises, yoga, etc.) If you find you are sad and don’t like to do activities that used to be fun, you are emotional and cry easily or you are overly worried and anxious all the time, please talk to us. Medications and/or therapy are very effective in treating these symptoms. Get help before if affects your life and relationships.
• Get adequate rest, 7 to 8 hours each night. It seems like there is always too much to do and not enough time to do it. Life never slows down, but YOU will if you don’t get adequate rest. Sleep is necessary to repair body tissues, eliminate the byproducts from thinking throughout the day and for emotional stability. Sleep is vital for optimal health and creates a sense of well-being.
• Get adequate calcium (approximately 1000mg per day, depending on your age). This is approximately 3 cups of milk per day. Bone formation and deposits of calcium are made up until age 25 or 30….and that’s all bone mass you ever get. Depositing adequate calcium during the formative years is essential in preventing fractures, pain and osteoporosis later in life. Easy supplementation includes calcium citrate, Tums, Viactiv (chocolate chews) or gummies.
• Get 1000 to 2000 IU of vitamin D daily. Vitamin D has been implicated in numerous body functions and lack of this vitamin can be detrimental to your health.

6. HOW TO ENJOY MARRIAGE AFTER THE “HONEYMOON” PHASE.

There are countless books, seminars, workshops, articles, journals, newspaper columns, chat rooms, websites and advice in this area. Simply, remember the man you fell in love with and why. It is vital to overlook the little annoying habits he may have and focus on how to make each other happy. Many marriages terminate because of incompatible goals or values, lack of understanding and just plain selfishness. Fundamental qualities of trust, honesty, mutual respect and effective channels of communication will help you connect with your spouse and enable you to truly be happy.   This isn’t always easy and it always takes work. The pay-off is well worth it.   If you are struggling in this area, ask for help.

Men and women act, communicate and think differently from each other. We are made this way on purpose.   Here is one resource that may shed some light as to why your husband says what he says and does what he does. Once you learn how thought processes between you and your husband are different, that opens the door to understanding. This allows you (as a couple) to use your different strengths to work together more effectively and completely. More reading about gender differences and relationships can be found here:

• The Proper Care and Feeding of Husbands by Dr. Laura Schlessinger
• The 5 Love Languages: The Secret to Love that Lasts by Gary Chapman

• If you are concerned about your relationship or future in-laws before getting married, please take the time to think about this marriage. Divorce always costs…. personally, emotionally, financially, etc. For a small fee, you can do an online assessment to see how fit you are for each other at relate-institute.org

Since financial stressors can play a huge role in relationships, here is one resource that may help:

• The Total Money Makeover by Dave Ramsey

7. WHERE TO GET HELP WHEN YOU HAVE QUESTIONS.

Every relationship and couple has their own unique joys and struggles. Many areas of disconnect are touched on above in regards to personal and emotional relationships and gender differences and expectations of each other. One common area of concern is decreased desire for sex or not understanding how to reach sexual fulfillment with each other. Hollywood portrays sex and intimate relationships as always being passionate, hot and steamy with partners “desperate” for each other. In reality, most love scenes seen on the screen are orchestrated by a director telling the actors where to look, how to move, spraying them down with fake sweat and “acting out” climacteric pleasure. Be realistic in your expectations of yourself and your relationship. Communicate what turns you on and what feels good during intercourse. Be respectful to each other. Be cautious with internet searches.   Don’t always believe the headlines and pictures on women’s magazines or the Hollywood and social media portrayals of sex. They aren’t real.

Here are a few reputable books that will help improve your understanding and seek for professional help if your sex life is affecting your relationship.

• Becoming One: Intimacy in Marriage by Robert Stahmann, Wayne Young & Julie Grover
• And They Were Not Ashamed: Strengthening Marriage Through Sexual Fulfillment by Laura Brotherson
• The Act of Marriage by Tim and Beverly LaHaye
• Getting Your Sex Life Off to a Great Start by Clifford & Joyce Penner

Best wishes as you begin your new life together. Please come talk to us about any specific questions or concerns you may have about getting married.