News & Events
So, you’re getting married?
- December 5, 2011
- Posted by: Sarah Azad
- Category: Marriage Medical Blog
Congratulations! God willing, this marriage will be a blessing for both you and your spouse.
But as the wedding day approaches, there are often unsettling questions that linger in the back of the mind of the bride-to-be. I see a handful of patients a year who come in before they marry to ask questions and to talk about birth control and other things. Recently, someone was telling me how little they knew before they married and how confusing their first few days of marriage were, so I decided to put a few pieces of information here, for those of you who want to be able to discreetly look it up online.
For all women who are engaged and looking forward to a wedding day, I do recommend that you see a doctor 3-4 months before the anticipated celebrations. Setting up an appointment with a gynecologist for this purpose does not mean they will do a pelvic exam, a common reason the unmarried avoid our offices. It is a conversation-only type of visit.
First, birth control:
Unless you are planning on getting pregnant right away (I have at least 5 patients a year that got pregnant on their wedding night), birth control is something you should consider. Generally, for patients who have never been sexually active, the birth control pill is the most comfortable—and reliable—method. There are cultural myths in numerous countries that women should not take the “pill” before they have their first child, that the “pill” somehow causes infertility if taken before a first child (but not after?). This is completely false. You can read more about the benefits and risk of birth control pills here.
Another consideration for starting birth control pills is that they take at least 2 weeks to work reliably, and in some cases three months before most or all the side-effects have resolved. Since one of those side effects can be emotional lability, I generally recommend women start birth control pills three months before their expected wedding date. That way, when the stress of last minute wedding planning starts, the emotional side effects of the pill will not be there to exacerbate the situation.
For women with acne, even a small amount, the birth control pill has an added benefit of clearing up skin very well.
And of course, there are other options, but in my experience, young women who are not previously sexually active, are not comfortable with things like the vaginal ring or the IUD. Condoms are a common type of birth control used by many couples and are not a bad option. They are not as effective (92% vs 97% effective) as the “pill” and they can become cumbersome in a stable, long-term relationship, where intercourse is frequent.
For some women this is an exciting prospect, while for others it causes a great deal of stress. One thing to remember is that many couples take several days, if not longer, before they are successfully (and comfortably) intimate. If you have chosen your partner well, he will be patient. Medically, I recommend for all women anticipating their first sexual experience to have lubrication on hand. Lubrication must be water-based (ie. KY Jelly) if you are also going to be using condoms. If not, any type of lubrication should be adequate, including Vaseline. But it can greatly reduce—if not eliminate—the discomfort associated with first sexual experiences.
Secondly, though there is some discomfort the first time a woman has intercourse, the hymen can heal if there is a long enough lapse. This is something to keep in mind, as I sometimes have patients with so much discomfort they go 2-3 weeks between attempts at intercourse, and the discomfort never seems to decrease, because the hymen is continually healing itself.
Finally, I am fortunate to be able to direct couples to an excellent resource put together by a couple in the community called The Veiled Garden for more explicit details. It is a great resource for Muslim couples with questions about intimacy. Please note, this website has a lot of graphic images, they are drawings and the authors of the site have done their best to keep them as modest as possible, but some readers of my blog have still found them to be too graphic. I have had the site reviewed by a scholar I trust who has also stated the site is useful,but that some of the things it describes may not be considered appropriate behavior by some, likely the majority, of scholars. Also, there are a lot of grammatical errors. However, the content is good. Ultimately, it is not my site, and I do not know the authors, but is the best resource I have found thus far on the internet. Also, it saves me the awkwardness of including much more here.
I hope this is helpful for those of embarking on the timeless journey of marriage.
And God knows best.
DISCLAIMER: Information in questions, answers, and other posts on this site are for general information, and are not intended to substitute for informed professional medical advice, and do not establish a physician-patient relationship. The site is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.
I’ve been recently getting closer and closer to Islam to the point that I’m thinking about converting. I wanted to ask, since that is what I’ve been told by muslim people around me, aren’t birth control metods haram?
May the blessings of Allah be upon you.
What a great question! I work with patients from a variety of religious backgrounds (Sunni, Shia, various schools, etc). I’ve also reached out to scholars of different schools, both Sunni and Shia to understand that variety of opinions on birth control.
The most agreed upon, allowed method, is “al-azl” or what we call “withdrawal”. It’s mentioned in the Sunnah. I have yet to hear a scholar say this method is not allowed (there are issues related to intention).
There are some schools and some scholars that do not allow any other form of preventing pregnancy. There are some that allow condoms in addition to “al azl” as it similarly prevents sperm from entering the womb.
The majority of teachers and scholars I’ve spoken with allow nearly all kinds of available birth control, including pills, the shot, the arm implant, and the IUDs. There is a separate article on my blog about IUDs with a list of well-known scholars and their views on the permissibility of the IUD.
Outside of having a valid, necessary medical reasons, permanent sterilization is not allowed by any scholar I’ve spoken with.
I hope this is helpful for you. And Allah knows best.
As’salam alaykum how are you Dr. Sarah i understand that you said not to post regarding medical issues. I had no other way of reaching out to you. There is something very important i would like to talk to you about. please contact me via email at email@example.com i am very sorry if i am to be of bother. may allah swt shower his mercy upon you. jazak allah khairun.
I only provide medical advice to patients registered in my office. Please feel free to contact my office to make an in person appointment: 650-396-8110.
As’salamu Alaykum Dr. Sarah i contacted your office to make an in person appointment and they said that you are no longer taking in any new patients. They asked me to provide them with the email adress stating that you said to make an in person appointment. I am not reaching out to be a long term patient of yours as i know you have many patients already. I just need to reach out to you regarding a matter that only you can help. May allah swt reward you, and may he grant you jannah alfirdous.
Jazak allah khairun.
Dear Dr Azad
I simply have a question for research, which I require an answer from a Muslim-Sunni perspective but also from a medical perspective.
Is it true that the hymen should not be associated with virginity and that a virginity/hymen exams does not exist and simply support a disgusting patriarchal trope?
According to research, I read the following:
1. Hymens are often flexible and remain despite being sexually active.
2. Some hymens are broken prior to penetrative sex.
3. Two-thirds of women have no bleeding with first coitus as the hymen does not have a rich blood supply. Therefore the concept of virginity meaning having a intact hymen is socially constructed?
4. And some virgins do not have hymens – especially when they do sports etc.
What do you think?