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.

Second, intimacy:
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.

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.