The honeymoon’s over before it can even begin

Sexual and reproductive health is the core of a strong and happy marriage, say experts
By Kumudini Hettiarachchi

There is much excitement and the preparations are done well in advance. The hotel is booked sometimes one year ahead of the “once in a lifetime” day. Fashion books are pored over, the trousseau and hairstyle decided on and much thought devoted to what flower combinations should be used.

Arrangements are perfected to a fine art, but disaster strikes the very note on which the day or to be exact the night should begin.

Bitterness, recrimination and accusations hit a climax, not only with the newly-wed couple but also relatives on both sides getting embroiled in a situation doomed to end in divorce.

After all the hype, the wine, the cake, the photographs and the money spent, the marriage is sometimes never consummated, let alone on the wedding night but even six or seven years after, MediScene learns.

“Honeymoon issues” will not only hit the couple on the wedding night but assail their relationship which sometimes may end in divorce or the two of them living like brother and sister, stresses Reproductive Health Consultant Dr. Sriani Basnayake who sometimes has to field phone calls in the middle of the night.

“This is because, the couple never prepares for the wedding night and some of them don’t have a clue about the sexual side,” explains Dr. Basnayake, with Sexual Medicine Specialist Dr. Lasantha Malavige adding that both men and women have anxiety issues.

Around 30% of married couples have sexual problems, MediScene learns and though the reason quoted for either unhappiness in the marriage or divorce maybe some other issue, if the real reason or root cause is probed it is sexual. The other issues given could range from alcohol or substance abuse to extra-marital affairs.

Although no data are available in Sri Lanka, according to Dr. Malavige, in the west studies have shown that 20% of consultations with general practitioners concern sexually-related issues. “Many couples here don’t know that help is available in western medicine for these problems and seek alternative therapies.”

Dealing with two of the most common problems faced by men, Dr. Malavige says they are Erectile Dysfunction and Premature Ejaculation.

Erectile Dysfunction (ED) or Impotence – This is a recurring inability to get an erection or keep the erection during sexual intercourse. The commonest cause of ED on the wedding night may be performance anxiety, explains this Sexual Medicine Specialist, which in turn could be due to excessive tiredness or lack of foreplay. If ED persists then physical (diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease) or psychological (stress, anxiety, guilt, depression, low self-esteem and fear of sexual failure) causes should be checked out. Lack of attraction or desire for the partner, could also be a rare cause.

Premature Ejaculation – This is when the male has an orgasm prematurely, just before or soon after penetration during sexual intercourse and could be due to anxiety or too much excitement. Psychological issues could also be a predominant factor. Dr. Basnayake, meanwhile, delves into the problems that are faced by women, Vaginismus being the most common.

Vaginismus – This is an involuntary spasm of the muscles surrounding the vagina. Such spasms close the vagina and make sexual intercourse difficult, painful and sometimes impossible. Vaginismus may develop due to anxiety regarding sexual intercourse.

Explaining that education, counselling, and behavioural exercises which include pelvic floor muscle contraction and relaxation help to alleviate this condition, Dr. Basnayake says that sometimes in Sri Lanka married peers of the bride-to-be may relate exaggerated stories about pain that terrify her.

Virginity -- Another issue could be the need to prove that the bride is a virgin, which leaves her tense and unrelaxed.

Lack of desire – This could also be a contributory factor especially if the bride has had a relationship but been forced to marry someone else.

Sometimes, honeymoon problems could arise due to not just one but the couple having issues such as difficulty getting physically close due to obesity, lack of understanding about each other’s anatomy (the groom not knowing where the bride’s vagina is, says Dr. Basnayake) and even ignorance on what sexual intercourse entails, MediScene learns.

Both these specialist doctors are of the opinion that it is important for reproductive health to be taught in school so that children would be armed with basic knowledge when they reach adulthood. Then they will not be groping in the dark for information which most people assume come “instinctively” or be misled by false information.

Sexual and reproductive health is the core around which not only a strong but also a happy marriage is built.

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