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Home Opinion Columnist

THE UNSPOKEN TRUTH: WHY PREMARITAL SEXUAL HEALTH AWARENESS IS CRUCIAL FOR MARITAL BLISS

Editor Sunrise by Editor Sunrise
June 7, 2025
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Game Changer By Sam Adeoye
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Marriage, often envisioned as a journey of shared dreams and unwavering companionship, can sometimes become a crucible of unexpected challenges. Among the most deeply personal and potentially devastating are issues related to sexual health and fertility, particularly when they emerge as unwelcome surprises after the vows have been exchanged.

The silence surrounding these topics before marriage can lead to profound suffering, emotional distress, and even the dissolution of what was meant to be a lifelong bond.

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This article delves into the critical importance of intending couples being fully aware of their partner’s sexual capacity and health status before marriage, supported by instances and research, and outlines pathways to salvage a marriage when these issues arise.


The Crushing Weight of Unforeseen Challenges
Imagine a couple, deeply in love, eagerly anticipating starting a family. They marry, filled with hope and excitement for their future together. Months turn into a year, then two, with no sign of pregnancy. Frustration mounts, followed by anxiety, and eventually, a gnawing suspicion that something is amiss. Medical tests are initiated, revealing a devastating truth: the wife has a health issue that makes conception impossible, or the husband suffers from erectile dysfunction or a critically low sperm count.

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This scenario, tragically common, casts a long shadow over the marriage. The initial joy gives way to grief, resentment, and a profound sense of betrayal, even if no malice was intended. The unspoken expectation of procreation, deeply ingrained in many cultures and personal desires, is shattered. The couple is left to grapple not only with a medical diagnosis but also with the emotional fallout of a future that looks vastly different from what they had envisioned.
Instance 1: The Case of “Amina and David”
Amina and David, after a whirlwind romance, married with plans for a large family. Amina, a vibrant 28-year-old, always assumed motherhood would come naturally. After a year of trying to conceive, tests revealed severe endometriosis, a condition that had silently ravaged her reproductive organs, making natural pregnancy highly unlikely.

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David, though supportive, struggled internally. He felt robbed of the experience of fatherhood and, at times, resented the lack of disclosure about Amina’s long-standing, though undiagnosed, menstrual pain before marriage. Amina, in turn, felt immense guilt and shame, believing she had “failed” him. Their once vibrant sexual intimacy dwindled, replaced by performance anxiety and the clinical pressure of timed intercourse.
Instance 2: The Plight of “Chinedu and Blessing”


Chinedu and Blessing’s story is equally poignant. Chinedu, a successful businessman, had always prided himself on his virility. After their wedding, Blessing noticed a consistent struggle with erectile dysfunction. Chinedu, embarrassed and ashamed, initially dismissed it as stress. As the issue persisted, he became withdrawn, avoiding intimacy, and Blessing felt increasingly rejected and confused. Eventually, medical consultation revealed not only ED but also a very low sperm count, a condition exacerbated by lifestyle choices he’d made years before marriage. The revelation plunged Blessing into despair, not just for the inability to conceive but also for the deception she felt. The foundation of trust in their marriage was severely shaken.

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The Scientific and Psychological Toll
These personal narratives are supported by extensive research highlighting the devastating impact of undisclosed sexual health issues on marital satisfaction and psychological well-being.
Infertility’s Psychological Impact:
A diagnosis of infertility, for instance, is often likened to grieving a death. Couples experience a range of emotions including shock, denial, anger, depression, guilt, and isolation. Research indicates that infertility can significantly strain relationship dynamics, leading to communication breakdowns, decreased intimacy, and increased marital conflict. A study published in the journal Fertility and Sterility found that couples struggling with infertility reported higher levels of stress, anxiety, and depressive symptoms compared to fertile couples. The constant cycle of hope and disappointment from failed treatments can be emotionally exhausting.
Erectile Dysfunction (ED) and Low Sperm Count:
For men, ED and low sperm count can strike at the core of their masculinity and self-esteem. The Cleveland Clinic reports that approximately 40% of men are affected by ED at age 40, and nearly 70% by age 70, with age being the most strongly associated variable. While age is a factor, ED can also stem from underlying health conditions, psychological stress, or lifestyle choices. Similarly, low sperm count, or oligospermia, can be caused by hormonal imbalances, infections, genetic factors, or environmental toxins. When these issues are discovered post-marriage, the impact on the male partner’s psychological state can be profound, leading to anxiety, depression, and a sense of inadequacy. For the female partner, it can lead to feelings of rejection, confusion, and a fear of unfulfilled desires for a family. A study in the Journal of Sexual Medicine found that couples where the male partner experienced ED reported significantly lower marital satisfaction and increased distress.


The silence around these issues pre-marriage can be particularly damaging. When a partner feels that critical information was withheld, it erodes the very foundation of trust and openness crucial for a healthy marriage.


The Imperative of Premarital Sexual Health Awareness
Given these profound consequences, it becomes abundantly clear that premarital sexual health awareness is not merely advisable but imperative. It is as crucial as discussing financial compatibility, family values, or future aspirations.
Why is it so important?

  • Informed Consent and Realistic Expectations: Marriage is a partnership built on shared understanding. When partners are fully aware of each other’s sexual health and fertility status, they enter the union with informed consent. They can discuss potential challenges, explore options, and set realistic expectations for their sexual life and family planning. This proactive approach prevents the shock and betrayal that can arise from unexpected discoveries.
  • Building Trust and Open Communication: Initiating conversations about sexual health before marriage fosters an environment of honesty and trust. It demonstrates a commitment to transparency and a willingness to tackle sensitive topics together. This foundation of open communication will be invaluable for navigating any future challenges, sexual or otherwise. Premarital counseling, especially with a focus on sexual intimacy and health, can provide a safe and structured space for these discussions. As highlighted by Still Committed blog, premarital counseling “builds a foundation of trust and openness. It shows that both partners are committed to a transparent relationship where they can discuss anything, including sensitive topics.”
  • Proactive Problem Solving: If potential issues are identified pre-marriage, couples can explore solutions and treatments together. This might involve fertility treatments, lifestyle changes, or psychological counseling. Addressing these concerns proactively allows couples to approach them as a united front, rather than being ambushed by them post-marriage, which can feel like a personal failing or a betrayal.
  • Emotional Preparedness: Even if no immediate solutions are available, knowing about a partner’s sexual health challenges allows both individuals to emotionally prepare and adjust their expectations. This preparedness can significantly reduce the emotional toll and resentment that often accompany unexpected revelations.
    What Couples Should Do: Practical Steps for Premarital Awareness
    While often uncomfortable, discussing sexual health before marriage is a profound act of love and respect. Here’s what intending couples should consider:
  • Open and Honest Dialogue:
  • Choose the Right Time and Place: Find a private, relaxed setting where both partners feel comfortable and unpressured. This isn’t a conversation for a noisy restaurant or a rushed moment.
  • Start with Generalities, Then Get Specific: Begin by discussing broader expectations around intimacy, children, and sexual desires. Gradually, as comfort builds, delve into personal sexual health histories.
  • Be Vulnerable and Non-Judgmental: Share your own health history openly and encourage your partner to do the same without judgment. Remember, the goal is mutual understanding and support, not blame.
  • Consider Questions Like:
    • “What are your expectations for our sexual intimacy in marriage?”
    • “Have you had any significant health issues that might affect our ability to have children or our sexual relationship?”
    • “Have you ever been tested for STIs, and when was your last test?” (This is crucial for preventing future health complications).
    • “Do you have any concerns about your fertility?”
    • “Are there any past experiences or traumas that might impact our sexual relationship?”
  • Normalize the Conversation: Frame it as a necessary part of building a strong, transparent foundation for marriage, just like discussing finances or future goals.
  • Premarital Counseling:
  • Seek out a qualified premarital counselor or sex therapist who can facilitate these sensitive discussions. A neutral third party can provide guidance, mediate potential discomfort, and offer tools for effective communication. Many counselors specifically address sexual expectations and health in their premarital programs.
  • Medical Check-ups and Fertility Assessments:
  • Both partners should consider getting comprehensive medical check-ups, including discussions with their doctors about reproductive health and fertility. While full fertility assessments might seem extreme, a general conversation with a healthcare provider can identify potential red flags or areas requiring further investigation. This is particularly important if either partner has a known medical condition that could impact fertility or sexual function.
  • For men, this could involve a semen analysis if there are any concerns or a desire for a baseline. For women, discussions about menstrual cycles, any pain, or prior diagnoses are vital.
  • Discuss Family Planning and Expectations:
  • Beyond fertility, talk about family size expectations, timelines for having children, and what steps you would be willing to take if conception proves difficult (e.g., fertility treatments, adoption). This ensures alignment on core life goals.
    Salvaging the Situation: When Challenges Arise Post-Marriage
    If, despite best efforts, sexual health or fertility issues emerge after marriage, the situation is undoubtedly challenging but not insurmountable. With commitment, empathy, and professional help, many marriages can not only survive but also emerge stronger.
  • Acknowledge and Validate Feelings:
  • The first step is to acknowledge the pain, frustration, and grief experienced by both partners. Validate each other’s feelings without judgment. It’s okay to feel angry, sad, or disappointed. Suppressing these emotions will only fester.
  • Open and Continuous Communication:
  • Now more than ever, open communication is paramount. Talk about how the issue is impacting each of you individually and as a couple. Avoid blame; focus on shared solutions.
  • “How Sexual Dysfunction Affects Your Marriage” (from Gerard Pregenzer, M.D.) emphasizes that “talking about it is the first step. Both parties must be willing to look at the problem and talk openly with each other.”
  • Seek Professional Help:
  • Medical Professionals: Consult with urologists, gynecologists, endocrinologists, and fertility specialists to understand the diagnosis, explore treatment options, and manage expectations. Medical advancements offer numerous possibilities, from hormone therapy and medications to assisted reproductive technologies (ART) like IVF and ICSI.
  • Sex Therapists: A certified sex therapist can provide guidance on navigating sexual intimacy when facing issues like ED or low libido. They can offer strategies to reduce performance anxiety, explore alternative forms of intimacy, and help couples reconnect on a physical and emotional level.
  • Couples Counseling: A couples therapist can help process the emotional fallout, improve communication, address resentment, and work through feelings of blame or inadequacy. They can also help couples redefine their vision of family and happiness.
  • Individual Therapy: Both partners may benefit from individual therapy to cope with the personal emotional burden, whether it’s grief over lost dreams or challenges to self-esteem.
  • Explore All Options for Family Building:
  • If infertility is the challenge, research and discuss all available avenues:
    • Fertility Treatments: IVF, IUI, medication, surgery.
    • Donor Gametes: Using donor sperm or eggs.
    • Surrogacy: If the female partner cannot carry a pregnancy.
    • Adoption: A beautiful path to parenthood for many couples.
    • Child-Free Living: For some, accepting a life without biological children can be a path to peace, especially when combined with a fulfilling marriage and alternative forms of nurturing.
  • Find Support Systems:
  • Connect with support groups for couples facing infertility or sexual dysfunction. Sharing experiences with others who understand can alleviate feelings of isolation and provide practical advice and emotional solidarity. Organizations like RESOLVE: The National Infertility Association offer directories of support groups.
  • Redefine Intimacy:
  • Sexual intimacy is not solely about procreation or penetrative sex. When facing physical limitations, couples can explore and rediscover other forms of intimacy: emotional, intellectual, spiritual, and physical touch that goes beyond intercourse. This can strengthen their bond and deepen their connection.
  • Practice Patience and Empathy:
  • Healing and adaptation take time. Be patient with yourselves and each other. Cultivate empathy for your partner’s experience and struggles. Remember that you are a team, facing this challenge together.
    Beyond the Pulpit: Navigating Sexual Intimacy Challenges with an Open Mind
    For many couples, marriage is deeply intertwined with their faith. Religious teachings often provide a moral compass, guiding beliefs about intimacy, procreation, and the very purpose of marriage. However, when faced with the intensely personal and often heartbreaking realities of sexual dysfunction or infertility, these deeply held beliefs can sometimes feel like an additional burden, creating conflict between spiritual convictions and the desire for a fulfilling marital life. It’s crucial for couples to understand that addressing these challenges often requires looking beyond rigid interpretations and seeking guidance that prioritizes compassion, understanding, and the well-being of the marital bond.
    No faith tradition intends for its adherents to suffer in silence or to endure a marriage devoid of intimacy and the possibility of children if solutions exist. Yet, some interpretations can lead to feelings of guilt, shame, or the belief that seeking medical intervention is a sign of weak faith or “playing God.” This can be particularly true for discussions around erectile dysfunction, low libido, or even exploring assisted reproductive technologies (ART) like IVF.
    Instance 3: The Struggle of “Pastor Mark and Sarah”
    Pastor Mark and Sarah, devout members of their church, had always envisioned a family. When Mark developed severe erectile dysfunction, which compounded his previously undiagnosed low sperm count, they initially felt immense spiritual turmoil. They believed their faith should be enough to overcome this “trial.” Sarah felt guilty for desiring a sexual relationship, fearing it was carnal. Mark, burdened by his role as a spiritual leader, felt immense shame and a profound sense of failure, convinced it was a punishment. They resisted medical help for months, praying for a miracle. Their spiritual advisors, while well-intentioned, offered only prayer, inadvertently prolonging their distress. It was only after immense marital strain that a compassionate elder privately encouraged them to seek medical advice, emphasizing that God also works through human knowledge and healing. This shift in perspective allowed them to pursue treatment and therapy, which ultimately brought them closer and addressed their physical challenges.
    This instance highlights a vital point: faith and science are not always at odds. Many religious perspectives, especially in contemporary thought, recognize that medical advancements are gifts that can alleviate suffering and enhance human well-being. The challenge lies in how individuals and communities interpret these intersections.
    Encouraging a Broader Perspective:
  • Seek Compassionate Spiritual Guidance:
  • Instead of relying on generalized interpretations, actively seek out religious leaders, mentors, or counselors within your faith who are known for their progressive, compassionate, and nuanced understanding of modern medical science and psychological well-being. Many denominations now offer specific guidance on reproductive ethics and marital intimacy that is both faithful and practical.
  • Engage in open dialogue about your specific challenges. A wise spiritual advisor will focus on the health and happiness of the couple, understanding that God’s plan often involves human agency and the pursuit of knowledge.
  • Focus on the Core Principles of Marriage:
  • Regardless of religious background, core tenets of marriage often include love, companionship, mutual support, commitment, and the desire for flourishing. When sexual or fertility issues arise, the focus should shift to how these challenges impact these fundamental principles.
  • Intimacy in marriage is multifaceted. While physical intimacy is crucial, emotional, spiritual, and intellectual intimacy are equally vital. If one aspect is challenged, couples can focus on strengthening the others. Many faith traditions emphasize selfless love and care for one’s partner, which includes addressing their needs and desires for intimacy and family.
  • Recognize the Role of Medical Science as a Gift:
  • For many, seeing medical professionals and exploring treatments is not a defiance of faith but an act of stewardship over the body and a pursuit of well-being. Just as one would seek medical help for any other illness, sexual health issues and infertility are medical conditions that deserve professional attention.
  • Prayer and medical intervention can coexist. For countless individuals, faith provides strength and solace during medical journeys, but it doesn’t preclude the need for expert care.
  • Prioritize Marital Unity and Well-being:
  • The health of the marriage itself should be paramount. When sexual or fertility issues create significant distress, they can erode the marital bond. Addressing these issues, even if it involves conversations or treatments that feel culturally or religiously unconventional, is often an act of protecting and nurturing the union.
  • Remember that love and compassion should always guide your decisions. This means supporting your partner through their struggles, even if it requires adjusting your own expectations or beliefs.
  • Reframe “Purpose”:
  • While procreation is often seen as a primary purpose of marriage in many faiths, it is rarely the sole purpose. Many couples, including those who are unable to have biological children, find immense fulfillment in their marriage through service, fostering relationships, spiritual growth, and contributing to the wider community. Redefining “purpose” can alleviate pressure and open doors to other forms of fulfillment.
    Ultimately, the journey through sexual health and fertility challenges in marriage is deeply personal. For couples grounded in faith, it requires a delicate balance of spiritual conviction and practical action. By seeking out enlightened spiritual guidance, focusing on the core principles of marital love, embracing medical science as a tool for healing, and prioritizing the overall well-being of the partnership, couples can navigate these sensitive issues with greater clarity, compassion, and ultimately, find a path to a more fulfilling and resilient marriage, regardless of the unique challenges they face.

Conclusion
The sanctity of marriage is often threatened not by a lack of love, but by the weight of unspoken truths and unaddressed expectations. While the journey of life is unpredictable, equipping ourselves with knowledge and fostering open communication before marriage can significantly mitigate potential suffering. Understanding a partner’s sexual capacity and health status is not about seeking perfection, but about embracing reality with honesty and preparedness. When unforeseen challenges related to fertility or sexual function arise, the bedrock of premarital transparency and a commitment to shared problem-solving become the very tools that can salvage the marriage. By fostering an environment of trust, seeking professional guidance, and embracing a holistic view of intimacy and family, couples can navigate these deeply personal trials, transforming potential heartbreak into a testament of enduring love and resilience.

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