Dr. Dinesh Doad

6 Reasons Pre-marital Counselling is Crucial for Indian Couples

A study published in the Journal of Family Psychology reveals that couples who opt for pre-marital counselling experience higher levels of conjugal satisfaction than couples who don’t go for it. Moreover, these couples, experience a 30% drop in the possibility of divorce over a 5-year period.

Pre-marital counselling is a wise choice as it can help you and your partner to better understand the dynamics of your relationship and build the foundation of a happy future together.

A pre-marital counselling helps you with the following factors-

1. Hygiene: Apart from stressing on the importance of personal health and hygiene, you would also hear a gynaecologist, emphasizing on the significance of sexual hygiene for a problem-free married life. While preventing infections that may affect your reproductive system, maintaining sexual hygiene can also significantly elevate the overall hygiene levels of your entire body.
2. Sex: Pre-marital sex counselling is essential as it helps to fill in the gaps in your knowledge of sex. During your consultation with a gynaecologist, you can expect to receive information about the male and female anatomy as well as about the actual act. Even thoughts like “sex can be painful” get addressed during the counselling.
3. Contraceptives: Counselling sessions with a gynaecologist can also help you in getting your facts right about pregnancy. He or she could guide you on how to work out safe and unsafe days to have sex; talk to you about contraceptive methods; and best family planning practices.
4. Folic acid for pregnancy: During a counselling session, you can expect to be encouraged by a gynaecologist to have Vitamin B (folic acid) before and during your pregnancy to avert birth defects in the brain and spinal cord of your potential offspring.  
5. Vaccines: Opting for a counselling session before marriage can help you to learn about vaccines that will protect you against cervical cancer (cancer of the cervix caused mainly by HPV- a virus) and rubella (a disease caused by the rubella virus, which can cause miscarriage, birth defects and stillbirth).
6. Medical investigations: You should also expect investigations based on the following tests-
   • Complete blood count test: The aim of this test is to assess your overall health and identify a range of disorders such as anaemia, leukaemia, and infection to name a few.
   • Fasting/blood sugar test: The test is performed to diagnose diabetes.  A fasting blood glucose level of less than 100mg/dl is considered normal.
   • Thyroid stimulating hormone test: This test is taken to check for problems in the thyroid gland.
   • Rubella test: It is used to identify antibodies that are formed in the blood, as a result of immunisation or the rubella infection.
   • HPLC (high performance liquid chromatography): The test is performed to determine Thalassemia.
   • Urine microscopy: The test helps in determining the condition of your urinary tract and kidney. It identifies injury, presence of disease or inflammation of these areas. If you wish to discuss about any specific problem, you can consult a psychologist.

Vaginal bleeding is something that most women experience between their periods when they are not due for a menstrual cycle. It is considered as an abnormal occurrence when you bleed before you are expecting your menstrual period, or after you are done with your monthly cycle. It is usually characterised by bouts of spotting where a thick brown reddish discharge may be experienced. Also, this kind of bleeding is considered abnormal if it occurs during pregnancy or menopause.

Here are a few causes of abnormal vaginal bleeding:

1. Hormones: An imbalance in the hormones like the estrogen and progesterone can lead to abnormal vaginal bleeding. These are the hormones that help in regulation of the monthly menstrual cycles. An imbalance can occur due to side effects caused by birth control pills that may not suit the individual, a contraceptive patch, or even contraceptive implants and injections. Further, an intrauterine device may also be the cause for this kind of bleeding. The hormonal balance can also get affected due to internal ailments like a dysfunctional thyroid gland and ovaries.
2. Pregnancy and Delivery: Some amount of spotting is considered normal in the first trimester of one's pregnancy. Yet, severe bleeding and persistent spotting must be reported to the gynaecologist immediately. Women also bleed for a while after the delivery of the baby, in the postpartum period. This may also happen when an abortion takes place as the uterus may not have come back to its original size and due to remaining foetal tissues within. Complications during the pregnancy like an ectopic pregnancy or a miscarriage can also lead to such kind of bleeding. An ectopic pregnancy is one where the egg gets implanted in the fallopian tube instead of entering and implanting itself in the uterus.
3. Fibroids: Uterine fibroids are usually considered as non-malignant and non-cancerous growths within the uterus. These are common in many women who have gone through childbirth. These fibroids can also cause some amount of bleeding and spotting.
4. Infections: When there is an infection in the reproductive organs like the ovaries and uterus of the patient, there may be some amount of bleeding. An infection in this area can also cause inflammation, which is one of the primary causes of abnormal bleeding. This can also occur due to a sexually transmitted disease or STD, as well as painful intercourse and sexual abuse which can lead to scarring as well.
5. Cancer: One of the least common causes includes cervical, ovarian and other forms of cancer. 

Stress and diabetes can also cause abnormal vaginal bleeding in rare cases. It is best to see a doctor as soon as such bleeding takes place.