In India, we have an age old system related to marriages. The girl and the guy meet each other, then their families meet and after a total of 3 meetings, they decide to get married. In fact, even before the girl and the guy meet, their KUNDLIS meet each other. Once the kundlis match, they are considered suitable for marriage. Then they have a small period of courtship, engagement and then marriage. They are expected to spend the night together immediately after marriage. In our country, talking about sex is taboo. The would be bride has to rely completely on either what her mother tells her, or what her married friends tell her, or if she is tech savvy, then what porn or books tell her. All this gives too much of false information. There is anxiety, inadequate knowledge and a sense of falling blindly into something. There is no person who can sit and tell her exactly what she needs to know. This is where pre marriage counselling plays a major part. A pre marriage counselor is a qualified gynecologist who can explain about sexual intercourse, her body, the changes which can occur, the pain that she may feel and also the contraceptive options available for her.

Another thing that has changed in the past few years is the lifestyle. We are now more experimental, open minded and basically a lot more free about things. There is increased incidence of premarital sex, alcohol, smoking and drugs. There is rise in diseases like HIV, hepatitis, syphilis, herpes and other sexually transmitted diseases. Since there is so much taboo related to sex, people are not really forthcoming about their past relationships and activities. So, basically when marriage is decided between two people, they do not know anything about each other. Even if a basic background check is done with neighbors, friends and family members, it is not enough. Pre marriage counselors advice the couple to undergo a series of tests which are very essential for their future. It is necessary to get the couple tested for these diseases as they can be transmitted sexually and can spoil the life of an innocent person.

Genetic diseases like thalassaemia are also very common in certain communities. Thalassaemia is of two types: minor and major. It is a disorder of blood production and is hereditary. Thalassaemia minor patients do not have any symptoms and are generally not diagnosed unless tested for the same. But if a thalassaemia minor marries another thalassaemia minor patient, there is 25% chance that the offspring will be a thalassaemia major, which means that by the age of about 4 months, the child will start requiring blood transfusions and median age of survival of such children is just 18 years. So the couple needs to be screened for thalassaemia which can be done by a simple blood test.

There is rise in impotence, homosexuality and also transgenders. When a proper pre marriage check up is done, some amount of clarity is attained about the subject and at least there is a dialogue about sexuality between the couple. A simple semen analysis and ultrasound can clear doubts about impotence and transgenders. Homosexuality is tricky and cannot be proved, but the couple can at least talk about it or ask each other about it before marriage.

Since there are lots of rituals before marriage, the girl might want to prepone or postpone her periods and the gynecologist can help her for the same.

So, the baseline is that every couple must visit a pre marriage counselor before marriage for a healthy and happy future.