Women's health issues / discerning marriage

[sbaker]

Women’s health issues in the context of a dating relationship / discerning marriage. At what point do you think someone should disclose medical conditions that could potentially affect sexual intimacy in marriage? (To clarify - I’m not referring to STDs or sexual history, and the context is within a chaste relationship). I’m specifically wondering about women’s health conditions such as endometriosis, vaginismus, vulvodynia, an unusually obstructive hymen, etc. which could potentially cause sex to be extremely painful or even impossible (at least without further medical intervention, surgery, physical therapy, etc).

Obviously this would not be appropriate to bring up on a first date and would need to be discussed before the wedding - but what is a good time between those points? Should this be discussed before engagement?

Any thoughts on how this could be approached appropriately and sensitively for the level of commitment present, while still encouraging open and honest dialogue? I’m also trying to think of this from a man’s perspective - how would you want to be informed that this could be an issue?

 

[MNathaniel]

I’m specifically wondering about women’s health conditions such as endometriosis, vaginismus, vulvodynia, an unusually obstructive hymen, etc. which could potentially cause sex to be extremely painful or even impossible (at least without further medical intervention, surgery, physical therapy, etc)… Should this be discussed before engagement?

That’s quite a diverse range of health conditions. Mentioning endometriosis would be a drastically different conversation from mentioning an “unusually obstructive hymen”.

If you or a loved one personally have one of these issues, it might be ideal to specific which of these issues you most need pastoral counsel with? Not necessarily mentioning to internet strangers, I hasten to add – but maybe asking a trusted priest?

What I will say (as a woman) is that if I had a medical condition that “could potentially cause sex to be… impossible”, I would absolutely consider myself obligated to discuss this long before engagement is on the table. That would otherwise be a very difficult situation to force the other person into, potentially forcing them to retract a marriage proposal, if they don’t feel personally prepared to commit to lifelong celibacy from the get-go. Some people might be capable of it – but it seems likely that many people who discern themselves called to marriage instead of celibate religious life, are expecting that sex will be part of their married life. If one partner knows in advance that sex is unlikely or even “impossible” in their future, this definitely needs to be discussed early enough that no hearts get broken.

I doubt there’s a calendar-based ‘rule’ for discerning this. I’d say, use your human judgment and intuition, on a case-by-case basis, to figure out with each individual man you date, at which point you have known each other long enough (and are serious enough about each other) that you trust him with this sensitive information, while not wasting time that you could both be spending meeting other more-compatible people, if this particular relationship won’t go anywhere once he finds out.

I’d also suggest not leading the conversation with mention of a specific word like “vaginismus”. If it gets to the point where you want to sound out what a specific man thinks he’d be capable of handling in a marriage, maybe start with something roundabout, like listening to a podcast on a related topic and seeing how he reacts. If you really want to mention that you personally have a medical issue, I’d lead with the bottom-line outcome (e.g. “I have been diagnosed with a medical condition that means I may be unable to engage in the marital embrace without significant pain”). If he’s going to reject a romantic relationship with you based on this bottom-line outcome, there’s no need for this person you’re no longer dating to also have very private knowledge about the specific condition of your genitalia.

Just my $0.02, for whatever it’s worth.

 

[sbaker]

@MNathaniel Thank you for your response. These issues can feel quite taboo to discuss and I appreciate your perspective.

 

[Irishmom2]

(at least without further medical intervention, surgery, physical therapy, etc).

I would think that a person would want to take care of any medical issues that they could before giving up and living with something that could be helped. And it would be better to take care of them now and not in the future as to avoid having to do so when they are in a serious relationship.

 

[MNathaniel]

A practical follow-up question that I hope is not too graphic: if a doctor has recommended vaginal dilator therapy (which is only necessary for the woman to go through if she is going to be having sex, which in this case would only be within marriage) would you advise going through the therapy before entering a serious relationship?

With respect, medical advice cannot be given here on CAF.

Please see Content Rule 11 in the FAQ:

1. Do not offer or solicit medical, psychiatric, psychological, or legal advice. Do not give advice that is contrary to civil law. Do not give advice to a minor that opposes the instruction of a parent or legal guardian. All such discussions should be directed to the proper authorities: parents, guardians, therapists, parish priests, or primary care providers.

The practical question you’re asking will depend on practical considerations (like the duration of time for which vaginal dilator therapy is required before sexual intercourse; is this duration longer than a typical Catholic engagement?), that a medical doctor would need to discuss with you. And for the psychological/spiritual aspect, a spiritual director or priest would probably best be able to help you customize whatever will be healthy conduct in your own life.

I think there are some feelings of (misplaced?) guilt associated with addressing sexual dysfunction before sex is even a licit near-term possibility. I think this is the underlying struggle both in knowing when/how to discuss the matter in dating, and knowing when to begin treatment. Does anyone have advice on this?

Without proposing to offer actual medical/psychological “advice”, I’ll say one thing about this: It seems to me that there should be no reason for “guilt” in addressing medical dysfunction in any bodily system. Sex isn’t dirty; sex is holy. It’s healthy for a body to be capable of having sex, even at an unknown future date. Sure, the sexual faculty can be misused – just like the digestive faculty can be misused. The potential for gluttony doesn’t mean a person should feel “guilty” for medically correcting something dysfunctional in their digestive system. The potential for lust doesn’t mean a person should feel “guilty” for medically correcting something dysfunctional in their reproductive system.

This isn’t the same as suggesting there’s some obligation for any given medical intervention. But I certainly don’t see why there should be any “guilt”. It’s not shameful to be prepared well in advance just in case we want to licitly participate in a certain activity sometime in the far future. Who knows what complicating obstacles (e.g. financial, or, say, a pandemic restricting access to specialists) might pop up in future, and then we regret not taking care of something way back when.

Again, just my $0.02. If this is a situation related to you or a loved one, my only real takeaway here is that I hope you feel free to make whatever choice seems best for you, in coordination with your doctor and priest, without feeling “guilty” one way or the other.