Rachel and John eagerly engaged in our premarital counseling sessions. As we waded through the battery of premarital inventories and family background, sex was next on our list.

This couple, like many I have counseled, was sexually active prior to meeting each other. Although committed to abstinence this time around, past sexual activity has taken a toll on their relationship contrary to what media and pop culture portray.

One of my questions in doing a sexual history (premarital or anytime) is, “Do either of you have any sexually transmitted diseases (STDs)?”

In Rachel and John’s case, both hesitated a moment. Neither had been tested. Both were aware that some STDs are silent, meaning there are no noticeable symptoms. Since statistics tell us that one out of two sexually active people will contract a STD by the age of 25, they’re at risk and were embarrassed. Though repentant and forgiven, emotions still ran high. The consequences of casual sex are rarely talked about or shown in media.

According to the Center for Disease Control and Prevention (CDC), 22.5 million cases of STDs were reported in the United States.  And while half of that number represents people age 15-24, 15% of new cases are now seen in people over 50. The numbers are staggering with an estimated one in four sexually active Americans contracting a STD at least once in his or her life. If left untreated, STDs can lead to birth defects, blindness, bone deformities, cancer, heart disease, infertility, pelvic inflammatory disease, stillbirths, chronic pain, intellectual disability and even death.

Of course, sex outside of marriage can also result in pregnancy. The notion of “safe-sex” is a lie that has been perpetrated in our culture for decades. Just ask one of the one million teens who will become pregnant in the coming year. Sadly, one-third of those pregnancies will end in abortion, which creates a new set of emotional scars.

And while Hollywood continues to parade it’s A-list of unwed women sporting swollen bellies, the best interests of the unborn go unnoticed. Researchers tell us that these children will be twice as likely to suffer psychiatric problems, twice as likely to drop out of school or become teenage parents, and will be more economically disadvantaged than those raised in intact two parent families.

Overall, premarital sex comes with risk, heartache and relationship challenges. This doesn’t mean that those challenges can’t be overcome, but don’t be lulled into the idea that premarital sex has no costs.