Many of us are familiar with the experience of making unsuccesful attempts for having a baby, either from our personal or friends' and relatives' experience. Experiencing Infertility has always a negative effect not only on the couple's quality of life but also on their psychological state and relationship. This is logical, as long as the couple's sexual life changes from the very first moment conception attempts start; spontaneity is replaced with sex as a 'compulsory act' on a schedule and sexual satisfaction is evlauated only in terms of the final outcome. And if menstruation (period) arrives, all expectations are eliminated. It is not rarely that the anxiety for conception turns into anxiety for sexual intercourse, given that the erotic/sexual game is replaced with thermometres and the sexual initiative becomes an obsessive-compulsive disorder. And it is then that the real problem emerges: the man -who is called to achieve erection on a specific date at a speific time- fails, and the women does not want even to hear about sex at any other time other than on fertile days, for conceiving a baby has become to her the sole purpose.
But let us have a look at sexual problems from a more general point of view.
Experts divide sexual function in 3 phases: a) Sexual Desire (when one wants to have sex, has sexual thoughts, fantasies etc), b) Sexual Arousal (this is naturally expressed with erection in men and with vaginal lubrication in women) and c) Orgasm (in men this coincides with ejaculation and in women it is usually expressed with contractions of the uterus and vagina). Problems occurring at any one of these three phases for prolonged time result in sexual dysfunctions.
The most frequent sexual dysfunction is erectile dysfunction (ED) in men and hypoactive sexual desire disorder (HSDD) in women. Other male problems tha may occur are HSDD and ejaculation problems. Other female problems are difficulty reaching orgasm and dyspareunia (painful sexual intercourse).
Sexual Dysfunctions & Infertility
The relationship between sexual dysfunctions and infertility can be mutual! In other words, sexual dysfunction may cause diificullty conceiving. And vice-verca, attempts to conceive may cause sexual dysfunctions.
Sexual dysfunctions may have preexisted, even before the infertility problem emerged. In fact, there are couples seeking treatments to resolve the problem of infertility and not their sexual problem, even though they are not sexually active any longer. However, frequent sexual contact is imperative for conceiving, particularly on fertile days. If the couple has rare sexual intercourses due to some dysfunction, then it is very likely that fertile days are missed and, thus, conception is not achieved.
On the other hand, the diagnosis of infertility and assisted reproduction methods often induce high stress and anxiety and are quite 'invasive', both organically and psychologically. Diagnosis and treatment of infertility are usually accompanied with symptoms of dysthymia, depression and tension in the couple's relationship. Repeated failed attempts for conceiving are an additional aggravating psychological factor for the couple. All the above create favor inhibition of sexual satisfaction and occurrence of sexual dysfunctions, both in the female and male. In fact, there are studies demonstrating that infertility has the highest impact on female sexuality of any other stress factor.
Time is surely not an ally; on the contrary, it is the biggest enemy. As time passes, the couple's psychological pressure leads to reduction of sexual satisfaction and erotic moments. As a consequence, some sexual dysfunction is very likely to emerge!
Can sexual dysfunctions be treated?
Today there are many ways available to treat sexual dysfunctions and in most cases these are simple and effective. Couples with infertility problem all over Europe receive consultative support from specialized psychologists. The European Society of Human Reproduction has drawn up special guidelines for providing psychological support to these couples, and particularly when they are to follow some assisted reproduction method (IVF/ In-Vitro Fertilization). This support plays a highly significant role in making decisions. resolving feelings of uncertainty, coping with periods of anticipation, facing failure, managing anxiety for the next attempt and the final outcome.
Making the first step to ask for help may be difficult, but this decision will give the opportunity for a new day to rise with love and sex -with a child being the most wonderful and precious outcome of this new day!