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Infertility brings about many changes in a couple's relationship. It may bond you closer together in unspoken sadness and hope - and allow mutual support and understanding which leads to a sharing never before experienced. Or it may bring out feelings of resentment, of guilt, and of despair. As the initial months of investigations turn into frustrating years it is not surprising that sex quickly loses many of its associations with fun and pleasure and instead becomes a chore with a single minded purpose.
Failure to conceive certainly destroys self esteem, self worth and sexuality. All these negative feelings are reflected in the bedroom, which is, after all, where all the 'problems' started.
The effect of infertility on sexuality is primarily due to its brutal impact on self-image. Fertility is one very basic expression of sexuality, and the man with six sons in many cultures has more status than a man who has borne none - he is considered to be more potent, more virile.
The emotional response to a diagnosis of infertility is a grief reaction. It involves many losses: those of potential children, the family dreamed about, genetic continuity, the experience of conception, pregnancy and birth, the gift of grandchildren to one's own parents, the central meaning of one's life plan and marriage, and the procreative potential in sexual relations. It is common for a woman to feel "less of a woman" and a man "less of a man", at least for a time, when faced with infertility. Many men describe that they feel like a "dud", or as a "sexual failure" and others feel emasculated.
Women, too, often feel their sexuality threatened when faced with the possibility of not becoming pregnant. Women are probably more powerfully socialised than men into the expectation that they shall conceive and become mothers in the normal course of events. When this process is thwarted, there is often the feeling of having failed as a "proper woman", as revealed in this statement:
I saw the blood (of the menstrual period) today. I feel weak and tearful. All the strength I'd thought I'd acquired just seems to have drained away. The discomfort serves as a reminder of my failure. For many women menstruation is a sign of femininity and potential for motherhood. All it signifies to me is my failure.
I have always been told I was pretty. I like the way I look, and I feel confident in social situations. After my pelvic surgery, the doctor told me he had never seen a worse mess of adhesions in his life. He said it looked like a little kid had been let loose with a pot of glue and stuck everything all together. I am ugly on the inside and pretty on the outside. I would gladly have the reverse if it would make me a baby.
Many infertile couples describe that the impact of infertility on their sexuality is heightened during the following four time periods:
The usual advice for a couple trying to start a family is to have unprotected sexual intercourse for at least twelve months before having fertility investigations. This waiting period can be nerve-wracking! Doubts about one's fertility almost always result in a heightened awareness of signs of fertility that surround us. Pregnant friends, noisy children in markets, media coverage of new reproductive technologies, hints from eager parents wanting grandchildren - all these can begin to erode the sexual self-confidence of the couple wishing to have children. Inevitably, sexual intercourse is timed for the fertile time of the woman's cycle. Spontaneity goes out of the window as the sexual life of a couple comes to be associated month after month with the failure to conceive. Men often feel they have been reduced to performing like a stud bull, and women may feel it is pointless to engage in sexual activity when it is unlikely to result in pregnancy.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
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