Content warning: The following article discusses infertility, which may be triggering for some readers.
When my husband and I decided we wanted to have a baby, I thought it would be simple: We’d have sex, and I’d get pregnant. Although I was only 29 years old, I felt like my hormonal clock was ticking. Still, it seemed easy for all the women I knew, so why would it be any different for me?
At first, trying to conceive was spontaneous and fun. As soon as we’d get home from work, my husband would drop his briefcase by the door, pull me in for a kiss, and my body would immediately respond. We’d stumble into the bedroom, laughing and undressing each other. It was reminiscent of our early days of dating—we couldn’t bear to be apart.
But after months of trying with no success, the thrill and excitement of our baby-making plans shifted to frustration and self-loathing. On countless nights, my anxiety kept me up for hours, as my mind raced with thoughts about everything that could be wrong with me (or him). I didn’t understand why I couldn’t get pregnant and worried we’d never become parents.
When trying to have a baby on our own didn’t work, my OB referred us to a reproductive endocrinologist. Over the next three years, we tried timed intercourse, intrauterine insemination (IUI), and in vitro fertilization (IVF). The process of trying to conceive took over our life. Sex became scheduled and mechanical; it wasn’t fun anymore. Even though I was thinking about sex more than ever, I lost interest in actually having it.
Throughout our infertility struggles, my husband tried to comfort me with physical touch, but I didn’t want it. Whenever he’d leaned in to kiss me, I’d push him away. I wanted to be held, but not caressed or kissed, and I felt guilty for wanting only certain types of physical touch, without giving my husband anything in return. “Sorry, I just can’t right now,” I’d say, guilt burning in my gut. “It’s okay, babe. I understand,” he’d respond.
I loved him, and I wanted a child, but my mind swirled with emotions—both hopeful and heartbroken—as I tried to make peace with what would become my new path toward motherhood. I couldn’t try to have a baby and still be intimate with my husband—it felt impossible. As my emotions crashed, so did my libido.
I didn’t know it then, but several years later, I learned that these physical symptoms are consistent with a condition called sexual dysfunction—a lack of interest in intimacy and intercourse as a result of significant stress. And though I felt alone in my struggle, I’m not. Forty percent of women and 30 percent of men experience sexual dysfunction during infertility, according to the American Society of Reproductive Medicine.
Even without an official diagnosis of sexual dysfunction, it’s normal for women, in particular, to not want sex during infertility, says Liz Grill, PsyD, a clinical psychologist and associate professor of psychology for the Weill Cornell Medicine Center for Reproductive Medicine and Infertility. Not only do women take on the physical burden caused by infertility with daily injections, blood draws, ultrasounds, and other invasive procedures, but “hormones can also make women feel emotionally and physically unwell, fatigued, and make sex less appealing,” says Grill. “For women, it usually boils down to low libido or desire, difficulty achieving orgasm, or pain during sex.”
Men can also experience the negative effects of sexual dysfunction during infertility. Some of the signs may be “not wanting to be touched,” and they may also “lose their sense of masculinity, which impacts self-esteem and sexual confidence,” Grill says.
Additionally, couples may experience a disconnect if one or more partners is struggling with sexual dysfunction. People can become “disconnected from their thoughts, feelings, bodies, and their environment,” says Grill. ”Disassociation from the body is a way to cope with traumatic and stressful situations; it’s a form of ‘fight, flight, or freeze’.”
My husband and I struggled with infertility for 10 years, and the toll on my body and mind often took a toll on our sex life. There were many times when sex became non-existent, and we had to lean into other forms of intimacy.
All of the emotional and physical pain finally felt worth it when we had our daughter and son via IVF, but there’s so much I know now that I wish I’d known then. Once I understood how sexual dysfunction affected my body and I had the right tools to cope with my conflicting emotions, my symptoms improved, which enhanced my quality of life and brought intimacy back into my marriage. Here’s what I learned:
1. Talk to your partner—about everything.
I didn’t think it was okay to talk about my issues with infertility and intimacy with anyone, even my husband. Although we were in this together, I wasn’t able to talk to him about my feelings of failure or lack of desire out of fear of being judged or dismissed. I thought that if I brought up how I was feeling about sex at some moments, my husband wouldn’t understand or he’d be frustrated with me. But, the reality was my lack of communication in those moments only made me feel more isolated and disconnected. Once I learned to talk with him about my fears and worries about sex and intimacy, the more emotionally connected and more comfortable I felt opening up.
Nobody wants to talk about the guilt of not having sex, as it’s often “the elephant in the room,” says Grill, but you can’t ignore it forever. And you shouldn’t. Open communication between partners can actually lead to an increased desire for sex, says Grill. Especially for women struggling with infertility, talking to your partner about the “stress you’re experiencing or the emotional pain you’re in creates connection,” she says.
Sharing your feelings with a therapist, especially one who specializes in sex therapy, can also help—it certainly did for me. My psychologist taught me how to communicate my feelings better with my husband, and how to cope with stress, anxiety, and grief through guided meditation and breathing exercises. One of the most valuable lessons he taught me was how to handle situations where I was triggered. He often reminded me: “You can’t control the thoughts coming into your mind, but you can control your response to it.”
2. Encourage your partner to provide non-sexual support.
Every time my husband pulled me in for a hug, I’d stand there motionless, hoping for support without expectations of sex. And if he did want more, I’d pull away before saying, “Sorry, I just needed a hug.” He understood, releasing any attempt to be intimate, but I still felt like I was constantly disappointing him… and myself. I didn’t know it was okay to want that—and nothing more—but it can be helpful for those dealing with sexual dysfunction to rely on “non-verbal closeness,” like hugging and holding hands, says Grill. It’s still a form of physical connection, but it’s not necessarily sexual.
If you struggle with not wanting to have sex when your partner does, Grill suggests saying something like: “This is how it has to be for now, but it’s temporary.” That can help with setting boundaries, opening the lines of communication, and, ultimately, easing pressure to be intimate.
3. Create opportunities to connect outside the bedroom.
During our first round of IVF, my husband and I went out for date night for the first time in months. Thanks to the hormone injections, my libido had returned, and my stomach bubbled with the long-awaited anticipation of wanting to initiate sex with him again. When we got home, my husband came up behind me and kissed me on my neck. I pulled him towards me and suddenly, my body warmed under his touch—I had a need to be held, desired, and close to him again. I felt like myself for the first time in years.
“People often deprive themselves of joy and pleasure as they go through infertility,” Grill says. We certainly had, but planning a couples’ activities outside of the bedroom brought us joy and pleasure in other ways. “By taking a small step toward talking and spending time together, it can help to bring closeness and intimacy back organically in a non-sexual way,” says Grill.
4. Incorporate pleasure back into your routine.
It can also help to have non-procreative sexual activity at other times of the month in areas of your home that are not associated with ovulation, according to Grill. “Fertility challenges can shift the focus of sexual activity from pleasure and connection to procreation and sex on demand,” she says. “[But] sex is not just vaginal penetration.”
Shifting the focus of intimacy from conception back to connection can help reduce the pressure people, especially women, feel to perform a sexual act during infertility. If you normally have sex in the bed during ovulation, for example, try spontaneous sex in places like on the couch or the floor, Grill suggests.
5. Redefine what intimacy means to you and your partner.
After our first embryo transfer, we had an agonizing two-week wait. I didn’t want to have sex during this time, for fear that might cause the transfer to fail. My husband seemed to understand, and we found other ways to connect. He cooked dinner so I could rest, and we laid together to binge-watch episodes of our favorite shows like Friends and Mad Men.
“There are so many other parts of intimacy, touch, and physical connection,” says Grill. Intimacy can take the form of leaving a playful sticky note on the counter, sending a thoughtful text, or sharing eye contact from across the room signaling the desire to connect with one another. Those small, simple gestures of connection from my husband reminded me he was there for me, no matter what, and helped bridge the gap of intimacy between us.
6. Try pelvic floor exercises to improve sexual function.
After giving birth to our daughter, I began to exercise again. I also started doing kegel exercises to strengthen my pelvic floor muscles, and noticed that, after a few weeks, my strength increased. The stronger I got, the more I felt aroused and interested in having sex. Plus, sex became more enjoyable, which made me want to have it even more.
This isn’t a coincidence—women with a stronger pelvic floor have higher rates of sexual activity and sexual function, per research in the International Urogynecology Journal. You can even try pelvic floor therapy to increase your strength and improve your overall sexual function.
7. Get back in touch with your sexuality.
It can be satisfying for women, especially those who have gone through infertility, to take charge when it comes to sex, Grill says. But first, they need to get back in touch with their own sexuality before trying to figure it out in their relationship, she adds. This process of self-discovery empowers women to speak up and share their desires with their partner, which can lead to a more satisfying sex life—for both partners.
I started listening to podcasts like Sex with Emily and audible books like Come As You Are, and the viral series, Fifty Shades of Grey. With encouragement from my therapist to try exposure therapy, which encourages patients to gradually face their fears, I began telling my husband what I wanted sexually and pushed through my fear of rejection. I told him I wanted to try new things in the bedroom, like trying roleplay and incorporating sex toys, and he embraced all of it. After not having any control over my body and my life for years, I finally felt empowered.
The more I talked about what excited me, the more we were aligned with one another’s needs. My husband and I began having sex a few days a week, which made me want it more. Each time, it became more intense and passionate, bringing us closer. After a few weeks of this new routine, I noticed we bickered less, and with increased desire, came even more intimacy.
Ultimately, the things that worked best for us stemmed from reconnecting with the basic tenets our relationship was built on, and it was surprisingly simple, once we opened up to one another. We talked about our feelings in the moment, made an effort to continue regular physical touch (hugs and hand holding), shared our fantasies, were open to trying new things sexually, and scheduled regular time together, even for a day date or a walk. All these have allowed us to reach a deeper connection and stronger desire—both emotionally and physically—than we’ve had before. After 18 years together, we’ve never been more in tune with one another’s needs, and that has allowed our whole life (especially our sex life) to thrive.
