Infertility, Sex and a Healthier You…..

Pamela Madsen, one of the nation's most outspoken and recognized fertility educators and patient advocates, is bringing her 20-plus years of experience into the service of East Coast Fertility. As East Coast Fertility’s new Director of Public Education, Ms. Madsen is reaching out to women-- and men—to integrate infertility prevention, protection and treatment into the general health care continuum.

From sexuality to conception, Ms. Madsen is picking up the threads of the national dialog she began as the founder and first Executive Director of the American Fertility Association, a national patient education and advocacy organization. Over the last two decades, Ms. Madsen has helped shatter the myths and taboos that surrounded fertility, infertility and its treatments. She has been one of the leading voices for full reproductive rights for everyone regardless of marital status or sexual preference. She has made the biological clock, one of the most poorly understood aspects of reproductive life, a key element in her unique approach to fertility preservation education.

Ms. Madsen forcefully represented patient views before major state and federal government agencies, including the President's Council on Bioethics, to move policy toward universal access to fertility care, mandated insurance and fertility preservation information.

This is another one of Ms. Madsens outstanding commentaries.

Sometimes sexperts give really stupid and meaningless advice that someone thinks looks good on paper - but we all know it is a complete line of bullshit. Take this response to an infertility and sexuality patient question on the new and fabulous Sex & a Healthier You website brought to us by The Association of Reproductive Health Professionals.

This patient shared that after months of trying to conceive a child that there was simply no passion or spark left to their sex life. No kidding? Been there - done that, got the tee shirt and wore it out. This is not a new complaint among those trying to conceive - in fact this sorry state of sexual disconnection, body image issues compounded by infertility plus the stress and pressure of having to perform on command is the bane of existence for most of the trying to conceive population. And it is the most ignored at fertility centers. Sex can make people uncomfortable - in case you didn’t know.

Part of the advice that was offered was to “First, take a break from trying to get pregnant. Take two or three months off—that won’t make much difference in the long run, and it could do wonders for your marriage. During that time, schedule a vacation. If money is tight, the “vacation” could be to a friend’s weekend house or even just a couple of days in a local hotel—anything to get into a new environment with no reminders of fertility issues. Or, have a “staycation”—take time off, stay at home and simply enjoy the time alone with your partner”.

Hmmmm…….really? Take a vacation from your infertility? Are people with cancer able to take a vacation from their cancer? Does this sexpert really believe that people are able to turn off a life crisis? And even if we were able to - is there any reality at all that two or three months of some kind of mental and physical vacation from infertility could possibly repair the damage caused by infertility enough to turn folks back into sex kittens? I truly doubt it. It took me years and I am as resilient as they come.

Sexuality and Infertility are especially difficult because the two are intertwined. Pat answers about vacations and bubble baths don’t even begin to touch the surface for recovery.

For women turning off infertility is especially difficult since they have a direct physical tie to their sexuality and infertility all in one when they bleed on a monthly basis. There is no vacation from that. There is no vacation from the time pressure or the urgency. For many couples putting off conception for two or three months is a very big deal. And no….I don’t think that having sex in different rooms - or positions is going to help very much either.

So…what do I think? I think that the most important message of all to communicate to infertility patients is that what they are feeling is perfectly normal. That’s it. The big advice! You are not alone.

It is so important for people to know that they are not alone in their disconnect from sexual pleasure and their lack of desire for physical intimacy during this time. Simply knowing that they are not broken as sexual beings when they are feeling like failures in their ability to reproduce can be incredibly healing all by itself.

By giving this message, there is an acknowledgment of normalcy when this couple is feeling incredibly not normal and broken in the most intimate part of their marriage - reproduction.

This is a really hard time for them. Acknowledge it deeply - and let them know again and again that what they are feeling is normal.

I think that the best advice after letting couple know that they are completely not alone in their feelings is to simply encourage couples to spend time holding each other.

Offering each other physical comfort by cuddling, holding, hugging, and offering each other massage can go a long way in helping couples reconnect to each other. Encouraging individuals who are struggling with infertility to make time to get regular body work in the form of massages can also help people who are struggling with infertility. Massage not only reduces stress - but it feels good! Getting physical reminders that our bodies can give us pleasure is so important when we are going through so much physical and emotional discomfort.

Massage therapy reminds us that our bodies can give us pleasure, and can help us to reconnect to our own physical selves in a loving way. When people are going through a tremendous amount of physical discomfort they can forget that our bodies can also be a source of pleasure.

I often shudder when I read advice to couples about sexuality. Perhaps it is because the sexperts feel like they have to be politically correct or too careful in the loaded world of sexuality. We all want to talk about sex - yet it all still makes us nervous. So “vacations”, and “try sex on the kitchen table” comes up a lot in advice columns. I wish that we could get more real sometimes - and say what is so.

It’s really hard to want sex for anybody when your sexual organs are being prodded and poked. When you have to give sperm samples. When you have to face your body shifting shape every month because of fertility drugs. When you core sexuality is deeply associated with your femaleness and maleness - and it is not working! So let’s say it - it is hard and it is normal - and you may feel broken and exhausted. But you are not sexually broken - you are simply done in - and what you are feeling is normal. Forgive yourself, forgive your body and forgive your partner. Perhaps that is the best gift you can give your sexuality and your marriage.

For us “experts” - giving permission to couples not to want sex can also be really healing - and in a time when there are no easy answers - it certainly feels more real.