Elisa Gores, Twig’s in-house reproductive counsellor and trained relationship and sex therapist, talks about sex and fertility and how to stay connected on your journey.

There’s a lot to talk and think about during your fertility journey. One topic that doesn’t often get addressed is the physical and emotional impact fertility treatment can have on your sex life. If you are partnered and are finding sexual intimacy difficult or different than it was before, know that what you’re experiencing is totally normal. 

There are a number of reasons why sex can feel less appealing or accessible to you during this process. Side effects of medications or the toll of invasive procedures can cause discomfort in your body, lower your libido, or make you feel like your body is not your own. Physical side effects like bloating, fatigue, or headaches usually don’t put people in the mood. 

There could also be a lot of pressure around sex during this time, especially if you’re trying to conceive through intercourse. The pressure to perform or get aroused during timed intercourse could make sex stressful or difficult. Similarly, the pressure to provide a sperm sample in the clinic might create anxiety or difficulty around erection or ejaculation. During this process, sex can become medical and the focus moves to timing and procreation, and away from intimacy and pleasure.

Stress or painful emotions can also affect your sex drive. Feelings of disappointment, guilt, resentment, or shame can disrupt your sexual response cycle, making it feel hard to access desire. Feeling like something is wrong with your body or working through grief of any kind may also affect your levels of desire or arousal. If any of these feelings are impacting your relationship with your partner and making it difficult to connect, that also may make it less appealing to engage sexually.

It’s natural to be concerned if your sex life has changed or is changing during this time. Try to be gentle with yourself and your partner and remind yourselves that this is temporary. This might be a good time to reevaluate some of the expectations you have of yourselves, your sex life and your sexuality. It’s OK if your sex life changes during this time and it doesn’t say anything about you or your partnership. 

There are some things you can try to help access or maintain intimacy and pleasure during this time, if that’s what you would like to do. If you are trying to conceive naturally, it is important to know your fertility window. Talk to your physician about timelines for sex around ovulation as you might have more time than you think you do to connect sexually. No matter how you are building your family, it is also important to try to plan times to be intimate with yourself and with your partner outside of this process. That might mean planning time to have sex for pleasure and connection, or even scheduling time to cuddle, engage in mindful touch, give each other a massage, or other forms of erotic or intimate touch. If physical intimacy feels inaccessible, are there other things you might plan to reconnect emotionally, romantically, or spiritually where you can focus on each other and the things you share? What kinds of things can you do, explore, or learn together?

Remember, just as you are so much more than your fertility journey, so is your relationship.

A couple of quick reminders:

• Lube is your friend! Whether your desire or arousal has changed recently or whether medications or stress are changing your body’s natural lubrication, don’t be afraid to use lube and lots of it. Just make sure that you are using a sperm-friendly or fertility-friendly kind!
• Pain with sex is not OK. If you’re experiencing pain with intercourse or other sexual activity, please speak with your fertility specialist and/or your family doctor. Not only could this be a clue to your fertility, it is also not something you have to be experiencing. 

Elisa is a trained relationship and sex therapist  and is a member of the Board of Examiners in Sex Therapy & Counselling in Ontario (BESTCO). If you would like to meet with her to discuss any of these issues, you can book a counselling session here.