Let’s Talk about Sex

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I want to talk about sex…  What I see in my practice is sexual dysfunction of many varieties.  It is so personal that people don’t really want to discuss it.  So I thought I would bring it out a bit.

When one thinks about fertility, sex would come to mind for many.  However, in my fertility practice it seems this is the one thing that is NOT happening.  Infertility is stressful enough and to have sex under duress, timed to ovulation, with two working people who have plenty of outside pressures, is a HECK of a lot to ask.  One of the first things to go is intimacy.  Many of my couples tell me that fertility sex is just another thing that they have to do.  The conventional wisdom to help with the stress of trying to conceive is to tell couples to go on vacation.

Women tend to talk about sexual issues with one another much more often than men. Many of my female clients talk about their mates with me.  For men, sexual issues can be a source of hidden shame, especially if they are trying to get their partner pregnant.  When I treat men for fertility, I let them know that many men feel the pressure to perform on schedule.  An act that was, at one time, a way to experience intimacy, pleasure, and mutual attraction, has now become another chore. Another job to perform, except this one can dredge up deep-seated emotions if the intended outcome, pregnancy, is not achieved.  I see the relief in their faces when they hear they are not alone.

In reproductive medicine, woman do many things to help improve the odds of conceiving, while the man has one major job, to give his specimen in a cup for either an IUI or an IVF.  And for some men this is an easier option. I asked a fertility urologist if he receives many referrals to evaluate males with sperm issues; his response, “No.”  I asked him why he thought this was so.  He replied that for fertility clinics if something is wrong with the male’s sperm that gives a good reason to suggest an IVF with ISSI (intracytoplasmic sperm injection). This is how many reproductive centers help increase pregnancy outcomes.  They offer to take the SEX right out of the equation.  And for some couples this is a relief, while for others, as much as they don’t want to do it, this type of reproductive medicine is the help they need.

I had a couple come to me for issues in fertility.  The woman was told that she had “bad eggs” during an IVF cycle.  However, the male had sperm issues too.  But no one had suggested to evaluate him to see what was going on until I recommended he consult a reproductive urologist.  What if his lifestyle was modifiable to improve his sperm?  What if he had a medical issue such as a varicocele that could be helped with surgery or certain herbs & nutritionals?  I knew he felt powerless to help his wife get pregnant with his sperm and doing an IVF to him was an expensive, and statistically a low success endeavor.  I suggested a protocol consisting of acupuncture, herbs, and lifestyle parameters. Knowing there were things he could do to help improve his situation, helped to alleviate his feelings of helplessness.

And so we are back to the male.  Where is their forum to get help for sexual dysfunction?  For sperm?  Do they discuss their plight with other men for some suggestions like women do?  Do they elbow each other in the locker room and talk about the pressure they feel to perform after working hard all day and feeling tired?  Where do they go to talk about what is going on, especially if they are not referred anywhere?  A woman told me that her husband had erectile dysfunction.  He didn’t want anyone to know.  How is he supposed to get help with this?

Statistics show that 43% of women and 31% of men report having at least one symptom of sexual dysfunction which is broken down into 3 phases: desire (you want to have sex), arousal (your body undergoes changes that allow you to have sex), and orgasm. Pain can also be a symptom that something has gone amiss.  Where fertility is concerned, it is possible for men to have erectile dysfunction due to the pressure to perform.

Sex is a very personal subject.  I feel fortunate to work with many couples who are seeking help in this very difficult arena.  And please forgive me for this moment of self-promotion, but…for starters, he can come see me.  My next piece of advice is for women to take the pressure off their guys.  Try not telling him when you are ovulating.  Try connecting with him when you are NOT ovulating. It is also important to KEEP SEX FUN.  And of course, communication is of the utmost importance.  Both men and women can acknowledge that issues in fertility DOES NOT make you less of a man or woman.  And don’t forget, the sexual union between partners can be healing.

In the words of the Taoist masters, from the Han Dynasty text, classic of the pure maiden, Su Nu.

Yellow Emperor asked his sexual mentor, Su Nu, the pure maiden, whether it was advisable for him to refrain from sex. She said, ‘If you do not copulate the Shen (Spirit), the Qi (Vital Energy) will be blocked. And then how will you reach a state of perfect health?’

Acupuncture and herbs are powerful tools to help with some sexual dysfunctions.  In our pharmacopeia there are herbs, like horny goat weed, that have been studied for their libido enhancing properties.  Men can also receive acupuncture to help deal with stress and improve libido, which is a healthier option than not sleeping or drinking more coffee.  Nutritionals like antioxidants are vital to helping with oxidative stress on sperm. The bottom line…there ARE options and help for men to improve and revitalize their fertility.

And then there are some couples with no issues with sex.  It is as easy as texting when your battery is full.

Dr. Denise Wiesner, DACM, L. Ac., ABORM, CEFP

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