Fertility & Sexuality

December 13, 2005 - Tuesday
1:34 PM to 2:34 PM (EST)
Guest Speakers: Bill Petok, PhD, PA

Categories
Fertility • Infertility • Sexual Health • Sexuality

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Bill__Petok	Hi everyone. I hope its warmer where you are!
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Bill__Petok	Well, it could be worse...at least its not snowing here. Yes, I suspect this topic can be a hot one for folks.
Bill__Petok	That's a good idea.
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Bill__Petok	I think the topic of sex and fertility can make people uncomfortable because when you are working with a reproductive specialist its as though your sex life is under the microscope. That tends to make folks self-conscious.
Bill__Petok	I wonder if anyone has had this experience?
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emma2004	I am surprised at how self-conc. we are...and how intrusive the questions feel. I am having a hard time getting over that...and my husband has an even harder time.
Bill__Petok	Emma, that is so familiar sounding. Many people feel the same way.
aweske	Yes! The romance seems to suffer when ovulation sticks are part of the foreplay!
emma2004	I don't know how to start relaxing and enjoying myself. And it is worse right now....
Bill__Petok	It does feel intrusive to have a "stranger" ask you about how frequently or in what positions you have intercourse.
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Bill__Petok	Aweske, it does seem terribly unromantic to have devices as part of the foreplay. One thing that I frequently recommend is that couples set aside time that is decidedly non-reproductive time for tenderness and love making.
emma2004	So, given that we have no choice but to endure this kind of probing...how do we make it ok and get on with things?
emma2004	literally, probing, by the way!
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Bill__Petok	Emma, its very important to keep the physical connection between the two of you even if it doesn't include lovemaking. Holding hands, snuggling, "necking" on the couch, all help keep the connection.
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wannababy	it seems that time is also an issue. Since we are so 'goal-oriented' we tend to focus on that. How do can I turn off the end goal thinking, i.e. a baby and 'waste time'....yikes that even sounds bad..
Bill__Petok	Wannababy, I couldn't have said it better. It does seem like non-goal directed sexual activity is "wasting time." Of course, nothing could be farther from the truth.
Bill__Petok	I have couples make "dates" with one another, promise they won't bring up treatment and enjoy the moment.
wannababy	the question really is, how to flip the switch. I can get that we need to-from and intellectual basis, but it is very difficult to let opportunities go by.
Lori	Hello! In June I had emergency surgery in which an ovary and tube were removed, how much does that effect hormones and 'drive'?
leanne	hi, i have a retroverted uterus whats the best position to get pregnant
Bill__Petok	Admittedly it takes some thought. And there isn't a switch to flip. If it were only that easy. It takes a reframing of "opportunities for reproduction" into "opportunities for connection." One could think about this as essential if you want to keep the warmth between the two of you so that a future child can see how loving people interact with each other.
Bill__Petok	Lori, do you still have one remaining ovary?
Bill__Petok	Leanne, that's really a medical question that I'm not the best person to answer. I'd consult with your reproductive specialist about that.
Lori	yes and we're hoping that it is in the right position to deliver the egg to the fallopian tube (it was pulled out of position bc of severe endo.) however no luck 3 tries later:(
Bill__Petok	Lori, if you have one remaining ovary then you are still getting natural androgens (testosterone) from it. We think that testosterone plays a role in libido. However, many psycho-social issues are equally important. For example, we know that people who are very tired or depressed or anxious can have diminished libido. Many of those things don't have anything to do with testosterone.
kholl69	I had a Tubal ligation reversal in April of this year and I had a secound HSG in September and found that only one side was successfull. Do the ovaries take turns releaseing eggs?
Lori	I've also noticed more emotional changes since about Sept. my fsh is 7.9 but no clue on other hormone levels
Bill__Petok	Kholl69, as a psychologist I'm not the best person to answer that question.
aweske	How can I get my husband to understand that questions like "where are you at in your cycle?" add pressure that takes away some of my drive?
capel	my wife and I have been trying for what seems like forever....and frankly, sex is like a full time job now. I don't want to disappoint her-we both want a baby, but I would like a break and I REALLY want to have some fun. We just don't seem like we are the same people.
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Bill__Petok	Lori, we know that infertility treatment can be an emotional roller coaster regardless of the specifics. And certainly the medications involved can cause emotional reactions.
Lori	interesting! I did lose lots of blood in the surgery and almost needed a transfusion...I am tired alot but I teach school and this time of year it can be a challenge!
Bill__Petok	aweske, for some men it just takes a straightforward statement "when you ask me where I am in my cycle I feel under pressure. As a result I don't feel very sexy or sexual. It would be better if you didn't ask those kinds of questions."
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Lori	I'm also a sriously slow typer...find and peck....Does progesterone effect drive?
emma2004	i like the idea of 'opportunity for connection' and having a loving relationship for the sake of our future child, but i wonder if my husband will relate to that kind of language and thought process..it seems kind of 'airy fairy' as he would say.
Bill__Petok	Capel, your comment is one I hear a lot. Sometimes it is a good idea to take a break from reproductive sex and just have sex for fun. When the pressure is off it can restore some of the loving feeling.
Bill__Petok	Lori, you've pinpointed a couple of variables that could be in play. Tired doesn't enhance sexuality. Just the opposite.
capel	how can i do that and not disappoint my wife? She will feel like i am giving up.
Bill__Petok	Emma, if that is the case you may want to consult with a mental health specialist who can help you two bridge the gap. Its not uncommon for a couple to be on different pages about this issue.
Bill__Petok	Capel, I'm not suggesting that you stop altogether. People do take "vacations" from many things. It isn't unusual for reproductive specialists to recommend that when they see a couple getting unusually stressed about the treatment process.
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Bill__Petok	Lori, progesterone can effect drive but it probably isn't the only thing going on for you.
Bill__Petok	Emma, does your husband see some of the issues involved in your treatment in a similar fashion to you?
Bill__Petok	Deb, that's a good observation. Couples can go into this with the understanding that it is stressful, that stress can have an effect on sexuality and take precautions. Plan to do things that you've enjoyed in the past, make dates to go away or have romantic dinners, take bubble baths, etc.
aweske	Is it a bad idea to try an anti depressant during this stressful time? Is this dangerous when trying to get pregnant?
Bill__Petok	I think its very important to know what things your partner finds comforting, both physically and emotionally and then do them.
Bill__Petok	Aweske, antidepressants can be helpful, but your physician must be on board with you using them. Some antidepressants can have detrimental effects on pregnancy. Research is always coming out that revises our knowledge. I would consult with your reproductive specialist. If he or she doesn't know the latest research they can easily find out.
aweske	Thank you for your help!
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Lori	Thanks, I got booted for a minute!
Bill__Petok	There are other stress reducing techniques that both men and women can use. An excellent resource for this is Alice Domar's book, Healing Mind, Healthy Woman. The first 5 or 6 chapters detail the effects of stress on health and give excellent suggestions for stress reduction. The last portion of the book deals with specific health issues, infertility being one of them.
Bill__Petok	Deb, it takes on greater significance for couples grappling with fertility because it feels like a constant assualt with examinations, tests, invasive procedures and friends and family not always understanding. So, a couple can truly come together and support each other during these times. We know that no two people go through this in the same way. Being able to appreciate this is essential in my view.
Bill__Petok	Too often one person thinks that because the other isn't in the same emotional place he/she doesn't "care". Usually that's not the case. We all have different ways of dealing with our emotional reactions and no one is "right." Besides, there are truly differences in how men and women cope with the stress of infertility. Vive la difference! its not bad, just different.
Lori	Thanks for the oppotunity to ask ?'s and get help. Much appreciated!
Bill__Petok	Deb, that's a good idea. First, it is well known that women tend to seek social support when they are in stressful situations. Consequently, they do things like talk to friends or join support groups, like AFA! Men, on the other hand, tend to resolve problems by retreating into thinking...into their caves. They are less likely to discuss a problem with someone. And they are quick to offer advice to those they love who are experiencing problems...out of loving helpfulness usually. We hate to see
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Bill__Petok	Sorry about that! Of course, most men don't like to feel helpless. After all, we are supposed to have answers!
emma2004	It's probably the same wiring that makes them unable to ask for directions or pick their underware up off of the floor.
wannababy	lol!
Bill__Petok	Emma, I think you are onto something there!
capel	ok, ok, no man-bashing here....
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Bill__Petok	But I don't want you to think that I'm bashing men. We really are decent folks most of the time. Just different from women. A good thing in most circumstances because the combination of two sets of strengths can be powerful.
Bobsbride	Hello, thank. I forgot about tonight.
Bill__Petok	Yes, keep the romance going in your relationship be reverting to things you enjoyed during less stressful times. Remember that sex has multiple functions, reproduction, relationship enhancement as well as "fun" and many others as well.
Bobsbride	Not this time, but thank you.
Bill__Petok	And finally, remember that sex is more than intercourse. Its a wonderfully long chain of physically intimate behavior that extends from hand holding onward.
Bill__Petok	Thanks, Deb. I always enjoy the opportunity afforded me by AFA to interact with folks on this topic.
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Bill__Petok	Yep. Crank it up!
Bobsbride	Thank you for coming here and I look forward to next time.
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Bill__Petok	Good night everyone.
Bill__Petok	Goodnight Deb. Thanks for having me on.
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