The Mental and Sexual Effects of Infertility

My first job after college taught me how deeply the medical establishment’s stigma runs against mental health and sexual health issues. I was administering a survey to cancer patients about seven different aspects of their health, including mental and sexual. While the patients unanimously thanked me for finally asking, the doctors’ responses ranged from mild discomfort to rage. This stigma spills over to research, impacting what we fund and study. That’s why I was so excited to stumble upon a recent study looking at the mental and sexual effects of infertility.

The Study: Mood, Sexual Function, and Sexual Well-Being

In the study, over 250 Iranian women completed surveys about their mood, sexual function, and sexual well-being. Just under half of the women were controls: they had no history of infertility. The remaining participants were about equally split among those dealing with primary infertility (when someone has not gotten pregnant after at least one year of having penis-in-vagina (PIV) sex without birth control) and secondary infertility (when someone has been able to get pregnant at least once, but now is unable).

The authors explored how each of these three factors—depression, sexual function, and sexual-related quality of life—interacted with infertility and each other. Here’s what they found.

The Results

Sexual (dys)function matters

Participants answered questions evaluating their sexual function in six areas: desire, arousal, lubrication, orgasm, satisfaction, and pain. Their total score shows sexual function or dysfunction. Those whose scores indicated they experienced sexual dysfunction—with or without infertility—reported more depression and a lower sexual-related quality of life.  The latter connection held true regardless of their age or duration of their marriage.

Depression impacts sexual-related quality of life

Participants with higher depression scores had lower sexual-related quality of life scores. This connection remained regardless of age or duration of marriage.

Infertility is linked with depression

Participants with either type of infertility reported significantly higher depression scores than those with no history of it.

Primary fertility impacts sexual function and quality of life

Sexual dysfunction was significantly higher in women struggling with primary infertility compared to those with secondary infertility and controls. There were no other major differences in sexual function among the groups.

Infertility wears on you and your relationship

Infertility affects all aspects of a person’s life: mental, physical, social, financial, sexual, and more. Therefore, it’s ridiculous that, as the authors note, “sexual function and sexual-related quality of life is not considered as it should be.” After all, the ideal sexual environment for most women is low stress, high trust, and high affection, and infertility can impact all three.

How to manage your mental and sexual health if you’re struggling with infertility

Though the study’s authors don’t offer suggestions for what to do about these impacts, here’s some suggestions that have helped my clients and friends on challenging fertility journeys.

  • Ongoing communication with your partner. Talk about what’s working and what’s not. Be there for each other. Share your feelings, even the scary ones.
  • Involve others. Inevitably you and your beau will need a break from supporting each other on this journey. Have at least a few people you can turn to for empathy and hugs. This also ensures that if one person is unavailable to support you, you have others to reach out to.
  • Get professional support. Now is a great time to start therapy on your own or with your partner—or both. Beyond that, explore modalities like acupuncture, reiki, massage, and yoga to help manage stress, stay connected with your body, and receive touch that’s neither sexual nor clinical in its intent.
  • Spontaneous physical intimacy. Spontaneous penis-in-vagina sex may no longer be possible. Ask yourselves: how else can you incorporate touch and connection into your relationship? One of me and my clients’ favorite rules is that when you’re on the couch, you must be touching. Hold hands, lay your head or feet in each other’s lap, or just have your thighs touching. Here are some more ideas to quickly reconnect.
  • Boundaries, boundaries, boundaries. Be a fierce advocate for yourself and your journey. Do you have friends or family who don’t get it? Take a step back from those relationships, at least for now. Can’t stand to see baby photos on social media? Unfollow/block/unfriend. Need to take time off from work to nurture your heart and can do so without sacrificing your survival? Do it. Be “selfish” right now. Put your health and your heart first.
  • Feel your feels. Whatever they are, they are valid. Struggling to embody that? Then watch This is Us or blast some Alanis Morissette and let the feelings flow.
  • Remind yourself that it’s about balance. Generally, it’s OK to do the thing that isn’t part of your protocol once in a while. Balance is something you achieve in a lifetime, not day-to-day.

Whatever your journey, remember that you are worthy

Everyone’s experience with infertility is different. While the medical establishment has a long way to go with supporting patients minds, bodies, and souls, know that you are not alone, that support is there, and that whatever path you take, whatever issues you experience, none of them take away from your inherent worth.


For additional resources for infertility support, information, and guidance, we recommend:

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