Sex therapy can assist couples and individuals going through infertility challenges, those who are pregnant and postpartum, those coping with perinatal loss, as well as in perimenopause and menopause.

Infertility

Those experiencing infertility know that there can be an enormous impact on sexual connection and overall intimacy. Attending regular appointments for treatments and testing is a process that removes the intimacy from conceiving, and many couples go through multiple cycles before they become pregnant. This can involve emotional highs and lows of both grief and hope. 

For many couples, getting pregnant means focusing on sex for procreation rather than pleasure and bonding. Monitoring ovulation can mean putting pressure on the couple or a partner to de-prioritize their needs for pleasure and bonding for the priority of conception, leading sex to become monotonous, mechanical, and ‘outcome’ focused. Seeing a sex therapist during and/or after the infertility journey can help couples with learning ways to reintegrate pleasure and connection into their sexual routine, paying closer attention to the ‘process’ of connection, rather than strictly the ‘outcome’.

At times, the impact of the infertility process can feel insurmountable; however, sex therapy can support individuals and couples with navigating these challenges while maintaining an emotionally, physically, and/or sexually intimate relationship. Due to feeling “touched out” from medical appointments and treatments, many women report their sexual libido decreasing. Partners can begin to withdraw and avoid intimacy altogether; however, a sex therapist can provide support by helping the couple communicate their needs and limits while building a stronger emotional bond involving care, acceptance, and hope along their journey.

Pregnancy and Postpartum

Due to the extent that the body experiences physical, emotional, and psychological changes throughout pregnancy and postpartum, it is a given that one’s sexual connection and experience with intimacy will change. 

For example, sexuality can be shifted when role expectations change (Buehler, 2018). Pregnant mothers and those around them carry the expectation to be selfless and nurturing towards their baby and their partner’s needs. In a heterosexual relationship, the father may carry the expectation of being the provider. Increased pressure to meet expectations, added responsibilities, and the natural exhaustion that comes with parenting can all contribute to the deprioritization of intimacy.

The daily life of parenting, work, and partnership can be an out-of-body experience, requiring a focus on ‘doing’ rather than ‘being’. Sex therapy can teach skills for returning to the body, with a focus on pleasurable sensations and emotional bonding. Research has demonstrated that mindfulness can support addressing challenges with libido and reduce sexual distress (Brotto, 2018).

Seeing a sex therapist can provide couples and individuals with the opportunity to better understand how changes in their relationship and life are impacting sexual intimacy. For couples who value their intimate relationship, participating in sex therapy can allow a safe and guided opportunity to reflect on new options for bonding and overcoming challenges that get in the way of their goals.

Perinatal loss 

The unforeseen ending of a pregnancy or the death of a newborn can have a devastating impact on a couple (Buehler, 2019). While miscarriages, stillbirths, and neonatal deaths are a loss in and of themselves, these also go hand-in-hand  with multiple changes involving physical, psychological, and sexual aspects of the body and the relationship. Sometimes these changes can lead a person to feel like they no longer know themselves or their partner. Shifts in the relationship may also be confusing and lead to a sense of disconnection, while each partner does their best to cope. 

Working with a sex therapist who is sensitive to and aware of these experiences is important. Therapy can provide couples with trauma-informed care through developing strategies to cope with the loss and rebuild intimacy in light of the experience. A sex therapist can help couples and individuals envision a realistic path involving multiple options for moving forward together, as a team, rather than leaving this responsibility up to just one of the partners. 

Perimenopause, Menopause, and Pleasure

From myths like “it’s no big deal” and “it’s all in your head,” women who are (peri)menopausal have received multiple messages suggesting that their emotional, sexual, and mood issues will be overlooked. 

Menopause is only one day in your life, where your body has gone 12 consecutive months without a period. On the other hand, perimenopause can be 4-7 years, and can be longer. Postmenopause consists of the months and years following menopause.

Throughout these stages, the body goes through numerous physical, physiological, and emotional changes. As a result of these changes, it is quite common for sexual experiences to change, and we are aware that many women and their partner(s) often experience a sense of loss, confusion, and hopelessness. Sex therapy is a supportive option that can provide individuals and couples with the guidance they need to re-learn their body, their needs, and reclaim peri(menopause) as an erotic rebirth. Menopause is not the end of pleasure. It is a new beginning, and sex therapy can play a key role in guiding you through changes with new tools, education, and psychotherapeutic support.

Some of the ways that sex therapy can support (peri)menopausal women include:

• Understanding ways that your libido has changed 
• Exploration of new pleasures 
• Discussing the impact of hormonal changes on sexual health and pleasure 
• Self-esteem and mood shifts 
• Guidance for improving libido and sexual response 
• Navigating relationship tensions 
• Helping partners understand menopause’s impact on sex
• Supporting couples rediscover intimacy
• Trauma-informed support for sexual challenges 
• Learning about the upsides of menopause!

In sex therapy, we move at the speed of trust. Together, we can help you find a new pathway to pleasure and connection. We will make space for the grief and loss that comes with changes in reproductive health, and help you understand what you desire throughout your journey.