117. Fertility Stress & Intimacy: What No One Talks About

What if the hardest part of trying to conceive isn’t the lab work—but what it does to your relationship? In this heartfelt episode, Dr. Monica Minjeur explores how timed intercourse can shift from connection to pressure and what couples can do to reclaim intimacy. You’ll hear Hannah and Ben’s story, plus practical ways to protect emotional closeness, ease fertility stress, and reframe the journey with compassion and clarity.

Learn how restorative fertility care supports both your hormones and your heart. Schedule a free discovery call at radiantclinic.com.

Transcript

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Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles, to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. What if the thing that nobody warned you about when trying to conceive wasn't lab work or the timing kits, but it was how trying to conceive might start to feel like a pressure test for your relationship? Today we're talking about the emotional side of fertility. What happens when intimacy becomes scheduled? What's normal to feel, even if you've never said it out loud, and how to rebuild connection and desire while still working towards pregnancy. So let's talk today about a patient's story of mine, and we'll call them Hannah and Ben. Now, they were in their early thirties and they had been trying to conceive for about 14 months. Their relationship was great. They were committed to each other and both of them deeply wanted to have a baby at first. Tracking their cycles and ovulation felt exciting and focused. But after a few months, timed intercourse became well. Tonight we just have to. If one of them was tired or traveling or sick, or just not in the mood, it became more tense. Hannah started feeling guilty when she said no. Ben started feeling like he had to perform on demand, and neither of them felt desired. They felt like this was just another task that needed to be checked off the list on certain days. They started quietly avoiding physical closeness outside of their fertile days because it had become so pressured, and that led to additional increased stress. After about a year of trying to conceive without success, sex felt pressured and prescriptive, and both Hannah and Ben felt alone on this journey that they were supposed to be trying to go through together. After an appointment at Hannah's OB doctor where she was told, well, you're still young. Just keep trying. She burst into tears afterwards, not because they still weren't pregnant, but because she felt like their marriage had become so focused on the end goal of having a baby, that they had lost some of the spark from spontaneous intimacy. Shortly after that OB appointment, Hannah and Ben came to us for fertility evaluation, looking for additional medical answers. We started with cycle charting to help them more accurately target intimacy during their fertile window. And upon review of their initial charting at their follow-up visit, I picked up that they were only physically intimate during their fertile window, which is something we commonly see in couples who are intently trying to conceive. First off, I've always validate both partners. Experience. This is common. You are not broken, your marriage isn't failing, and this can feel like a lot of pressure. The next steps then was that I guided Hannah and Ben to help them to narrow the trial window around the fertile time. They had previously been told that they had to try and be intimate every two days for two weeks in the middle of their cycles. Giving them a more clear, focused, and obvious window based on her cervical mucus observations. Helped them to understand when the actual timing made sense, and most importantly, I encourage them to be spontaneous with physical closeness outside of that fertile window, whether it led to sex or not. The intention should be to protect the rest of the month from feeling like work and get away from needing to check the box to make sure intimacy happens at just the right time. Over the next few cycles, Hannah and Ben built in time for physical closeness without feeling like it needed to always lead to sex. And by their next visit, they both said the pressure levels had come down. They still wanted a baby, but they wanted to stay married through the process, not just end up pregnant and feeling exhausted and resentful. That shift mattered to both of them, whether conception happened each cycle or not. So let's look at the big picture here, and let's talk in real life about what patients tell us in private. Here are some of the things that I've heard when we dig deeper and ask the real questions. I oftentimes hear sex becomes more about performance instead of connection. And of course when you're told you have to have intercourse on this day or you're wasting a month, it can start to feel like a test that you either pass or fail, and that's a huge psychological load for you to carry emotionally. We also hear that desire for wanting to be together is oftentimes replaced by anxiety, and it's very common for one or both partners to feel lower desire when sex is on a schedule. That's not necessarily low libido. That's a nervous system. That is in a performance mindset. If you constantly are telling your body that this is the time that I must do X, Y, Z, of course there's going to be additional pressure and anxiety every single month. We also hear that rejection feels a lot bigger rather than just one person saying, I'm tired. The other person might hear you, don't care about our future family enough. Or maybe you don't actually want to even have a kid and that's not fair. It's real, and we hear this all the time in normal situations where one partner might say no, it might just be not a big deal, but when you are trying to conceive every time that there is a no feels tremendously bigger. The other big one that we talked about often, and this is what we saw with Hannah and Ben's case, is that intimacy outside of those fertile days can disappear. So sometimes couples will feel like if we are kissing or touching or you know, giving each other a massage, that they're worried it sends the wrong signal or it can create additional pressure. So sometimes we find that partners withdraw or cut back on that intimacy altogether because it's adding these mixed signals and then we get shame and guilt that creep in and people can start to look around and think, well, everyone else gets pregnant and they're just having fun. Why doesn't this work for us? And that isolation can be very intense, especially if you have been trying to get pregnant for months. Or years. And here's the big truth. None of these reactions mean that you're not committed to each other, that your relationship is falling apart, or that you'll never get pregnant. They just mean that you're under emotional stress, and it's not something that we commonly talk about or teach you how to carry it together. So let's talk about some practical steps on how we help to protect your relationship during the time of conception. And this is really where restorative reproductive medicine isn't just different medically, it's different for your relationship because it's important to me that yes, we evaluate all of the medical things, but we also want to improve your overall health through this process. And that includes your emotional, mental, and relationship health. So here's a few tips that we use in our practice in order to help make this more practical. So first and most importantly is, is we've shortened the pressure window of when do we actually have a chance of conceiving. When you are utilizing fertility awareness charting, we help to identify the most fertile window using real time biomarkers like cervical mucus or to temperature spikes or your LH surge. Rather than just guessing or using an app that's predictive from the last month, this helps us to narrow in the must try timeframe to just a few days to really turn down the pressure you can move away from. We have to force it and make this happen every other day for a two week timeframe. And we don't know exactly even when this could happen to. We're gonna focus here at this time that we know that fertility matters. Step number two is, is that we separate medical evaluation from the emotional blame, and although we're constantly looking at a complete cycle based medical workup early, including early cycle and mid luteal phase labs, as well as male factor evaluation, we want couples to understand that there is actual physiology and medicine and biology and chemistry that are going on. Rather than thinking it's your fault or it's my fault, or this is a problem with me, or this is a problem with us, or we are broken. When each partner can see that there's underlying issues going on that may be hormonal, inflammatory, or ovulatory that haven't been evaluated yet, the pressure on bedroom performance oftentimes drops. We help you shift from we're failing or we don't know what's wrong to. We haven't treated all of the underlying causes yet, but now we have a clear path forward. Step number three is I explicitly give you permission for intimacy that is not intercourse. So in addition to outside of the fertile window, but even during it, we actively encourage couples to reclaim that physical closeness that doesn't always have to lead to intimacy. So whether that's just touching, holding hands, kissing, massaging, or sleeping skin to skin, if that's comfortable for you, you want to be able to still foster that physical closeness without always feeling the need to be on call. For it needing to lead to something more. Getting that physical intimacy back in a way that is low pressure is so important to maintaining that closeness within your relationship. And then the fourth thing is, is that we always are talking openly about details of timing, of intercourse, timing of labs, and how that's feeling from an emotional standpoint. So whether there's stress, whether you've had a miscarriage or there's pain or fatigue, all of these things impact, desire. For example, sometimes one partner needs more time to warm up. Or different pacing in order to feel connected again, and that's not dysfunction. That's just the reality of stress that can play a role when it comes to the timing and the intensity that goes along with intercourse. Now, one other piece that I'll add in here is, is that if there is pain with intercourse or lack of desire, this can be a bigger part of the picture. So there may be things like pelvic floor tension or anatomic dysfunction, things like endometriosis, which can cause significant pain with intercourse. All of these things we're looking at and treating as a medical issue and referring on to other specialists when needed. So a pelvic floor physical therapist, maybe a surgeon for evaluation of endometriosis or counseling or therapy. Physical pain and emotional pressure regarding sex is a solvable problem and not something that you have to carry on your own. And then finally, we encourage people that it's okay to take a break if needed. Now this doesn't mean you need to stop trying to conceive altogether, but giving yourselves permission to not try to conceive in a cycle can be really liberating for many couples. So set aside the charting for a month. Talk with your doctor about pausing medicines for a cycle or more. Skip the lab tests and have a rest cycle where you can just reset. This kind of pause can be so critical to help keeping your stress levels in check and helps to foster healthy relationships that aren't so mission focused. On the end goal of just having a baby. So if you are in the midst of this, what are some things you can do right now? First and foremost, if you haven't already, I would encourage you to have that open discussion with your partner. Name the pressure, and talk about it out loud. Maybe just say something like, look, I love you and I'm glad we're trying to get pregnant, but I'm struggling with how scheduled this feels. Having this conversation is an invitation for further discussion, and it shows that you care more about just the outcome. Another thing that you can try is to use real data, not just guesswork. Tracking your fertile window with a science backed fertility awareness method can help you to narrow down that timeframe, and it helps both partners mentally because it focuses your efforts instead of spreading yourself thin over the course of a two to three week timeframe. If you don't know when you actually are fertile. And most importantly, get evaluated sooner than later. If you've been trying for more than six months, and especially if you know when your fertile window is, please seek out evaluation. Many people within the medical community will tell you to wait a full year before you seek help. But if you are targeting your fertile window already and not having any success with conceiving, it's important to start that evaluation process sooner than later. And finally watch for red flags in your relationship and start to make changes early. So if you find that you're avoiding physical touch because you don't wanna send the wrong message, and that's not normally how you would react, that's a sign to pay attention. If sex makes you feel anxious or painful more than you feel connected, these are signs that you deserve additional evaluation, not a sign that you're failing. And the last one that I would point out is, is that if one person in the relationship is carrying all of the burden of tracking the cycle and timing and recording medications and all of these pieces all by themselves, that's a good time to have a conversation with your partner. Within our practice, we oftentimes are encouraging one of the partners to take care of the observations and the other partner to actually manage the tracking. Now, in most cases, this is going to mean that the woman is going to be evaluating her signs, checking her temperature, checking cervical mucus, and the male partner is the one that's going to be doing the actual recording. This helps to bring both of you into this so that it is not just putting so much burden on one side of the situation. Imagine if trying to conceive doesn't mean losing the part of your relationship that made you want a family together in the first place. Imagine having a focused fertile window instead of constant pressure, having medical insight and permission to hold each other without a clock running. Over time, your fertility journey can become something you navigate side by side to help improve your overall health. And promote fertility.

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If you're ready to work with our elite team of healthcare professionals, go to our website, radiant clinic.com to schedule a free discovery call and learn more about our package based pricing for comprehensive care. We are currently able to see people for in-person appointments in our Cedar Rapids, Iowa Clinic, or can arrange for a telehealth visit if you live in many different states across the us. Check out our website for current states that we can serve medical clients and let us know if your state is not listed to see if we can still cover you there as we are constantly expanding our reach. Please note that our fertility educators are able to take care of clients no matter where they live. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of Cycle Wisdom.