Category Archives: Sexual Healths

sexual health problems

How to avoid sexual health problems

We compile some of the best and most useful tips to avoid sexual health problems, and so that you can enjoy your relationship 100%. Complications that we can easily avoid and simple habits that should be acquired right now.

Among the most annoying, painful and even “embarrassing” diseases and complications that exist are sexual health problems. We refer to sexually transmitted diseases, lack of sexual appetite or erectile dysfunction problems, among others. For this reason, in this post we have decided to collect some simple tips that will teach you how to avoid sexual health problems . Let’s go there.

How to avoid sexual health problems, 10 tips

It is very important, as we said, to acquire a series of habits to maintain our sexual health. In India it still seems that both women and men do not pay much attention to certain aspects such as having a Pap smear or using contraceptive methods. If you want to avoid sexual health problems take note.

Meet your partner

The first thing you should do is get to know the other person. If your partner suffers from a sexually transmitted disease, or for example is prone to vaginal candidiasis, it will be helpful to know in advance to know when you should or should not have sex.

The communication

In this sense, communication is also important, starting from the basis that a healthy sexual relationship must be based on respect and mutual understanding and on the consent of both parties.

Communication prevents misunderstandings and can become a strong aphrodisiac.

Exercise or play sports

Practicing a sport or exercising will also help us avoid sexual health problems, since we will experience an emotional improvement and when we feel good about ourselves, libido will increase. Without forgetting the physical condition, not least to be able to enjoy sex.

In this sense, there are numerous sports that benefit sexual health. For women, swimming can help strengthen the pelvic floor and prevent vaginismus or other difficulties in reaching orgasm.

As far as men are concerned, sport can help overcome ejaculation problems or erectile dysfunction.

Another of the sports that is recommended to practice to improve sexual health is pilates, as long as you do not have pelvic floor problems. Yoga also helps combat sexual appetite problems.

Inform

One of the main problems that exist today is the lack of information, or rather we should say of interest. For example, would you know what the difference is between AIDS and HIV?

Information is within our reach, increasingly available and accessible, however there is still a lot of ignorance about one’s own body and a mentality of “I have everything under control” or “this is not going to happen to me”.

The best remedy is to inform yourself, read, consult a sexologist and know yourself.

Beware of risky practices

The most common risky practice is usually having sex without contraceptives, a frequent and common mistake with painful consequences: sexually transmitted diseases, unwanted pregnancy, etc. As simple as it is, why take the risk?

No Smoking

It is clinically proven that tobacco use decreases fertility. In the case of men, for example, it affects blood flow in the penis and causes early aging of their arteries.

Corporal hygiene

Maintaining good body hygiene also prevents infection. A clean body is synonymous with a healthy body. However, when it comes to sexual health, we must take special care, among other things, in avoiding the removal of public hair or remembering to urinate after intercourse, a practice that we should carry out in order to protect ourselves from diseases that can endanger health.

Control of emotions

One of the main things we must do is avoid toxic relationships. Self-control is also important, as stress can reduce sexual desire.

Turn to experts

In the case of women, it is crucial to attend regular gynecological check-ups. If you have any symptoms or doubts, it is always advisable to visit a sex specialist in Delhi.

Have a good diet

A diet high in saturated fat can lead to sexual problems, such as decreased concentration of sperm in the ejaculate or less sperm fluid.

And finally, you should not forget numerous health benefits of sex. Any problem that can reduce them is worth fighting and/or avoiding.

Remember, any query or doubt you have should be resolved as soon as possible; Before the appearance of symptoms of any disease or sexual dysfunction consult your sexologist doctor in Delhi without feeling ashamed about it. At Dr P K Gupta Clinic you will be in the best hands. We have the best professionals who will guide you in order to prevent possible diseases or, on the contrary, if you already have any symptoms, they will treat you as a matter of urgency.

If you want to fully enjoy yourself with your partner, start with these useful tips. You will appreciate it.

erection problems

Pathologies that condition the appearance of erectile dysfunction

Various pathologies and lifestyle can condition the appearance of erectile dysfunction. Knowing and valuing them is key to improving the quality of life of those affected

That prostate pathologies determine the appearance of erectile dysfunction is a clear fact, but the pathophysiological mechanism is not well understood. Many patients suffering from prostate problems (benign hyperplasia, prostate cancer) may be older and, therefore, the incidence of both conditions increases.

BPH has a side effect due to the treatments used, especially 5alpha reductase inhibitors, which are directly implicated in a possible decrease in libido and, to a lesser extent, worsening of the quality of erections, due to a decreased levels of dehydrotestosterone (active metabolite of testosterone (DHT)).

Regarding Peyronie’s disease, it is considered that the pathophysiological mechanism of erectile dysfunction is an alteration of the normal structure of the penis, preventing the veno-occlusive mechanism from working correctly and causing it due to venous leak. However, when vascular studies of the penis are performed, more varied findings are found. It is common, for example, for patients suffering from Peyronie’s disease to previously present pathologies that predispose to the development of erectile dysfunction due to lack of arterial supply.

When considering surgical treatment, it is important to assess the degree of erectile dysfunction that the patient has, since the success or failure of the intervention will largely depend on this assessment.

Priapism

After ischemic priapism (intense erection, prolonged for more than 4 hours), there is a lack of oxygen supply to the corpora cavernosa, causing an inflammatory process and possible fibrosis of the same, resulting in a very difficult erectile dysfunction. treatment.

In ischemic priapisms refractory to treatment, the early placement of an early penile prosthesis has been postulated to treat the consequent erectile dysfunction that will occur and the priapism definitively, with successful results.

A very particular case is recurrent priapism, which can be treated with phosphodiesterase 5 inhibitors (drugs used for erectile dysfunction), given that they seem to favor the correct flow of red blood cells through the vessels.

Kidney failure and dialysis are two situations in which widespread vascular damage occurs, leading to a situation of erectile dysfunction due to lack of vascular supply. In addition, in many cases kidney failure coexists with diabetes which, like dialysis, can cause erectile dysfunction of neurogenic origin. These cases of erectile dysfunction have a poor response to the usual treatments.

Cardiovascular risk

Any cardiovascular risk factor is a risk factor for erectile dysfunction. Thus, diabetes, hypercholesterolemia, … can cause it. In fact, in patients who present erectile dysfunction, it is necessary to screen for coronary pathology. The diameter of the penile arteries is slightly less than that of the coronary arteries. For this reason, when erectile dysfunction appears, it is known that the next ones to be obstructed are the coronary arteries, putting the patient’s life at risk.

Regarding high blood pressure, it should be noted that after diabetes it is the most important factor responsible for erectile dysfunction, not so much because of hypertension itself, but because of the treatments used, such as beta-blockers or thiazide diuretics, which can produce problems in erectile function due to its intrinsic mechanism of action.

Lifestyle modifications to improve cardiovascular risk factors help improve sexual function.

Hypogonadism is a direct cause of erectile dysfunction. In these cases, substitution with exogenous testosterone serves to relieve not only erectile dysfunction but also the rest of the symptoms caused, as well as to restore its serum levels and avoid complications derived from its long-term deficit.

Consumption of toxic substances

The consumption of any type of narcotic alters the erectile function. Cannabinoids are associated with hypogonadism, which can secondarily cause erectile dysfunction. Other drugs, such as cocaine, are powerful vascoconstrictors that can cause, with continued use, erectile dysfunction due to lack of vascular supply. It is very common for young patients, accustomed to sex with drugs (“chem-sex”), to counteract the effects of cocaine with other vasodilator drugs in order to maintain a sexual relationship.

As for alcohol, while moderate amounts have always been considered heart-healthy, its excessive consumption can lead to peripheral nerve degeneration that leads to the appearance of neurogenic-type erectile dysfunction, which is difficult to treat with the most conservative therapies.

Alterations in the CNS

For their part, patients with spinal cord injury, multiple sclerosis, sequelae of acute cerebrovascular accidents may have altered regulation at the CNS level, which favors the appearance of erectile dysfunction of neurological origin; that is, the sexual stimulus is not transmitted and an erection does not occur.

However, reflex erections may appear. In these cases, treatment should be based on PGE, initially intraurethral. In the event that it is secondary to ACVA, it may have an added vascular factor as the origin of the ED.

Both depression as a pathological entity and its treatment have been identified as independent risk factors for erectile dysfunction. In addition, a state of depression or anxiety favors a lack of libido and anticipatory anxiety, favoring the development of erectile dysfunction of psychogenic origin, in addition to medication, as well as other sexual disorders such as premature ejaculation.

Treatments with 5PDE or PGE inhibitors are usually effective, but the depressive picture must be managed, since it is essential for the patient to have a satisfactory sexual activity.

phimosis

Phimosis and excess foreskin

“Phimosis and excess foreskin can make glans exposure and local hygiene difficult”

The penis has skin that covers the glans (head of the penis). This skin is called the foreskin and in many cases, it can be affected by problems. Patients who have excess penile skin and cannot expose the glans are carriers of phimosis. If the patient has a lot of skin but manages to expose the glans, he has an excess foreskin.

Phimosis and excess foreskin can make it difficult to expose the glans and clean the area, which can lead to infection in the area (called balanitis). This infection can cause itching, pain, and redness and is very uncomfortable for the patient. Usually, it can be caused by a fungus and improves with local treatment with ointment.

Phimosis can occur at any age, being very common in children, but it can also happen in adults and elderly patients. In cases where local treatment does not improve the infection or when the patient has very closed phimosis, surgery needs to be performed.

To prevent yourself and ask questions about the topic, the best strategy is to look for your sexologist in Delhi.

man's sexual life change at 40 years of age

Does a man’s sexual life change at 40 years of age?

It is not a law of life, but after turning 40, a man may begin to feel that he does not have the potency and sexual desire as before. And your concern only compounds the problem. Couples can help their partner to regain his appetite for sex, and for that, it is very important to know the causes of this gradual change in male sexual life and what we can do to avoid the progressive decrease in sexual desire of the forty-year-old man.

Causes of male sex life changes

Andropause

After age 40, men decrease the production of testosterone, the key hormone of male sexual desire, in a process similar to that of menopause in women.

Low male self-esteem

As always, women are better informed and prepared for menopause, however, most men do not know anything about andropause and when it appears they suffer a drop in their self-esteem. This is the true cause that leads the 40-year-old to look for younger women to reaffirm their attractiveness and sexual potency.

Effects of stress on men

Stress reduces the sex drive in men and women. After the age of forty, the loss of self-esteem causes stress; conflicts at work cause stress; worries with the economic crisis cause stress. And stress, we already know, causes a decrease in desire for sex.

Professional problems and the social future

At the age of 40, either you have succeeded professionally or it will be very difficult to do so. The fight for the long-awaited professional promotion, the fear of unemployment, and the pressure of young professionals (and women, especially) push men into unbridled professional and social dynamics. And the great victim is sex.

The physical decline of man

Youth is not eternal and you cannot fight against a sedentary lifestyle, hair loss, big belly, smoking, and drinking too much alcohol. When the man notices his masculine physical decline in front of the mirror, he loses appreciation for his figure, loses self-esteem, and the desire for sex sinks.

Consult Dr P K Gupta, best sexologist in Delhi, if you have any sexual problems.

hiv and covid 19

COVID-19 and the HIV Response

The COVID-19 pandemic was (and still is) a harsh burden on the ability to access healthcare services and resources globally. Before the pandemic, doctors and public health officials were hopeful that the decline in HIV cases would continue to drop, and a campaign to eliminate the AIDS epidemic by 2030 was underway. Then, the pandemic hit and set that goal back.

So how exactly has COVID-19 affected HIV response? Broadly speaking, the pandemic impacted the healthcare access of marginalized communities the most¹. Low-income workers and people of color were disproportionately impacted, and ethnic minority groups already faced more barriers in regards to healthcare equity before the pandemic begun². Coupled with the fact that HIV is most prevalent amongst low-income and marginalized groups, COVID-19 only made the fight for healthcare equality and against HIV more difficult. In total, over 20 million people became unemployed, leading many to lose their health insurance and unable to access necessary preventative HIV resources.

Over the course of the pandemic, there have been 670,000 less HIV screenings and 4,900 less diagnoses of HIV. PrEP prescriptions have declined 21% nationally. While these seem to be good signs, experts warn that it’s because less people are going to clinics to be tested and treated due to fears of contracting the virus, economic hardships, and stricter interactactions with physicians³. Drug overdoses have continued to rise, which doesn’t bode well for the 66% of HIV transmissions that happen via needles. As of 2019, 19% of people with HIV did not know they had it, and it’s possible that number has increased since the pandemic.  But, the fight against HIV is far from over and still looks hopeful. Over the past decade, HIV cases have dropped 23%³. The pandemic may have slowed progress, but the goal of eradicating HIV is far from unachievable. The focus is to get back on track by increasing resources available, urging more people to be tested, and promoting the use of PrEP and condoms. With the end of the pandemic on the horizon, it’s crucial to get back on track by advocating and supporting preventative measures against HIV. It takes all of us to do it.

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good sex

The four words that ensure good sex

Normalizing giving and receiving feedback is essential, according to experts

Communication is not just what we do when we have to present a work in public, give a speech or simply call a friend. Forgetting this information may be damaging your life, in every way, also your sex life. Although speaking is a spontaneous and natural act, this fact quickly gets us used to not paying attention to what we say but, above all, to what we do not say.

Having a healthy sex life often depends on a phrase as simple as it is ignored: have you ever asked the other person what they like? This is the key to sexual pedagogy that many specialists are trying to do today, because in the age of communication it disappears from the most daily actions. Dr. P K Gupta, the best sexologist in Delhi who disseminates his knowledge through blogs, emphasizes the importance of asking, knowing, and engaging in a dialogue that helps bring people closer (even closer) in their sexual relationships.

“In my opinion, one of the hottest things is when a couple asks: ‘Like this?’“, Dr Gupta says in one of his posts. For this sexologist in Delhi, communication is a necessary tool for pleasure, since asking gives rise to experiment: “Having control of sex and letting your partner know when he is doing something right leads to more pleasure and a deeper connection.” Also, ensure that talking during sex improves communication in other areas of your life.

Essential for affection

It is impossible for the other person to know everything about you, not even if it is your partner, because sometimes even you don’t really know what you like and what you don’t, precisely because you ignore the occasional chat. “Some of us hope that our partners intuitively know our sexual desires, but that is rarely possible,” says Dr Gupta in this sense, and many people seem to agree with him.

There are many people who comment on his blogs to reaffirm his message: asking is “essential” also for affection, another basic aspect for a relationship to grow. Without forgetting the macho component that often surrounds this non-practice, as if women do not enjoy sex exactly the same as a man, and in different ways as well.

That is why a sexual education that dialogue, feminist and diverse is so important, because the whole of society depends on it. But do not be overwhelmed, even if sleeping with someone is a political act, perhaps it is that politics is simpler than it seems. Remember: you just have to ask. “Normalize giving and receiving feedback in bed,” as Dr Gupta says.

Penis condition

Penis condition: early warning sign

Experts say the best measure of a man’s health is the amount of penile erection, as a man’s health also affects his erection.

By the early 2000s, it became clear that men with heart disease were more likely to develop erectile dysfunction. But recent research has also revealed that erectile dysfunction in seemingly healthy men may be an early sign of heart disease.

Early warning sign

The Mayo Clinic study involved 1,400 men who had never been diagnosed with heart disease before. Men with erectile dysfunction had an 80 percent chance of developing heart disease within a decade, regardless of whether they smoked, had high blood pressure, were overweight, or had diabetes.

POTENCY TEST

Many men jeopardize their strength and performance with their lifestyle without being aware of it. Take the test and find out if your potency is at risk!

Completing the potency test

The most dramatic increase in the risk of heart disease was seen in men in their 40s who experienced erectile dysfunction. They had twice the risk of developing heart disease compared to men of similar age but did not have erectile dysfunction. The same is supported by another study published in the Journal of the American Medical Association in 2005, which found that men over the age of 55 had a 45 percent higher risk of developing heart disease within a five-year period than those who had erectile dysfunction. experienced.

Hardening of the arteries

Erectile dysfunction and heart disease are common causes of atherosclerosis known as the hardening of the arteries. This means that plaques caused by fat deposits within the arteries harden the walls of the arteries and restrict blood flow. Small pieces of plaque can become detached and, as they flow through the bloodstream, cause obstruction somewhere else. If it happens in the heart, it causes a heart attack, if in the brain, it causes a stroke.

Experts say the disease begins with damage to the endothelium. How does all this relate to an erection?

For the penis to be rigid, it must be saturated with blood, and for this to happen, the endothelium must rest so that the arteries can dilate and blood can flow into the penis.
The arteries leading to the penis are smaller than those leading to the heart or brain. Hardening of the arteries affects the smaller arteries much earlier than the larger ones.

This is why a sexologist in Delhi advises all 45-50 age groups of men who are struggling with erectile dysfunction to have an examination as soon as possible. Timely lifestyle changes such as quitting smoking, eating healthy, and exercising regularly can prevent the development of heart disease.

Many doctors claim from their professional experience that while men have a much harder time transitioning to a healthier lifestyle in the hope of a longer life if they feel they can improve their erectile dysfunction, they are more willing to change.

How do you control premature ejaculation

How do you control premature ejaculation?

Premature ejaculation affects many men worldwide, it is the most common sexual problem among those under 40 years of age. It is important to understand the physical and mental causes behind the problem, but until this happens, fortunately, many techniques will help to delay or eliminate premature ejaculation.

Take a deep breath!

deep breath

Deep breathing is a form of meditation that often helps control sexual desire and tension leading to premature ejaculation. Superficial, rapid breathing speeds up the pulse, which can cause premature erections and ejaculation.

Try to inhale the air well for 5 seconds, then hold it in for 3 seconds and only then blow it out slowly, again for 5 seconds. If you can continue this rhythmic breathing for 5 minutes, you can take great advantage of it in the bedroom too! In addition, trying to breathe with your partner, paying attention to each other, greatly enhances intimacy.

Masturbate more often!

masturbation

There are practical reasons for this advice: although men have significant amounts of sperm, they are not infinite. The more times you masturbate, the next time you can delay ejaculation longer.

Try interrupted masturbation! The point of this is that when you feel an orgasm approaching, it stops and then, after a short rest, continues to satisfy and stop, gradually getting closer and closer to orgasm, until you can no longer stop. Try pushing this out for 15 minutes, but if you feel your testicles or penis hurt, don’t stop yourself anymore. If you do this exercise regularly, you can experience where the point from which there is “no going back” is. If you feel you are already a master of technique, you can also try it in the bedroom.

Pressure

pressure

Applying pressure to the bottom of the penis – to the same point that helps to delay orgasm during intermittent masturbation – can slightly reduce the amount of erection, thus delaying ejaculation. Once you know exactly what this point is, you can even ask your partner to help you practice this technique.

Kegel practice

kegel exercise

The relatively easy and discreet Kegel exercise is not only beneficial for women. There is no better way to train pelvic floor muscles and strengthen the pubococcygeus muscle (PC muscle). The PC muscle is located between the pubic bone and the coccyx and helps control urine and ejaculation, respectively.

The easiest way to train this muscle is to try to stop urine leaking on the toilet. To do this, you need to use the PC muscle. During Kegel exercise, this muscle should be stretched for approx. 10 seconds, then relax. Perform at least three sequences of exercises in a row, with 10-second breaks between them. You can do the exercise anywhere, anytime, either while driving or in front of the TV. The exercise strengthens the PC muscle so you can delay ejaculation by tightening it near orgasm.

Try new sex poses!

sexual dysfunction in women

Real sex is more than a traditional source of physical pleasure. Try new sex poses or apply tantric techniques during intimate togetherness! You may even find that you last longer in certain poses, ejaculate later. Generally, when the woman is on top, premature ejaculation can be delayed while the missionary pose is avoided.

If you feel close to orgasm, stop the stimulation (e.g., pull out your penis for a short time), stretch your PC muscle, and take a deep breath! Repeat this until the ejaculation compulsion is gone.

Condom

condom

A condom reduces the sensitivity of the penis, so stimulation is less of a problem. Avoid condoms with warm lubricants that provide a warm atmosphere – the more stimulation, the greater the risk of premature ejaculation.

The use of a benzocaine condom, which can delay ejaculation by up to 5 minutes, is highly recommended. These condoms are treated with a mild anesthetic, benzocaine, which helps prevent premature ejaculation by reducing sexual stimulation. Don’t worry, you’ll still enjoy being together. If in doubt, try masturbating first to see the benefits of using it.

If you are allergic to latex, look for a condom based on polyurethane or polyisoprene.

Talk to your partner!

Communication is the basis of any relationship, and when it comes to sex, it is also important. Talk to your partner about premature ejaculation. Tell her if you feel close to ejaculation and interrupt the act for a short time. This can be a great time to pamper your partner orally or manually. If you feel ready again, they can continue making love.

Don’t have unrealistic expectations!

Focus on the joy! Premature ejaculation has no definition given in minutes or seconds. When stressed, it is not only psychologically unhealthy, but can even trigger premature ejaculation. Talk openly and honestly with your partner about your problem and possible alternatives. Remember, sex should be joyful and not stressful.

erectile dysfunction treatment in Delhi

Erectile dysfunction can indicate severe trouble

Did you know that erectile dysfunction can be the first symptom of an unrecognized cardiovascular disease?

The explanation lies in the fact that erectile dysfunction (hereinafter referred to as ED) and vascular disease are a number of common risk factors (eg smoking, hypertension, diabetes, blood lipid disorders, alcohol abuse.). The connection point is the disease of the blood vessel wall, atherosclerosis.

The ED therapy includes real medical success stories in recent years.

The more knowledge and experience is accumulated, the more medical specialties become “interested” in the treatment of erectile dysfunction, which has been shamefully silenced so far.

These specializations include cardiology (cardiology), neurology, and diabetology.

Diabetes increases the development of erectile dysfunction to the greatest extent, smoking is about twice the risk, and fat metabolism disorder also increases the risk of developing ED by just as much. High blood pressure alone increases the risk, but certain medications used to treat it also adversely affect potency.

Recognizing the connection between at-risk groups is of paramount importance when it comes to erectile dysfunction in the sexologist clinic in Delhi. It may reveal previously unrecognized cardiovascular disease, diabetes, and high blood pressure.

If at least three or more cardiovascular risk factors are present in a patient with erectile dysfunction who does not otherwise have cardiovascular symptoms, a detailed cardiac examination is recommended.

As a result, not only will the treatment of Erectile dysfunction become safer, but nowadays, the screening and early prevention of the leading cardiovascular death in our country will also be given more space!

The other part of the patients is already known as cardiovascular patients. Sex is associated with well-known physical exertion. This does not mean that e.g. a patient who has had a heart attack cannot complete her life with sexual pleasures. A risk assessment and the need to take certain medications (e.g., nitrates) can be accurately judged by a proper cardiological examination. If the condition of our heart patients is good, we can safely recommend sex life. In the case of erectile dysfunction, we can recommend the taking of the desired tablet from several types of medicines, so that you can also use your heart medicines safely. The resumption of sex life should be part of the rehabilitation of the cardiological patient.

In high-risk patients (arrhythmias, severe valvular disease), a cardiologist’s decision is also required. In such cases, treatment of the underlying disease is often required as a first step, and treatment of sexual dysfunction should be postponed.

Of course, the complete diagnosis and analysis of ED is still the responsibility of the best sexologist in Delhi, but more and more often a cardiologist should be considered in case of increased cardiovascular risk or complaints.

I encourage erectile dysfunction sufferers to communicate more boldly and openly with their doctors, as their complaints can be remedied with great success these days!

Stigma Surrounding Infertility

‘So Many Live in Silence’ Due to Stigma Surrounding Infertility

“People feel immense pressure to be able to have their own child. Therefore, if there is difficulty having a child or conceiving, people often feel like a failure.”

Infertility Awareness Week is close to my heart. Just over five years ago, I was diagnosed with endometriosis, a chronic reproductive health condition that, among other debilitating symptoms, can cause infertility.

At 27 years old and very much single, I’ve had more conversations than I can count about preserving my fertility, about the impact the ovarian reconstruction I had two summers ago might have on my ability to conceive, and about the high likelihood that I will need a hysterectomy to treat suspected adenomyosis, a disease distinct from endometriosis that grows in the uterine walls.

Almost all of my close friends also have endometriosis. I’ve watched people I love and others in the community experience pregnancy losses and navigate the often traumatic process of in vitro fertilization.

We live in a society that still designates value to people assigned female at birth by their reproductive capabilities, which means infertility is commonly accompanied by feelings of inadequacy and shame.

Sex. Abortion. Parenthood. Power.

Then there’s the outside judgment—like comments about your worthiness as a partner if you’re unable to conceive. Or questions like, “Why don’t you adopt?” But once you’re faced with the reality of infertility, you realize it’s much more complicated than that. For example, people with disabilities and chronic illnesses can be legally discriminated against in the adoption process—meaning that, for many, IVF might be their only shot at starting a family.

But the IVF process itself, like much of health care, is dictated by a patient’s privilege and economic status. IVF is costly, and insurance coverage for it is abysmal, which means that your ability to have a child through IVF hinges on your financial situation. (Only 19 states require insurance plans to cover some level of infertility treatment, and only 13 of those states require IVF coverage, according to the national infertility association Resolve.) LGBTQ couples face added discrimination and financial barriers, as much of the discourse around IVF—and even the way infertility is medically defined—revolves around cisgender heterosexual couples.

Infertility is common, but discussing it remains incredibly fraught. We talked to Dr. Mary Jane Minkin, clinical professor of obstetrics and gynecology at Yale Medical School, and Dr. Banafsheh N. Kashani, a reproductive endocrinology and infertility specialist, to help demystify the topic and cut through the stigma and taboo. The interviews have been edited for length and clarity.

Rewire News Group: Can you define infertility and what causes it?

Dr. Mary Jane Minkin: If a person is under 35, we usually define infertility as one year of trying to conceive without success (and that means having regular intercourse, at least every other night, at least around ovulation). For a person 35 or older, we usually use six months trying and not conceiving to begin evaluation.

Dr. Banafsheh N. Kashani: There are different causes of infertility, but they can be due to a “male factor” from low sperm numbers or low motility. Alternatively, infertility can be due to a “female factor.” This can be related to an ovarian factor and an issue with ovulation, or egg quality, which often declines as a result of increasing maternal age. Other female factors include an issue with the fallopian tubes being blocked or poorly functioning, or a problem with the uterus or womb which does not allow a pregnancy to implant or develop.

Why are conversations about infertility and pregnancy loss rife with stigma?

BK: People feel immense pressure to be able to have their own child. Therefore, if there is difficulty having a child or conceiving, people often feel like a failure. It’s a sensitive and intimate subject and so many live in silence and do not feel comfortable sharing their stories.

As a provider, I allow my patients to open up and share their stories from the first moment I meet them. I make sure they are so comfortable, that they feel like they are having a conversation with their best friend. This allows patients to finally open up and express all of their emotions, which they had been otherwise holding back. And most importantly, I want them to know they are not alone. Infertility and pregnancy loss are far more common than we think, because so many suffer in silence.

MJM: Indeed, sometimes people do feel a stigma—which they really shouldn’t. At least 10 percent of couples will have significant infertility issues, and we need to support these couples as they go through the process of trying to conceive.

How do the cost barriers to infertility care impact access?

MJM: Fertility therapy can be costly, and its coverage varies from state to state. Just the cost of some of the medications used to help people ovulate (one of the causes of infertility is not ovulating well) can be thousands of dollars.

BK: There are some states that have mandated coverages for infertility testing and treatment, but the majority of states do not. As a result, many couples delay getting tested to determine the cause of their infertility. This delay can have a huge impact, as some forms of infertility are treatable through surgery, medications, or supplements.

Unfortunately, for the majority of couples with infertility, treatments tend to be out of pocket—and some services like In vitro fertilization (IVF) can cost upwards of $20,000. This cost can be prohibitive to getting the proper treatment.

Can you talk a little bit about the psychological toll of infertility? Do you have any suggestions for patients on how to cope with it?

BK: Infertility treatments are hard and take a physical and mental toll on all couples. Not only can there be physical pain as a result of the injections, and bloating and discomfort throughout the process, there is also an emotional burden. The hormone therapies can make people feel more emotional or have mood swings. Additionally, treatments are often described as a roller coaster with ups and downs. All of this can have a significant psychological impact.

My recommendation is for couples to find a support group. Finding support allows couples to talk more openly about their struggles, the many ups and downs of the process, and also hear success stories. These success stories often provide hope that can push couples through the difficult times.

To that point, many of the couples I know dealing with infertility and undergoing IVF struggle with intimacy. Why do you think it’s so common for intimacy to suffer when a couple is going through infertility?

MJM: Going through the infertility process can really take the fun out of having sex. The medicalization can take sex from a loving and fun event to a chore; but it’s always good to still view it as a solid part of your relationship and make it as enjoyable as possible.

BK: Unfortunately, when trying to conceive, there is a lot of pressure to have intercourse and get pregnant that month. We all know that ovulation occurs one day of the month, and that is why there is a lot of pressure to have intercourse around the time of ovulation. But this often puts a lot of strain on a relationship. When sex is scheduled it is less fun, and often partners feel incredible amounts of pressure to perform. This can affect a relationship long-term. Some have described that sex becomes a chore rather than a fun and intimate connection. It’s important to recognize if this change is taking place in your relationship, and make sure to have intimate moments outside the fertile window as well.

When patients start coming to you, what are some of the most common misconceptions they have about IVF and infertility care?

MJM: Many couples don’t know about infertility care. And the first thing to understand is that it’s ideal to start by talking with your OB-GYN provider first, before jumping right off to an infertility doc. Many of the preliminary tests can be done by your regular provider, and they can start doing some interventions.

For example, if you are not ovulating well, there are some oral pills that can be used to help. You don’t have to jump into injectable medications right away. So start with a conversation with your regular provider, and go from there.

BK: Patients are often so worried that seeking a fertility specialist or sexologist in Delhi means they have to have IVF. This is a myth. There are so many ways to naturally optimize fertility, such as through the use of vitamins, supplements, and dietary changes. There are fertility-friendly lubricants, such as Pre-Seed, which can help increase the chances of getting pregnant each month. Also, many worry that treatments are expensive, but there are many ways that treatments can be made more affordable for couples.

Most fertile people do not understand how hard it is to be infertile. No one can truly understand the grief, sadness, and struggles that couples go through when trying to conceive and being unsuccessful.

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