Sexual Dysfunction and Its Impact on Fertility - Insights from the 26th SMSNA Annual Fall Scientific Meeting
At the second day of the 26th SMSNA Annual Fall Scientific Meeting, Dr. Jessica Yih highlighted important considerations regarding male and female sexual dysfunction as barriers to conception. Erectile dysfunction (ED) is common in males seeking care for infertility, while dyspareunia, or pain during intercourse, is frequently observed in females undergoing fertility treatment. Dr. Yih suggests that these issues are often linked to the heightened anxiety surrounding fertility and family planning.
Clinicians and fertility specialists should evaluate both partners. For the female partner, a thorough pelvic and vulvar examination is recommended, with specific attention to the vestibule and pelvic floor tension, as these may be sources of pain. The most common causes of dyspareunia include vaginismus (involuntary clenching of the pelvic and surrounding muscles), provoked vestibulodynia (pain at the vestibule upon touch), pelvic floor muscle dysfunction, and endometriosis. The male partner should undergo a standard ED workup, including semen analysis, hormone testing, and related evaluations.
When sexual dysfunction is present, fertility treatment should begin with addressing the dysfunction itself. For female partners, treatment options may include pelvic floor physical therapy, vaginal dilator therapy, and botulinum toxin injections. Additionally, Dr. Yih recommends home insemination kits as an alternative when penetrative intercourse is difficult. She also advises that female patients consider not disclosing their fertility window to their partner, as doing so may increase pressure and anxiety for both individuals.
Ultimately, Dr. Yih emphasizes a multidisciplinary, couple-centered approach that acknowledges and addresses these significant yet often underrecognized aspects of sexual dysfunction in the context of fertility care.
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