By Dr Camilla Rosan

Lots of couples report that sex becomes routine and montoneous when trying to conceive. This isn’t surprising, as there can be more pressure to have sex more or less regularly then you might usually as well as to have sex at certain times of the month. Sex can become mechanical or functional as opposed to passionate and spontaneous. Couples often “schedule” sex for the fertile window, or sex is replaced with medical fertility treatments.

We know that this can have a negative impact on a couple’s sex life with one a third of couples experiencing sexual difficulties during fertility treatment. Sex and intimacy is one of the issues that all parents argue about the most in their relationship, but it is also one of the areas that gets talked about the least.

There are a number of reasons that couples might notice changes to their sex life:

1.The monotony of routine

Trying for a baby can mean that sex is happening on a schedule. This can be challenging for both members of a couple and can leave sex feeling functional, with the loss of  passion or spontaneity. This can have an adverse impact on the intimacy a couple may feel and in some case can be fundamental to their connection and identity. Many couples also report that foreplay reduces when trying to conceive as there is a need to ‘get on with it’. Without foreplay, adequate time might not be given to arousing each other – and for women this may lead to vaginal dryness and in some cases sexual pain.

2. Pressure to conceive can lead to secondary sexual function difficulties.

Many couples feel a lot of pressure to ‘make this time count’ – as they feel it is their one window for the month to become pregnant. This can make sex a time of high-stress. When our bodies are in this mode – both our bodies and mind respond. Our minds are distracted thinking about ‘how this didn’t work before’ or ‘how this might not work’ and it can be hard to get in the mood. Our body responds by rushing blood to the major muscle groups and away from our sexual organs. As an erection is essentially blood flow to the penis – this can make it hard for a man to obtain and/or retain an erection. Similarly for a woman, this may mean that she is not as naturally lubricated as usual or can struggle to orgasm. This in turn could be interpreted by a partner that they are no longer sexually attractive – and serve to reduce their confidence. You can see how things can get complicated very quickly when stress gets in the way!

3. Feeling down or worried can lead to sexual interest dropping off

Many people struggling to conceive experience feelings of depression or anxiety– and when you are feeling down there is a tendency for your sexual interest and arousal to decrease. Also if you are taking antidepressants, it is possible that they are causing changes to your sexual interest as an unwanted side effect.


Here are some tips on how you can improve your sex life and intimacy:

1. Make time for each other:
It is hard to rekindle a sex life if you are not getting along that well at the moment and the major focus of your life and all your conversations is fertility. It can take over. Many couples find that it is important to ring-fence some alone time each week to connect with the things that brought them together. Create a date night, play sport together, go for a walk – do the things you love as just the two of you.

2. Talk about sex:
It can feel embarrassing to talk about sex with a partner, but having a conversation about how you would like your sex life to be is the first step towards doing things differently.

3. Be flexible with the rules:
You will have been given a whole host of guidance from professionals and perhaps also from the internet about when and how to have sex to increase your chances of getting pregnant. Remember though that having a routine does not mean that you cannot be spontaneous. You can still have sex in between the routine when the moment takes you – wherever it takes you. Be kind and understanding with yourself when you are not in the mood to have sex on ‘ovulation day’. You may find if you let the pressure off – your libido will increase!

4. Invest in foreplay:
There are many different ways to have sex and be sexual and although penetration is the only way to get pregnant – it should be part of a wider package. Build in time for seduction, foreplay and sensual activity. Giving and receiving massages or taking a bath together can be a helpful way to build intimacy ahead of intercourse. Studies have shown that when couples massage each other for 20 minutes, twice a week, it can lead to improved couple relationship and individual emotional wellbeing and infant birth outcomes (which is a great excuse for a massage!).

5. Use lubricant:
Lubricant is fantastic. Using lubricant can help if you are experiencing vaginal dryness and avoid pain on intercourse – and improves the experience for everyone.

6.Vary your sex life:

Do you always have sex before you go to sleep? Could that be when you’re most tired? Do you always have sex in the same position? What about place? Could you try somewhere new?

7. Talk to your GP:
If you are having difficulties with your sex life then talk to your GP and ask to be referred for psychosexual therapy or medication. Psychosexual therapy is available through some sexual health and family planning clinics and from Relate. A range of both private and NHS specialists can be found on the Institute of Psychosexual. Medicine website (

8. Get your medication right and speak up:

If you suspect that any changes to your sex life might be as a result of sexual side effects to a new medication you are taking then talk to your doctor about this. Sexual wellbeing is an essential part of your identity as your doctor should prioritise it as he/she does with all other parts of your health.

Check out online resources such as Relate or NHS Choices on the range of ways you can approach your sex life. A major characteristic of couples who have a happy sex life is that they see sex as a way to have more fun, to feel satisfied, and to feel valued and accepted in their relationship.