While a tight correlation exists between sexual dysfunction and infertility, sexual dysfunction is not considered a cause of infertility, which is defined as such “after two years of regular sexual intercourse, without contraception.” Medical experts on infertility, including physicians, nurses, and counselors, have recently attempted to integrate sex counseling into their expertise. I describe the current situation surrounding infertility medical practice in Japan and suggest several potential ways to link sexual health with infertility treatment.
The following explains the recent increase in collaboration efforts between sex therapists and medical experts on infertility.
1. Progress in reproductive medicine has made treatment choices more inclusive and difficult. As such, care providers of sexual health as well as infertility treatment are now finding themselves more heavily involved in the decision-making process concerning patients.
2. Ten years ago, The Japan Society for Infertility Counseling was founded, representing a turning point when medical experts on infertility recognized sexual dysfunction as part of their target objectives. Sexual dysfunction and infertility: Two categories of problems exist with regard to sexual dysfunction-related infertility.
Category 1 is sexual dysfunction, which can cause sterility due to issues such as erectile disorders (ED), vaginismus, or ejaculatory disorders. Previously, most of our patients with female sexual dysfunction (FSD) were affiicted by vaginismus, and desired to pursue pregnancy through sex therapy. Today, many patients with FSD still pursue childbearing, and an increasing number of people elect to treat infertility that does not require sexual intercourse.
Category 2 represents sexual dysfunction due to infertility or its therapy. ED associated with scheduled intercourse has been well researched. Fewer studies on FSD-related infertility have been conducted relative to those on infertility in males. Stress and stress-related diseases are more common among women affected by infertility. While infertility counselors, whose main purpose is to support female patients, can attain skills in sex counseling through listening to their patients, the number of sex therapists who can address FSD remains insufficient in Japan.
Perspectives: Collaborative efforts among experts in sex therapy and infertility treatment are necessary, and infertility counselors would benefit from focusing on sex therapy. Conversely, sex therapists should work proactively to accept and manage referred and difficult cases, while working to obtain updated information regarding infertility treatment, so that infertile couples are not misled.
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