Sexual well-being can change significantly in the face of reproductive challenges, such as the transition to parenthood and the process of medically assisted reproduction. Researchers have discovered that couples face numerous challenges to their sexual health when trying to start a family, with one common challenge being pregnancy loss, experienced by up to 25% of women. Surprisingly, the impact of pregnancy loss on sexual health and well-being is significantly understudied, despite the known mental and physical health implications of such losses.

Existing studies, though limited, show that pregnancy loss is linked to lower sexual function and desire for both partners. Some evidence suggests decreased sexual desire in individuals who were pregnant. Additionally, these studies indicate that pregnancy loss can result in lower sexual intimacy and satisfaction for those who were pregnant and emotional and physiological challenges for their partners. However, most of these studies focus on those with multiple losses, which affects only 1% to 5% of couples, and few include data from both partners in a couple.

To address this gap, researchers launched the Acknowledging Loss Outcomes and Experiences (ALOE) study in 2020. This longitudinal study involved 148 couples who had experienced a pregnancy loss within the past four months. Both partners completed four monthly surveys, and the study excluded couples undergoing fertility treatment due to its unique sexual challenges.

Compared to control couples with no history of pregnancy loss, couples who had recently experienced a loss reported lower sexual satisfaction 3-4 months post-loss and increased discrepancies in sexual desire between partners. Interestingly, the study found no differences in sexual function, desire, or frequency, but partners of those who had lost a pregnancy reported lower sexual distress, possibly because they were prioritizing grief management and supporting their partner over sexual activity.

Participants in the ALOE study also provided qualitative responses about how pregnancy loss affected their sexual well-being. These responses revealed additional impacts not captured in the quantitative data, such as negative health and body image changes, sex becoming mechanical and focused on conception, and the interference of anxiety, fear, grief, and low mood on sexual well-being.

On the other hand, some couples reported experiencing relationship growth and enhanced intimacy following the loss, although most positives were mentioned alongside negative changes. This underscores that pregnancy loss affects physical health, mental health, and the well-being of sexual relationships.

The researchers emphasized the need for better support for couples from healthcare professionals. They found that many couples felt their psychological and sexual difficulties were neglected or invalidated by professionals. To improve support, the researchers offer three suggestions:

1. Discuss Sexuality, Not Just Contraception: Practitioners should address sexual well-being after pregnancy loss, not just contraception. This includes discussing changes to the sexual relationship, offering opportunities to talk about sexual concerns, and providing resources for sexual and mental health.
2. Make Every Loss Count: Professionals should support couples after any pregnancy loss, not just after multiple losses. This includes discussing sexuality and providing appropriate resources and counseling.
3. Consider Partners’ Experiences: Partners often feel neglected by medical professionals after a loss. Treatment models that integrate partners can help address their sexual challenges and support the couple as a whole.

In summary, many couples face difficulties with sexual well-being after a pregnancy loss, and there is a need for enhanced support and understanding from researchers and practitioners. By focusing on sexual well-being in the context of pregnancy loss, the professional community can better support couples facing these challenges.

References:

• Allsop, D. B., & Rosen, N. O. (2024). Addressing the sexual difficulties of pregnancy loss for couples in clinical care and research. The Journal of Sexual Medicine, 21(6), 507–508. https://doi.org/10.1093/jsxmed/qdae044
  
  
• Diamond, D. J., & Diamond, M. O. (2016). Understanding and treating the psychosocial consequences of pregnancy loss. In A. Wenzel (Ed.), The Oxford handbook of perinatal psychology (pp. 487-523). Oxford University Press.