Do you have a sex problem which you would like us to help sort out? Write to us here and we'll do our best. To kick off this series of sex advice, Dr Karen Gurney, @thesexdoctor on Instagram, and director of the Havelock Clinic, answers one reader question...
Help! I've recently had a miscarriage which ended in surgery. Although we've come to terms with what happened my husband and I tried having sex last night but it felt clinical and I ended up an emotional mess. I really want to get jiggy again, I miss sex but I feel my fanny and everything inside is broken. All I could think of was the docs, jabs and ultrasound probing. How can I feel sexy instead of a Holby City extra? X
Dr Karen Gurney says:
I’m really sorry to hear about your miscarriage.
The psychological effects of miscarriage have been well documented and it can be a real struggle to manage the loss, sadness and grief for both partners. Up to 15% of women in one study experienced clinically significant anxiety or depression after a miscarriage, so the first thing to check in with you on is your mood. Anxiety and depression have an impact on our sex drive and also our ability to get turned on during sex, so it’s important to note that the grief and sadness hasn’t become a more established mood difficulty that needs further help. Talk to your GP if you have any concerns about this and they can point you in the right direction.
Saying that, from your message it seems you are keen to get back into sex again, so perhaps it’s more the experience of miscarriage and the medicalisation of your bits rather than your mood which is getting in the way and this would be really normal. Medical procedures, trauma or investigations can sometimes leave us associating our genitals with clinical examinations which can be unsexy at best, and traumatic at worst. Our brains are great at putting two things together to make an association, it’s part of how we make sense of the world and learn. If an experience was particularly difficult or stressful, our brains try to be helpful by making this link more quickly (thanks brain!). When this happens with sex it can be annoying, as the sensation of touch which used to be associated with, say, sexy thoughts and excitement can be hijacked by more negative brain associations such as images or memories of legs in stirrups, the feel of rubber gloves on skin, or fear. This process reduces our ability to get turned on, making any touch to our genitals feel clinical and totally unsexy, further reinforcing the problem.
It’s not just the partner who was pregnant who can experience worries about sex after miscarriage., For both partners the act of sex can be a reminder of what has happened and can lead to low desire, or difficulties with erections or orgasms.
The best way around this is to make sure that you get back into sex in a way that has the fewest associations with the medical procedures as possible. For example, it would be a good idea to avoid penetrative sex, or any positions or types of touch which you associate with what happened as much as possible at first. There are plenty of parts of your body or types of sex that you can have that won’t have those associations - start with these first and then, only once you’re used to being sexual together again, move on to penetrative sex.
Lastly, talk as much as you can together about how you feel and what’s on your mind about sex. Use each other as a resource to brainstorm what might help, try it out but if it doesn’t go to plan allow yourself to be as ‘emotional’ as you want, you’ve been through a lot and you’re on a journey with this that will change over time. The other thing to say is that it’s great that you feel like having sex at all at this stage. Nurture that, and don’t feel that the sex has to be earth-shattering at first. With a bit of patience, perseverance and communication the association should quickly wear away and you’ll soon be back on track having the sex you want.’
Dr Karen Gurney
Clinical Psychologist and Psychosexologist
Director- The Havelock Clinic