When Baby-Making Takes A Toll On Your Sexuality

Jessica Preston

Thank you so much for having me. It is my pleasure.

Betsy Greenleaf, DO, FACOOG (Distinguished)

This must be a fun thing to work with couples on this. I know we were talking the other day; your success rates are through the roof, which is amazing. I was going to ask you, When you were starting with couples, where do you start with, and how does that fertility stress impact what patients are going through when couples are going through?

Jessica Preston

Yes. Thank you for asking that specifically. As for stress, I know we do a lot with nutrition, stress, and other lifestyles, but it is stress that is impactful on relationships specifically. When we think about the science behind it when we are in stressful states or fight or flight, the way that that impacts our physiology is that we end up with an increase in cortisol, which is another stress hormone, and other chemicals. When that happens, it can impact our testosterone or estrogen. Those can go down. It can impact our fertility. But when those sex hormones decline, we also see a decrease in libido in that space as well.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I remember years ago, and I have two kids now that are in their teens. But I remember that the whole fertility journey was a pain in the buttocks. You go through so many years in your life and you think, All right, well, I am just going to go off birth control, and it is just going to happen because I have tried so many years not to get pregnant, and then all of a sudden it did not happen. This became extremely stressful, as I previously stated. Those are the two things you do not want to have to go up there.

Jessica Preston

Yes, exactly. When that happens, I tell everybody we work with that trying to get pregnant is fun for one month only because you are excited and you think you are going to get pregnant right away. Or you might not, but you think it is not a big deal until you end up getting your period when you think you have done everything right, and you cannot help it, even if you do not feel the high-stress level. It does impact us to say what went wrong here, and then we will tell a little story or we will say, Okay, we have told you it takes longer to conceive potentially. Maybe it just wasn’t this month, but after that, trying becomes trying. 

I remember when I was on my fertility journey because we struggled with conception, but we did end up with twins with some assistance. But I remember on one occasion in particular when my husband was more interested in doing the dishes than he was in doing his wife. It was impactful to me that I thought, This is crazy, that that could happen where the stress is so high that it completely distracted me from something so pleasurable historically.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That starts to affect our relationship, too. Now that starts to add on itself because, all right, sex now becomes a stressor, and then that starts affecting the relationship. Then how do you heal that to bring things back during the time of trying to get fertile and then also to save that marriage or relationship forever going forward?

Jessica Preston

I think that it is important to be aware very early on that this is a normal thing. The sooner we can be aware of that, the sooner we can start speaking as a couple about how we can get through this. It is exactly right. What you are saying is exactly right. The people that I work with and the things that go through your head, especially people that have been challenged for a while with fertility, start looking at their partner and pointing fingers at each other, and they cannot help it because of the stress state. 

But that is insidious. It gets there slowly in the beginning. You can pull away from each other a little bit and just say, Okay, I am doing my part, and you are doing your part. But then eventually there is a little bit of a disconnect, which can be more of a rift. The sooner we see, Okay, this is going to be. We are going to have to put some effort forth here to address the elephant in the room, talk about it early, and then if you need some help, get some help, and just try to have an open conversation.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Sometimes I wonder, even on that fertility journey, if it gets to a point where one person in the couple may want that child. The other one is, Well, I am just going along for the ride because this is what the partner wants. then that even becomes this relationship rift.

Jessica Preston

It can be that I find that it is not as much that a lot of the time, and there might be one driving person. But once fertility becomes a struggle, both seem to be more involved. When one person is absent, there is usually a reason. It is usually fear or shame. To be honest, it can very much be. I think this is my fault, so I am just not going to want it out of fear that it might not happen. I am going to pull back out of the situation, and that causes a rift as well. When the other person is saying, We can do it, we can do it, we got this, let us make this happen. 

Addressing those parts is important as well. In a nice conversation, we do a lot of work. I do a lot of work with something called Imago Dialogue. We recommend non-violent communication. These are Marshall Rosenberg’s works. This is how you can have a conversation and address an open question with your partner, such as I am feeling a certain way. Are you open to having a conversation with me about it?

Betsy Greenleaf, DO, FACOOG (Distinguished)

That is, it seems it comes down to any relationship, whether you are trying to conceive or you are just maybe having stress or stressors when it comes to libido in general, it seems the key answer to all this is communication.

Jessica Preston

Very much so. Absolutely. I am a big fan of love languages. I do not, where you learn what your partner’s love language is and then try to apply it. We cannot respond to our partner in the way we want to be loved. We need to love them in the way that they need to be loved. I think it is important, whether it is fertility or otherwise. How are we going to nurture our partners so that they can feel safe, loved, and secure so that we can have these conversations and openly communicate?

Betsy Greenleaf, DO, FACOOG (Distinguished)

Then when does sex? I remember there was one time when we were trying to have kids, and it was when I was ovulating. You did that ovulation predictor test, and you just looked over at each other tonight. I do not know, I do not feel this. But it was this whole, whole pressure. If we do not do this tonight, it is going to be another whole month. But the reason I bring that up, too, is, when sex starts to become a chore, are there other ways to connect?

Jessica Preston

Yes. Without. Yes, absolutely. There are several things. First of all, No, it is a chore. No, it is for a purpose. We have gone from play to purpose in our sexual lives at that point. Play seems to be on the back burner; remember, play, introduce new things, explore new areas, and dive into that if you are willing. Some couples are more adventurous in that space, and some are less adventurous, and everything is acceptable. I think that is something that everyone needs to know. Whatever your sexual life is for you, it is completely normal and acceptable. so find a way. 

Laughter is key. I am trying to find a way to connect, know that you are in this together, and bond in that space. Also remember that when we have touch, even just physical touch, spend one. I recommend if you go out on a date per week, and I know everyone’s busy, and maybe you cannot but find a way to snuggle on the couch or cuddle in the mornings or on Saturdays because just a physical touch does not even have to be intimate in any way. Physical touch increases oxytocin, and when we increase oxytocin, studies have demonstrated that an increase in oxytocin will decrease cortisol. 

Cortisol is the stress hormone we discussed earlier, and when it rises, it is fight or flight for us. That is one of the major stressors that impact our sex hormones. Even if just the oxytocin from physical touch is going to help, know that that physical connection is going to make a difference for you and find ways to fit that in. Watch a movie together, make it light, make it fun,  and just enjoy each other’s company. On those days, just as you mentioned, we had the same thing on earth today and every other day during this period. You have to work early, and I have to work late. How are we going to do that? We have got 15 minutes and a performance. What is that going to be? Make it the best. Do the best that you can. I would say to play with it and try to have some fun. 

If you cannot make it through, here is the part that nobody wants to think about. Having the baby is the easy part. Once the baby is here, you are going to be challenged with trying to figure out when you are going to have sex. so you might as well practice now. Prep while there is no baby around. How are we going to make this work, then? Just use this as practice and find ways that are going to work for you.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That is the key because once the kids come, it is a whole different story.

Jessica Preston

You do not even know certain things.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I was thinking about it too, but I forgot what I was going to say about what you were talking about. I forgot the question, but I guess what other specific techniques can you recommend to help bridge that gap and create a more fulfilling connection with a couple, especially when we are under stress? I know what I was going to talk about: this role of stress, I am always talking about how stress and sex do not exist at the same time. You see this time and time again with couples that cannot get pregnant, and then they give up or they adopt. Now that stress has taken off, all of a sudden they get pregnant. Doesn’t that mean there is another stressor?

Jessica Preston

Yes, that chronic stressor. You do not even. whenever we have that shadow of infertility over our heads, it does not lift. It is always there. We just make it through the days, but it does not change our neurochemistry. We still end up in this phase where our cortisol is higher, our hormones are impacted, and our mood is impacted. When our mood is impacted, that impacts our serotonin and our dopamine as well. That has a cascade effect as well. We feel a little less light, and when we have that and it becomes normal, it can then just feel consistently the same. But it does not mean that the hormones will normalize. They are still high. 

When you then adopt and now you are distracted from that and you are not thinking about it every day and you have a baby, we all, those of us that have struggled with fertility, want to kick someone in the face nicely if they say, Just relax and it will happen. But the truth is, once we are no longer in that stressful state related to our fertility, then those hormones can be regulated. then it is not relaxing. It is that the fight-or-flight state has now alleviated itself. Our cortisol is in a different space. Our estrogen and testosterone levels can rise. Our serotonin and dopamine can be better. Then we can be in that space where we can conceive. 

I think people do not realize the science behind it. When we have those stressors, the stressors change our chemistry. The chemistry causes us to not conceive. That is what we have to be aware of. We become parents. Then there is all of that that goes with being a parent. When you adopt, right? Your oxytocin does go up. We are snuggling with our baby. All of our hormones say I am a mom; you are a dad. We get into that actual chemical state, where that is what we are. We accept it holistically with our whole body, and then we can conceive.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I love that for that brain-body connection. When you are working with couples and because of this stress level and this pressure, you almost always put this internal deadline on things, especially for women. It is unfortunate. As we get older, we start getting labels for advanced maternal age. You feel this. There is this ticking time bomb. What other things can you recommend to couples, to just step back and reduce that level of stress?

Jessica Preston

Knowing that you are a team with good communication is number one. The first thing that we need to do as individuals is accept that we are on this journey and that we can conceive. We work with people, helping them with their nervous system regulation, so we get their bodies out of fight or flight, get them to rest, digest, and procreate, and then we help them with baby blocks. We do a very mild, gentle form of hypnotherapy that helps couples, and we have them do this work together. 

Things that you can do together with the understanding that we need some time alone as well are important. Great communication. Babe, I love you, and I need this time with you to spend with you. But I need a little bit of time by myself just to collect myself, be okay, and come right back to you and put an end to what that means to me. I just need an hour. then how about at 9:00? We get together, and we can watch the next episode of fill-in-the-blank and snuggle on the couch. How does that sound? 

Having that communication back and forth, not just an open-ended on both sides, not just an open-ended, I need some time to myself. Because now your partners feel you are separate, even more saying I need a little time to myself. When are we going to touch base again? Having that plan is a very safe, nervous system thing for both parties. saying this is where I need to be right now. Let us connect at this time. How does that sound to you? Get an agreement and stick to it. I think that is very important. 

Another thing that we do a lot of work with is teaching introductory tantra ideas and thoughts because, in tantra, a lot of people think that this is crazy sex or whatever. Do whatever you want. As I said, your life is normal. Your sexual life is normal as long as it is yours and in agreement. But tantra is intimacy. We teach eye gazing, and we and you can have a couple that has been together for 15 years and they cannot stare into each other’s eyes. They were just staring at a pimple on my face, or, I swear, they were just thinking what I was thinking. They were thinking I was thinking terrible things. But you get people doing this regularly, and it does increase intimacy. You can watch them visibly relax as a partner, as partners, as a couple, and then it allows them that space to have more communication, let their guard down more, and have more open communication.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That is what I wanted to ask you to do. This is so fascinating. What about levels? Do you run into levels of trauma—not necessarily big trauma, but maybe hidden traumas or generational traumas?

Jessica Preston

I need to just make a disclaimer that we are not trauma therapy. That is just that we are not, but we do. Of course, things come up. Trauma is on a different level, and it is a big buzzword right now. Trauma at different levels for different people. You can have people who had major trauma in childhood, and then you can have people who have had little blips of it. But one way or another,  we have the need to feel accepted, loved, and safe. The way that trauma comes in, at whatever level people come in, is a feeling of being unsafe. 

We will refer out if someone needs true trauma therapy, but we do talk a lot about safety. I have a somatic coach, so we are a team of coaches. We have somebody in every area, and we are all there for everyone. We have a somatic coach who talks about the feeling in your body and how you can let that go through you and gives some good examples. We do a lot, a lot with that. But yes, most definitely trauma, the infertility itself is a little T. This is my dream, and I thought I could have it. Since I was a child, I wanted a family. What does this mean? Then the story stops, and then we do not know what to do with this story. 

We are lost, we are isolated, we are alone, and we are afraid because our community around us has gotten pregnant. Our sister got pregnant. Our best friend got pregnant. Now here we are, where everyone’s saying, Are you pregnant? They see you are not drinking your glass of wine. How about now? You do not want to go to anything? We are running into the holiday season here shortly, and we end up having a lot of conversations in our community about how we address when people bring things up and how we prepare ourselves before going into a conversation. How do we prepare ourselves before going to a family dinner or a holiday party? We must get that reserve so we can build some resilience. It is slow and steady, but it is us every day.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Then, sometimes even within couples, because if we are starting to get into that fight or flight, even just the simplest touch control is making us jumpy, and here we are. We are supposed to be calming that nervous system, but you almost get defensive in that situation. Any tips to, at the moment, decrease that nervous system so that you can get that connection with the partner and get the act done?

Jessica Preston

If someone cannot be physically touched, I recommend sitting, eye gazing, looking into each other’s eyes, not speaking, and breathing in synchrony. that helps soothe people’s nervous systems. Then they can find themselves on the same page a little bit more. Now, if you are down to 15 minutes, that might not work for you. I will be very honest: if you are feeling you cannot be touched and you are going to detest it for 15 minutes, skip the month. Worse things have happened than skipping a month. Try again next month. Give yourself a full 30 days and then focus on how we can connect better so that next month is easier, as frequently as one person is. 

As we said, Go-getter, let us do it. The other one is that I need time. We feel like teenagers all over again. He is going to take me to the movies. Is he going to want to kiss me? If that is where we get, and we are 35, 40, or 45, and we are thinking, Why is this happening? But it is normal. I just want to keep saying over and over again that this is so normal. We all get here, and we are confused, scared, and do not know what to do. Just slowly take the steps. Know your partner. This is the person you chose to spend the rest of your life with. Just nurture each other and love each other through it. You can get there.

Betsy Greenleaf, DO, FACOOG (Distinguished)

This is great because of a lot of the techniques that you are teaching. I am sure the couples do not see this as a gift when they are in that moment. But I almost feel they are the lucky ones because they are learning these techniques versus someone who just got pregnant and now has to deal with similar issues of intimacy later on in the relationship as opposed to, okay, we are learning that. We are learning the skills now, and this is going to help us going forward.

Jessica Preston

Yes, we have been surprised ourselves. I will be very honest with you. We are completely in love with our system because we see exactly that. We have gotten to the part about saying getting pregnant is the easy part. The rest of it is developing communication styles and having this connectivity with our partner that you never would have expected in terms of love and intimacy. We teach intimacy and eroticism. We teach both extremes of that because when you get there, you do not want to be the best friend; you want to be the best friend, but you do not want to be just friends. 

We need to make sure that we are still in that space of how we keep this going. It is incredible watching these couples adore each other, and that is the right word. Just the look in their eyes of adoration for each other. This process is everything. I cannot wait to see how these families grow even more and have more babies, and how those relationships and communication styles can increase all of that love and intimacy that we have in the world.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That brings up a good point. I have to ask you: what is the difference between intimacy and eroticism? Because, especially once the kids come, I do not want to scare away people who have not had kids. Yes, but once the kids come, you can fall into that roommate situation where it is, say, a roommate.

Jessica Preston

Yes. That is exactly right. I am so glad. That is why I gave that warning early on when we were talking about just starting now, finding a way to have fun, and doing everything now. Intimacy is closeness. It is a connection in such a way that it makes us feel incredibly safe. Eroticism, we enjoy it as a mystery. When we are incredibly safe, connected, and intimate with someone, the mystery seems to be gone. It is important. 

There are some skills and that. Esther Perel, I do not know if you or anybody else yet follows her. She is amazing with intimacy and eroticism. What can we do to keep the erotic A lot of it is to observe your partner out in the wild. When you are out at a holiday party or whatever it might be observe how dynamic they are out and speaking with other people and having some mystery. I do not mean secrecy—nothing that makes people feel unsafe. Humor is great sarcasm for those who can. I am not a sarcastic person, and I do not tolerate it well, to be honest. It does not hit me right. But for some people, it does help with the eroticism piece. 

Then once again, in your sexuality, you can find places in that space where you can figure out what is acceptable and safe, where you can push the line a little bit, where it is comfortable for both of you, and make sure you have that open communication. We recommend having that open communication established first. But also the other thing that is a little an interesting conversation, but I think it is important to bring up because all of it for people that are starting families is that there is a concept, and this is, I would like you to think of this from an observer lens. I am not asking about us being in a relationship, but from observing outside of the relationship. 

There is always the potential that someone can interfere in your marriage and your relationship. Hit it head-on. How are you going to deal with that? Because that is a safety piece. It is not erotic when you feel your relationship is being threatened; it is a safety piece. But have that conversation. These conversations were putting it out in front of us. When we are having fertility struggles, women frequently say, Why would my husband stay with me? Someone could get someone else pregnant. We do a number on ourselves, and we get into a toxic spiral with that. We need to not have that happen because what will happen is that we will pull back from our husbands or we will be angry with our husbands because of our thoughts, and they can do the same. 

40% of fertility struggles have a male factor, so men are frequently emasculated in this space. We do a lot of work with men in men’s work, and men support men in this space. For them to know that my wife loves me, they are emasculated. They feel they are less of a provider, less of that strong masculine. We must have these conversations when they come up in our minds. Even if they do. I heard this on this summit that I was listening to, and they said they brought this up. Communication should happen. We should have the conversation that there can always be the thought that someone else might be in your life. There is no one in mind, but I worry that you might find somebody else more appealing and that you could have a baby with somebody else because, as I thought, I feel I am falling short here in that area, and I would like to talk about that. 

Are you open? I love that. I’d like to talk about that. Are you open? There is no acute accusation here. I am not saying you went and slept with you; fill in the blank or whatever. I am just saying this is how I am feeling with my security space. How are you feeling about this space? Can we say, What are we going to do if we feel this way? How are we going to communicate? It could simply be a safe word or a keyword. I am going to say, Orange monkeys, whenever I am feeling insecure about some woman in your office, you are going to know, and I do not have to have this conversation. then that means tonight you can just bring me a little extra love.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I love that. I think that is amazing for the fertility space. But I am also thinking that this is something we could all be carrying forward and take tips from because that is so. You made me start thinking that I have been married for 20 years. I do not think I have ever had that conversation. This is great because you could use this for everyone as an excuse if you just come out of nowhere, it might be a little weird, but that is how I am going to plan on doing it. I am going to be. Hey, I was interviewing somebody for the summit. You guys can all say you were watching the summit and this came up. Let us talk about this. I love that. That is a great tip. 

Is there anything that I did not ask you that you can think of that you think is important for us to know?

Jessica Preston

I think the one thing I wanted to make sure everyone knew is that your sex life is still going to suffer once babies come along and find ways to be creative, and no, this is more of a libido summit I would recommend, as for all, libido starts with communication, connection, intimacy. Everything else, when we started with libido when we first started dating and everything was hot and fantastic, and then life gets in the way, schedule it if you have to. Prioritize what you have to. Understand that you are both going to be going through phases where there is going to be a lower libido. It is not personal. It is never personal. 

Have the conversations and just keep the communication open, develop deep intimacy, and then play with the erotic. Esther Perel Gottman Institute, they have gone into the Gottman, and there are huge amount of information there where you can start learning about the conversation. Learning about the Imago Dialogue is huge. You can print out and print out a little Imago Dialogue. I can even get you some Imago Dialogue handouts. Sit on the couch and practice together while you are reading a script. Nonviolent communication is very good, and people just love each other. I think that is it.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That is beautiful. Before we go, I just want to ask if you can do a couple more examples of the Imago Dialogue, just because I want to highlight that one. That is good.

Jessica Preston

Okay. I will tell you. I have a team of eight coaches, and I have two rock stars at Imago, and I am not one of them. Whenever we practice Imago with our couples, I am the first one to raise my hand and say, I am going to be the one that you are going to watch. That does not do this well. But I have some, and I am very grateful. I give myself a lot of grace and kindness to be able to communicate. 

We had a sample. I will give you an example of when we were practicing as a team before for our coaches to practice together, and I had one of my coaches come up with an idea. These are two people who speak very well and fluently in Imago. She said she was pretending it was her husband. She said it. I always feel I am the one who has a concern, and I would like to talk with you about it. You always say what it is about. Do not leave someone hanging. I want to talk. Do not say it at breakfast. I want to talk with you about something else tonight. They are going to think about it all day. I want to. I have something I need to speak with you about. Are you open? Do we have some time tonight to speak about this? What I would like to talk about is, or you can say what it is about. Which I would probably do, and what might be better is, There is nothing wrong. There is something that I am not angry, about anything. I am just stuck on; the fact that the toilet paper cannot ever be put on the toilet paper roll. I do not know. I do not know why it is bothering me so much. Are you open to having a conversation? Then the response was, Yes, I can have that conversation. 

Imago is one person bringing forth a concern and the other person only hearing it, not giving anything else. I am Mike Butcher. This is a little bit because I am not the pro on this, but she said something along the lines of, The toilet paper is right there. I am not sure why I am always the person who has to put the toilet paper and the toilet paper roll. The partner said, Okay, so what I am hearing is that you are frustrated because you are the only person putting the toilet paper on the toilet paper roll. She said, Yes. He said, Is there more? She said, Well, I am not sure what it is about that, but it just seems that when I sit down, it just makes me feel so upset, and I feel like I am asking for such a simple task that I feel you could do it. 

Then he said, Okay, so what I am hearing is mirror back. Is there more? You say, Is there more until there is no more? Mirror back and then say, I can see how you would be upset with me about that. You have mentioned it several times, and I have not done it. Maybe if we put a roll of toilet paper on the back of the toilet so it was conveniently there, then maybe that is a way that I could remember to put the toilet paper on the toilet paper roll. How does that sound? She says, Yes, I think that would work. That is an example. 

But what was beautiful about this with two people who were not partners, but we were just practicing that she at the end, and this was a real scenario in her own home, she said. What I realized was in his not putting the toilet paper on the toilet paper roll, I felt I was not being loved. It was just such a simple act of love that was not thought of by your partner. In this communication style, we are not triggering each other; we are not defensive. We are learning from each other; we are learning from our partner’s communication styles; and we are learning about their needs. Remember a while ago I said, Learn how your partner needs to be loved, not how you want to love them. She loves him by putting the toilet paper roll on. But that means he is not seeing it. He does not see that part. What he is seeing is what his love languages and messages are. 

In learning Imago we get to be curious. Curiosity is one of my favorite words. We get to be curious about our partner. We get to learn all of those pieces of them that are just subtle that they need. When we meet those needs, we see them light up. When we see them light up, we can see all of that intimacy connecting. You become a couple or a team; you work together, and then it is more fun and playful. You can easily then have a deeper conversation about: Where do we want to take this sex life of ours? What might be a little bit different that we want to introduce to be able to spice it up and add eroticism? It is a beautiful cycle.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That is, that was a great example. That was amazing. Where can people find out more about you and the work that you do?

Jessica Preston

Okay. We are at Denovo Fertility. Denovo means to start anew. We were starting anew with all of our couples, and we are at DenovoFertility.com, and you can find us there. If you have questions about us, you can send an email to [email protected] and feel free to reach out. We do discovery calls. If you make a discovery call, you will get one of our coaches. You are not going to get a sales force or a sales call. You are going to be able to speak to one of our coaches directly and ask any questions that you might have.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That is great. Thank you so much, Jessica, for taking the time to talk to us. This has been amazing.

Jessica Preston

Thank you so much for having me. It was all my pleasure. I hope it was helpful.

Betsy Greenleaf, DO, FACOOG (Distinguished)

All right, everybody, make sure you go check out Denovo Fertility and stick around because we have more great sessions coming up.