Infertile Men And Mental Health Issues

Infertile Men And Mental Health Issues image
Infertile Men And Mental Health Issues

Infertile Men And Mental Health Issues

Infertility refers to an inability to procreate or impregnate a woman despite recurrent successful attempts of sexual intercourse for a period of more than 2 years. The clinical criteria and diagnostic classifications varies; but regardless of the pathophysiology, infertility can have deleterious effects on the quality of life of any male.

According to latest statistics reported by American Society for Reproductive Women (1) investigators reported the prevalence of infertility in the American population to be as high as 5%. Study also suggested that approximately one-third of all the reported cases of infertility are primarily due to male issues.

What Are Some Implications Of Infertility On The Mental Health Of Males?

According to a new report released by Harvard Medical School (2), investigators reported that as many as 1.3 million males who seek fertility counseling, reports psychological stress and other mental health issues. The most common signs of mental stress are;

  • Recurring episodes of moderate to severe headaches that may interferes with the capacity of the individual to perform day-to-day activities.
  • Emotional outbursts and negative changes in mood.
  • Signs of anxiety, agitation, irritability and depression (as evidenced by changes in heart rate, onset of recurring stomach pain due to dyspepsia). According to a Taiwanese study, investigators reported that the prevalence of depression and anxiety is much higher (23%) in infertile males as compared to general population (only 11%).
  • Inability to sleep properly at night (includes insomnia, frequent awakenings at night, poor quality and rhythm of sleep).

Quality of Life and Male Infertility imageBesides psychological issues, a number of males also develop physical ailments and sexual dysfunction (especially symptoms like poor libido, low sex drive, erectile dysfunction etc.) are extremely common in infertile males.

According to a new study conducted in over 200 infertile couples, more than 15% participants agreed that learning about the infertility was the most unexpected and depressing event of their lives. Study also suggested that infertility news impact males more significantly than females and may culminate in poor self-esteem and depression.

In most cases, infertility is reversible with lifestyle modification, use of certain drugs and other assistive treatments. Research and clinical data indicates that small changes in lifestyle (such as quitting smoking or limiting alcohol consumption) can also improve fertility. In many cases, the primary cause of infertility is excessive mental stress (due to work, personal matters or due to delay in conception). According to a study reported in the Indian Journal of Medical Research (3), investigators suggested that chronic mental stress can negatively affect the quality of sperms and semen. Based on the analysis of semen obtained from 27 volunteers, it was observed that high mental stress is related to high serum levels of superoxide dismutase as well as the enzyme catalase in the serum; directly contributing to the poor motility index of sperms and overall concentration of spermatozoa in the semen.

Additionally, there are so many interventions that can help in addressing the distress and psychological discomfort caused by infertility; such as:

  • Assistive reproductive techniques
  • Adoption or fostering a child

Investigators analyzed 545 couples (1090 males and females) who were undergoing infertility treatments; such as in-vitro fertilization (IVF) to conclude that at least one psychiatric condition was present in about 10.2% males and 30.8% females. The high prevalence suggests that infertility as well as treatment process is stressful and optimal interventions should be sought for excellent results.

Infertility And Interventions To Restore Optimal Mental Health:

Psychotherapy is the best option in all such patients who are dealing with mental stress due to infertility.  There are several varieties, but investigators believe that following two options must be considered in all the cases as a preventive option.

  • Interpersonal therapy: The news of infertility often compromises the quality of relationships; further worsening the stress element. It is therefore advised to opt for interpersonal therapy to improve the quality of relationship with the partner in order to resolve conflicts and look for practical solutions.
  • Cognitive behavioral therapy: This therapy aims to improve the cognitive processes in the individuals to alleviate stress.

Besides counseling, you can always opt for proper medical help to address the infertility and resulting mental distress. Most promising interventions are:

  • Medications: Pharmaceutical agents like anti-anxiety drugs or antidepressants can help a great deal in controlling the symptoms of severe mental ailments; where counseling doesn’t help. It is very important
  • Relaxation techniques: In mild to moderate cases, relaxation techniques are definitely helpful and includes meditation, yoga, hypnotherapy, guided imagery, deep breathing and other stress relieving exercises.

It is highly advised to speak to your doctor to learn more about the possible causes and pathophysiology of infertility.

References:

1. https://www.asrm.org/detail.aspx?id=2322

2. http://www.health.harvard.edu/newsletter_article/The-psychological-impact-of-infertility-and-its-treatment

3. Eskiocak, S., Gozen, A. S., Kilic, A. S., & Molla, S. (2005). Association between mental stress & some antioxidant enzymes of seminal plasma. Indian Journal of Medical Research, 122(6), 491.

4. Volgsten, H., Svanberg, A. S., Ekselius, L., Lundkvist, Ö., & Poromaa, I. S. (2008). Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Human Reproduction, 23(9), 2056-2063.

5. Repokari, L., Punamäki, R. L., Poikkeus, P., Vilska, S., Unkila-Kallio, L., Sinkkonen, J., … & Tulppala, M. (2005). The impact of successful assisted reproduction treatment on female and male mental health during transition to parenthood: a prospective controlled study. Human Reproduction, 20(11), 3238-3247.