Whether it’s panicking about an irregular cycle, queuing up for an emergency morning after pill or actively beginning to try for a baby, at some point, most of us will be confronted with our reproductive health status. ‘Reproductive health’ covers everything from STIs and sexual satisfaction to hormonal imbalances and fertility. But while it’s standard decency to tell a partner if you’ve got a sexually transmitted disease, we don’t really have a disclosure framework when it comes to things like endometriosis or polycystic ovarian syndrome (PCOS).

Given that these conditions often impact our fertility and sex lives, do we owe it to our partners to tell them if we know that conception might be slightly trickier? What if regular pain, bloating or low libido render sex impossible? Does the other person deserve to know why we might not be in the mood as often as they are? 

Gina* lives with endometriosis and tells Strong Women that she’s started to avoid dating people who are sure they want children. “I know there’s a chance that I won’t be able to provide that,” she says, “so I avoid telling anyone I date about my diagnosis because I get the feeling that it’s not a very attractive trait. 

“Sometimes I’ll be in crippling pain on the bathroom floor and I don’t think many people want to know about that. Between that and the chance that I won’t be able to have children, it’s a bit of an ick.” 

Connie* was diagnosed with endometriosis when she was 17 and, like Gina, has avoided telling partners. “Anytime the pain was too bad, I would make up excuses not to see them or put off having sex. I thought that being open about my condition might scare them off, that they’d think I was already thinking about a future together when they might not see us as anything serious.”

Of course, it’s not always about fertility or the initial diagnosis. Alex’s partner knows all about her PCOS and the role that might play in future family planning. What he didn’t know, however, is just how painful sex can be. “Sex was really painful, but I didn’t want to ruin the moment or make him feel that he was doing something wrong.”

When she did eventually tell her boyfriend, they struggled for months with intimacy. “He didn’t want to hurt me, and I wanted to show him it was OK. It affected us for a long time.” 

Ultimately, deciding whether to talk about our bodies is entirely our own choice. But with so many of us grappling with the weight of symptoms and consequences, how can we navigate conversations around these diagnoses talking about them does feel right? 

Ethically speaking, it’s important to be transparent about conditions that could impact fertility, says gynaecologist Dr Deepti Pinto Rosario. “Choosing whether or not to have children is a non-negotiable for many people, which is why I urge every couple contemplating a serious relationship to lay their cards on the table. Your partner may be open to changing their mind but it’s important they know about their partner’s reproductive health at the time that they commit.”

However, she clarifies that deciding when you have reached this point will differ for everyone. Health psychologist Dr Sula Windgassen, agrees: “Some people take things slow, in which case it may not be necessary to open up a conversation that makes you feel particularly vulnerable early on. However, for other people who feel like things are increasing in seriousness or for whom the health condition is becoming a barrier to intimacy (sex or emotional), it may be important to open up sooner.” 

Even when fertility is not the central issue, talking about your reproductive health has benefits for your wellbeing. “Reproductive health conditions can cause a lot of pain and discomfort, which impact how you are able to function,” says Dr Windgassen. “A lot of women keep it to themselves because they feel like it makes them a burden, but this perpetuates an internal message that you have something to feel ashamed of when, in fact, what you deserve is care and understanding.”

A partner can also provide practical support in terms of managing health admin and working out healthcare decisions. “There may be contraceptive choices that could be helpful to consider as a couple. Ultimately, the less you talk with your partner, the more the onus is on you to figure everything out on your own,” says Dr Windgassen. 

While there may be a whole host of benefits to talking to a partner about our reproductive health, it’s still an exposing situation to be in – especially if the relationship is relatively new or unstable. So, what can we do to get ourselves to a point where we feel ready to talk?

Marriage and family therapist Shadeen Francis suggests that it could be helpful to reach out to trusted friends, family, a support group or a qualified therapist. “Opening up can be a powerful step in breaking down the walls of shame. It can help you to feel part of a larger community facing similar challenges, which helps to destigmatise the issue, both for yourself and your wider circles.”

If talking about your condition to anyone is too much right now, Aoife Drury, a psychosexual and relationship therapist, suggests writing down some of your worries to help you better understand the anxious thoughts you’re having. You can then hand these over to your partner if you ever do decide to share. 

Practise saying it out loud

“Saying difficult or emotional things is hard and bodily reactions to this stress can make it even harder,” explains Dr Windgassen. “Speaking out loud allows your body to habituate to the stress response, which can help to curb the emotional activation when you talk to your partner.”

Choose a familiar, safe space

Francis suggests choosing a place where you both feel comfortable and emotionally present. “It’s not just about finding the right time, but also about feeling emotionally prepared to share something personal. Considering the setting can set the stage for a gentler conversation.”

Do your research

She also advises gathering information about infertility, potential treatments and options ahead of time, so that you can enter the conversation feeling informed. That doesn’t mean, however, that we’re responsible for educating our partners. “This conversation is about building understanding and support, not just sharing information. This will likely not be a one-time conversation, so go slowly and be gentle with yourselves and each other.” 

The possibility of being met with rejection is a major barrier to talking about reproductive health. It’s why it can be helpful to tell a close family member or friend that you’re planning to have the conversation so that they can be there to debrief and support you in the aftermath.

If you do get a negative reaction from your partner, Dr Windgassen advises against rushing to ‘fix’ the situation. She explains that it’s important to process your emotions, as it’s during this time that our brain forms sweeping and unhelpful generalisations about ourselves and future relationships. “Often we will internalise rejection as a sign that we are not enough and that every partner we meet in the future will respond to us in the same way.”

Instead, she suggests: “Talk to yourself as you would to a friend. That can help to gain perspective and separate yourself from the negative emotional thoughts you’ve internalised.” 

No matter how your partner reacts, it’s important to know that you are not to blame.

Francis concludes: “A loving, worthwhile partner will value you for who you are, not just your reproductive capabilities. Painful sex, low libido and infertility are medical issues that can often be managed with the right support. 

“Honesty and openness are key – don’t let fear of rejection stop you from seeking a fulfilling relationship. Everyone deserves love and companionship, and your challenges can be a part of your story, not the entirety of it.” 

*Names have been changed. 

Images: Getty