The purpose of the essay was to examine the impact of sterility on a woman's self-esteem. While it is commonly believed that sterility has a profound effect, some studies suggest that in specific circumstances, women may experience an improvement in their marital relationships due to infertility. Furthermore, other research indicates that infertile women do not undergo any significant changes in their lives after being diagnosed with this condition.
Although numerous studies have provided solid evidence of declining self-esteem in women facing infertility, it cannot be definitively concluded that the inability to conceive naturally is solely responsible for a significant decrease in dignity. The relationship between cause and effect in this case is not straightforward because a woman's loss of confidence is a result of various events triggered by the emergence of the problem. Factors such as how family, friends, and partner...
s react, as well as changing sociocultural attitudes towards infertility across different cultures and time periods contribute to this phenomenon. One valuable resource for my research was a national survey conducted in the United States, where social tolerance and acceptance are promoted. Additionally, financial resources and access to public healthcare may also impact these findings.
Hence, it is necessary to conduct more cross-cultural studies to determine the overall perspective on the issue. However, it is still difficult to take a universal stance due to various contributing factors. Regardless, the comprehensive analysis presented in the essay's conclusion shows that women who struggle with infertility suffer significant damage to their self-esteem. "You [mothers] are the true architects of the nation wherever you reside, as you have established places of strength, peace, and security. These become the backbone of any
"Motherhood is near to deity. It is the highest, holiest service to be assumed by world," said President Gordon B. Hinckley in regards to maternity, as stated by the First Presidency. However, what happens to a woman who cannot experience the closeness to deity due to her biology? Why does nature go against the purpose of womanhood? Infertility can cause women to feel a loss of power and control, resulting in decreased self-esteem (Johnson, 1996) and has been described as a developmental crisis often experienced as a selfish injury (Kraft et al.)."
, 1980 as cited in Downey, 1992) . The societal impact of involuntary childlessness has been viewed as a stigma (Miall, 1986 as cited in Downey, 1992), resulting in a damaged identity (Matthews & Matthews, 1986 as cited in Downey, 1992). The severity of the stressor, the inability to achieve the life goal of having children, has been likened to death and divorce (Mahlstedt, 1985 as cited in Downey, 1992). "The choice of the topic was clear for me as I envision my future in medicine with a specific interest in the psychology of women. The profession that effectively combines these two fields is gynecology."
As a result, I am going to visit a progressive doctor who specializes in gynecology, endocrinology, and obstetrics. These fields encompass not just medical aspects but also vital psychological elements within this domain. Regrettably, physicians often neglect the psychological aspect of individuals. While research on the remarkable capabilities of the human brain is still in its early stages, scientific studies provide ample evidence of the link between spirituality and everyday life. Put simply, thoughts, hope, and beliefs have a significant
biological impact on perceived well-being despite being frequently disregarded. The focus on infertile women began when I encountered this issue while hospitalized. It became evident that an inadequacy in gender-related anatomy undermines women's self-esteem and creates a perception of compromised femininity.
The main purpose of this article is to analyze how infertility impacts a woman's self-esteem and overall well-being, including mental health, social factors, and work productivity. The goal is to offer evidence-based insights into the effects of infertility on a woman's self-esteem. It is important to investigate the nature of infertility and its impact on individuals because it is a significant area of research.
According to the American Society for Reproductive Medicine, infertility is a disease that affects the reproductive system's ability to carry out reproduction. It is typically diagnosed after actively trying to conceive for a year, although women over 35 are advised to seek diagnosis and treatment within six months. Statistics reveal that fertility issues impact over 7.3 million Americans, which is equivalent to one in eight couples of childbearing age. Both male and female factors equally contribute to fertility problems, but women often unfairly blame themselves despite logical explanations. Treating infertility can involve methods such as hormone treatments, insemination, in vitro fertilization (IVF), and surgery. According to Branden (1992), self-esteem refers to perceiving oneself as capable of facing life's challenges and deserving happiness.
This definition does not specify the environmental factors that contribute to a positive self-esteem or the emotional and behavioral outcomes. However, when societal expectations are not met, environmental factors become significant. Throughout all societies, women have been connected to being nurturing mothers. Infertile women feel a lack of fulfillment in their
expected social role. Branded expanded on this theory.
He said that the need for self-confidence comes from two fundamental facts - both inherent to our species. The first is that our survival and ability to navigate the environment depend on the proper use of our consciousness. The second is that the proper use of our consciousness is not automatic or predetermined by nature. There is a significant element of choice and personal responsibility in regulating its activity. Infertility is an unexpected developmental crisis (Kodadek, 1988).
Many adult women believed that the ability to have a child was a personal decision, so it was upsetting when this choice was taken away.
The Impact of Decreased Self-Esteem
Self-esteem plays a crucial role in our motivation and inspiration. When we have high self-esteem, we are more likely to achieve our goals, leading to feelings of happiness and fulfillment.
It is crucial to maintain a high level of self-esteem for experiencing satisfaction (Branden, 1992). However, if self-esteem declines, it can lead to feelings of anxiety, defeat, and desperation. Several theories on depression suggest that having negative thoughts about oneself increases the likelihood of experiencing depression (Beck, 1967; Brown & Harris, 1978 as cited in Andrews & Brown, 1993). The relationship between attributing causes to events and depression has been recently examined (Brewin, 1985; Peterson & Seligman, 1984 as cited in Brewin & Furnham, 1986). It has been discovered that there is a significant correlation between self-esteem and depression.
According to the research, individuals who rate themselves as experiencing similar negative outcomes frequently tend to have lower self-esteem. It is apparent that compared to men, women often display excessive self-criticism, making them more vulnerable to damaging
their self-esteem. Sanford & Donovan (1987) state that many women suffer from the adverse effects of low self-esteem. They often feel inadequate or worthless, are dissatisfied with their bodies, and lack confidence in their physical appearance. Additionally, women's inclination to reject the idea of deserving happiness and success is reinforced by a lack of belief in being loved and doubts about their talents, competence, and intelligence.
The article examines the impact of feminine factors on women's self-esteem and their significant consequences during severe crisis situations. The data shows that depression is twice as likely to occur in women compared to men (Bhatia & A ; Bhatia, 1999). While the diagnostic criteria for depression are not gender-specific, women with depression often display additional symptoms such as guilt, anxiety, increased appetite, sleep disturbances, weight gain, and co-occurring eating disorders. The specific reasons for this gender disparity are unclear due to limited data; however, it is believed that a combination of cognitive differences, biological factors, and a higher prevalence of psychosocial and economic stresses among women contribute to their heightened vulnerability to depression.
The increased vulnerability to depression in women may be caused by various biologic mechanisms. These mechanisms include differences in brain structure and function, genetic factors, and the impact of female hormones on neurotransmitters and enzyme functions in susceptible individuals. Despite seeming contradictory, these facts highlight nature's imperfections. Women are predisposed to depression due to biology but this also leads to reproductive dysfunction, creating a harmful cycle.
The question of the additional consequences resulting from decreased self-esteem arises. The perception of diminished self-worth is often seen as a sign of weakness or excessive complaining. However, the main psychological harm
starts with a decrease in self-evaluation, leading to depression and ultimately culminating in suicide. Although both males and females face a significant risk for self-destructive behavior due to depression, young adult women, particularly those under 30 and during their reproductive period, have shown a higher rate of suicide attempts (Bhatia & Bhatia, 1999).
The most common method used by adult females is self-poisoning, accounting for 70% of all suicide attempts. In conclusion, even a slightly altered perception of self-worth can become a deadly process.
Emotional Aspects of Infertility
Resolve (2010) states that managing the emotional rollercoaster of medical interventions, uncertainty about outcomes, and the tough decision-making process is one of the most difficult aspects of dealing with infertility. Feelings associated with infertility include a sense of loss, denial, shock, anger, numbness, guilt, and shame.
Shame is a distressing emotion that is powerful and connected to various aspects of self-worth, including feelings of inadequacy, imperfection, and vulnerability. Witnessing the impact on a woman's self-esteem when she cannot conceive is disheartening. As she goes through unsuccessful attempts at pregnancy, she gradually understands that her desired goal will never be accomplished. Regrettably, this understanding prevents her from fully preserving her self-perception because her inability to reproduce becomes central to how she defines herself. Ultimately, all these negative emotions merge and result in profound uncertainty as the dream of starting a family falls apart.
The impact of chronic infertility is not limited to the adult female themselves, but also affects their family and partner, who share in the emotional burden. This condition's most devastating aspect is that over time, it permeates all aspects of life, much like a blanket of snow covering other abilities.
This process usually goes unnoticed, as the shame associated with it is unconsciously concealed to avoid feelings of inadequacy. The statistics suggest that there are significantly more women struggling with infertility than one might expect. The reason for this lack of awareness and underestimated numbers is that reproductive failure is not a common illness.
The psychological aspects involved lead to a desire to hide the issue. However, the results obtained in the nationwide study (Schering-Plough and Merck & Co., Inc., 2009) demonstrate that avoiding discussions about the problem actually worsens it. 72 percent acknowledge that talking to others about the process has made it easier to deal with.
For women fighting with the disease, the painful experience includes grieving for loved ones and other hidden losses. These losses can be analyzed on various levels such as "loss of stability in family and personal relationships, loss of work productivity, loss of a sense of spirituality and sense of hope for the future" (Resolve, 2010). These damages are further consequences of low feelings of dignity. The application of inhibitory defense mechanisms like denial, repression, rejection of diagnosis, projection, and isolation is one method of changing the perception of this situation (Griffin & Clapp, 1986; Reading & Kerin, 1989; Bidzan & Jozefiak, 2002 as cited in Bidzan, Bidzan, and Smutek, 2006). Some women with infertility alter their views on having children. A study conducted by Bidzan, Bidzan, and Smutek (2006) investigated the sense of control over life in three groups: women with infertility, urinary incontinence, and cervical cancer.
The group of sterile adult females had the lowest evaluations. However, it was also found that the level of psychological quality of life
remains unchanged in terms of emotional life, depression, fear, and positive feelings. This suggests that over time, patients adapt to the illness. A similar study (Kowalik et al., 2001 as cited in Bidzan, Bidzan, and Smutek, 2006) confirmed these findings and showed no correlation between the progression of the illness and the level of life satisfaction. This was also observed in a study on sterile adult females (Hearn et al., 1987 as cited in Bidzan, Bidzan, and Smutek, 2006) where life satisfaction persisted despite the illness.
The Schering-Plough and Merck & Co., Inc. (2009) national study revealed numerous reasons why the inability to conceive can be devastating to a woman's self-esteem. These consequences greatly impact my perspectives and beliefs.
The study involved 585 adult females and males. Among the women surveyed, 71% expressed that infertility made them feel flawed, while 50% of the men stated that it made them feel inadequate. Additionally, 50% of the couples confessed to hiding their feelings from each other. Although a significant number of men acknowledged feeling disapproval, statistics support that women are still more concerned about the challenges of getting pregnant.
Graph 1 - The responses obtained in the National Survey regarding who is more worried about having difficulty getting pregnant were analyzed for both men and women. It is evident from Graph 1 that women admit to feeling more worried and twice as concerned about experiencing trouble conceiving compared to men.
From a men's perspective, women tend to feel more bothered about certain things than men do. Similar results were found in response to other questions. 75% of surveyed women claim to resent people who take getting pregnant for granted, and 72%
resent people who give advice because they were able to get pregnant without fertility interventions. According to the results obtained in the graph below, 58% of women say they get tired of people asking them about the progress of their pregnancy, and 60% receive suggestions on how to conceive.
Graph 2 - Answers obtained in the National Survey in response to the question: 'Couples who have told others about their difficulty in getting pregnant: How much do you agree or disagree with each of the following statements when it comes to difficulty in getting pregnant?'.
The results displayed indicate the consequences achieved within a group of adult females. The probable reason for this is that withdrawal mechanisms are attributed to a decrease in self-esteem and, consequently, a reduced desire to interact with individuals who previously knew these women as different individuals prior to the unfortunate event. Females facing difficulties in feeling inadequate attempt to conceal these emotions to avoid detection, resulting in their avoidance of situations where they may become exposed. According to a survey, 56% of women surveyed confess feeling uneasy around pregnant women or couples with infants.
Moreover, 67 percent of individuals try to hide their feelings about the difficulty of getting pregnant from their family and friends. What surprised me a lot was that more couples agreed that their struggle in getting pregnant has brought them closer together (58 percent) compared to those who say that it has hurt their relationship (36 percent). These results provide hope that infertility can unexpectedly lead to positive outcomes. This aspect balances out the extreme hypotheses stated in response to the question.
- Answers obtained in the
National Survey in response to the question directed towards women: "Overall, how supportive has your partner been in the following areas?" It turns out that a significant responsibility lies on men sharing the same burden. As can be easily observed in Graph 3, the majority of women feel supported by their partners not only because of their presence during medical appointments but also due to their empathy towards their emotional instability.
Based on observation, it appears that women can gain strength by emulating their spouses' attitudes towards the difficulties they encounter. Overcoming such painful experiences, as revealed in the study, can strengthen the bond between spouses. Despite their own inability to fulfill women's roles, women find solace from their spouses and, as a result, find independence in love. This finding aligns with the results of the Islington survey (Brown & Harris, 1978, as cited in Andrews & Brown, 1993), which indicated that low self-esteem is associated with negative aspects in current intimate relationships, such as negative partner interaction and lack of support.
Graph 4 - Answers obtained in the National Survey regarding the perceived challenges of getting pregnant. The results are differentiated by gender. As shown on Graph 4, women tend to attribute the difficulty to their own side. According to my expectations, over half of men admitted that the challenge of getting pregnant lies with the woman.
Women who have female parents have been unfairly burdened with the responsibility of reproduction for centuries.
Graph 5 - The results obtained from the National Survey show the responses to the question asking about negative emotions associated with difficulty in getting pregnant. The results are differentiated between men and women.
Graph 6 - The results obtained from the National Survey show the responses to the question asking about negative emotions associated with difficulty in getting pregnant. The results are differentiated between men and women.
My analysis of the graphs above reveals that Graph 5 depicts a higher occurrence of negative feelings in women, while Graph 6 shows a higher occurrence of negative feelings in men. Upon studying these graphs, it becomes evident that women tend to experience more feelings that contribute to unstable self-esteem, such as feelings of hopelessness, guilt, desolation, isolation, and loss of attraction. Kodadek's (1988) study on a group of sterile women found a positive correlation between lower levels of self-esteem and their perception of their body image. The women in the study also reported a connection between their level of self-esteem and their feelings of disaffection. On the other hand, men reported a stronger presence of feelings associated with confusion, such as a lack of answers and frustration. They acknowledged feeling overwhelmed, drained, and more vulnerable.
However, it is interesting to note that more work forces claim to experience stigmatization, which contradicts my belief that this job is more common among adult females. Another tragic aspect of the issue is that attempting to get pregnant also has a negative impact on intimacy. Over half of all adult women report that infertility has made sex a physically and emotionally challenging time. Additionally, half of women say that infertility has taken the fun and spontaneity out of their sex life, and over 40% of couples report feeling sexually unattractive. Undoubtedly, women are often judged based on their physical attractiveness. Therefore, any decrease in feeling sexually
attractive results in reduced opportunities not only in society but also in the labor market, which can undoubtedly trigger feelings of incompetence.
DESTRUCTIVE DIMENSION OF THE TREATMENT
There is another aspect related to the topic that deserves attention. The sterility intervention has been shown to cause both anxiety and depression. Parikh et al. (1991) found that women seeking IVF treatment had lower self-esteem and confidence compared to a control group of fertile women. Depression, anxiety, and hostility scores were higher in women during the embryo transfer stage of IVF compared to their pre-treatment visits. After a failed IVF cycle, women experienced a further decrease in self-esteem and an increase in depression compared to before starting the treatment.
Comparisons between adult females undergoing repeated IVF rhythms and first-time participants suggest that ongoing intervention may lead to an increase in depressive symptoms. In another study (Brand, 1989; Connolly, Edelmann, & Cooke, 1987; Daniluk, 1988; Lalos, Lalos, Jacobsson, & von Schoultz, 1985; Stewart & Robinson, 1989 as cited in Downey, 1992), while undergoing evaluation and intervention for sterility, women have been reported to experience heartache, denial, anger, high levels of anxiety and depression, lowered self-esteem, poor body image, marital troubles, and problems with sexual identity and performance. Another study (Verhaak, Smeenk, Evers, Kremer, Kraaimaat, & Braat, 2006) focused on examining how women emotionally adapt to the various stages of IVF treatment regarding anxiety, depression or general distress before, during and after different treatment cycles. The findings indicated that women starting IVF were only slightly different emotionally from the control groups. Unsuccessful treatment raised the women's levels of negative emotions, which continued after consecutive unsuccessful cycles. The research delivers a variety of
evidence that the damage to self-esteem of infertile women is a complex process rooted not only in the fact of having the condition but also in experiencing distressing effects.
Regrettably, job stress plays a significant role in this matter. It is alarming to see the extent of the issue, specifically the prevalence of psychiatric disorders in individuals undergoing fertility treatment as determined by standardized diagnostic tools. Research conducted at Taipei Veterans General Hospital by Chen et al. revealed this phenomenon.
, 2004), "Female adults attending an assisted reproduction clinic were evaluated using the Mini-International Neuropsychiatric Interview. Out of the 112 participants, 40.2 percent met criteria for a psychiatric disorder. The most common diagnosis was generalized anxiety disorder (23.2 percent), followed by major depressive disorder (17.0 percent) and dysthymic disorder (9.8 percent)." "Research has shown that infertility can lead to clinically significant psychiatric symptoms in over a third of the women who receive treatment" (McEwan, Costello, & A; Taylor, 1987 as cited in Downey, 1992).
In the study conducted by Keye, Deneris, Wilson, and Sullivan in 1981 (as cited in Downey, 1992), 57 percent of sterile adult females stated that "sterility was the hardest thing they had had to face in life."
After considering all the evidence presented in various studies, it is undeniable that the experience of sterility negatively impacts a woman's self-esteem. The failure of treatment cycles significantly contributes to the erosion of confidence. Additionally, the high prevalence of meeting criteria for psychiatric disorders strongly supports this conclusion. However, it cannot be assumed that illness completely destroys one's self-worth.
national study found that the job paradoxically strengthened most couples' relationships, leading to a strong sense of appreciation. Many organizations and websites aimed at supporting infertile women confirm the extent of this issue. However, it is important to note that the participants in the national study were Americans, so the collected responses are limited to the United States population, which is a specific country with unique sociocultural aspects. Due to the high standard of living, financial capabilities, and relatively wide range of opportunities, the positive results obtained may be considered somewhat exaggerated. Additionally, the overall level of life satisfaction is quite high, which could make the reinforcing effect on relationships unrepresentative of the broader global population.
Another aspect of cross-cultural research pertains to the differences in sociocultural beliefs regarding reproduction and household dynamics. These differences should not be compared directly, as they vary from country to country. Conducting more studies on this topic in various countries would help increase the global understanding of the issue. However, there is a greater number of studies that highlight the negative impact of fertility issues on the confidence of affected women. In my opinion, it is important for leading medical professionals to inform women with infertility about coping techniques, as their words often hold significant influence.
In addition to staying informed, it is important to emphasize the promotion of connecting with others and not avoiding contact with family members. Women who are affected by such situations should be consistently reassured that it is possible to transform feelings of failure into empathy for oneself and others who also go through difficult times in life. This involves acknowledging one's strength, accepting limitations, and
taking pride in one's resilience. It is crucial that women feel supported and empowered to express their emotions, whether through crying or expressing anger, while also being reassured that they possess immense inner strength to face challenges and accept boundaries. This aligns with the Zen proverb that suggests controlling a bull by giving it ample space to roam freely.
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