Signs and Symptoms of Infertility in Women and Men

1. Irregular Menstrual Cycles

Irregular or absent menstrual cycles are often among the first noticeable signs of potential fertility issues in women. A healthy menstrual cycle typically ranges from 21 to 35 days, with periods arriving at roughly the same time each month. When cycles are unpredictable, unusually short, excessively long, or missed altogether, it can signal ovulatory problems such as polycystic ovary syndrome (PCOS) or hormonal imbalances—both of which can hinder the release of eggs necessary for conception (American College of Obstetricians and Gynecologists).

Think of your menstrual cycle as a monthly “report card” for reproductive health: consistent cycles suggest regular ovulation, while erratic patterns may indicate underlying issues. To better understand your cycle, keep a menstrual diary or use a period tracking app to note the start and end dates, flow characteristics, and any unusual symptoms. This information is valuable for both personal awareness and for sharing with your healthcare provider. If you notice persistent irregularities, it’s important to seek medical advice early, as prompt evaluation can help diagnose causes and improve the chances of successful treatment (CDC – Infertility).

2. Painful Periods or Pelvic Pain

Chronic pelvic pain or unusually severe menstrual cramps—beyond what most women experience—can be an important sign of underlying reproductive disorders, such as endometriosis or pelvic inflammatory disease (PID). Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing inflammation and scarring. Women with endometriosis may report sharp, stabbing pain during periods, ongoing discomfort unrelated to menstruation, or pain during intercourse. These symptoms can significantly impact daily life, making it difficult to attend work, school, or social events.

For example, if you find yourself routinely missing activities or relying on strong pain medications for relief during your period, this may indicate a problem. Signs to watch for include pelvic pain that persists throughout the month, pain during bowel movements or urination, and abnormal bleeding between periods. Such symptoms warrant prompt medical evaluation, as untreated conditions like endometriosis can lead to fertility challenges (NICHD – Endometriosis: Symptoms). Early diagnosis and management may help preserve fertility and improve quality of life. If pelvic pain is interfering with your routine, consult a healthcare provider for proper assessment.

3. Heavy or Light Menstrual Bleeding

Abnormal menstrual bleeding—either unusually heavy (menorrhagia) or extremely light (hypomenorrhea)—can be a symptom of underlying reproductive health issues that may affect fertility. Heavy bleeding often involves soaking through pads or tampons every hour for several consecutive hours, passing large blood clots, or needing to change protection overnight. This can be caused by uterine polyps, fibroids, hormonal imbalances, or bleeding disorders (CDC – Heavy Menstrual Bleeding).

Conversely, very light periods or missed periods may reflect problems such as thyroid dysfunction, stress, or low body weight—all of which can disrupt hormone production and ovulation. In some cases, structural abnormalities within the uterus or the presence of scar tissue (Asherman’s syndrome) may also result in scanty menstrual flow (Mayo Clinic – Menstrual Cycle: What’s normal, what’s not).

If you consistently experience periods that are much heavier or lighter than usual, or if bleeding is accompanied by severe pain, fatigue, or dizziness, it’s important to consult a healthcare provider. Early evaluation can help identify the cause and guide effective treatment to protect overall reproductive health and fertility.

4. Changes in Sexual Desire

A noticeable drop or fluctuation in sexual desire (libido) can be a subtle yet important symptom of fertility issues in both men and women. Hormonal imbalances, such as low estrogen or testosterone, thyroid disorders, or elevated prolactin levels, often underlie these changes. For instance, women with polycystic ovary syndrome (PCOS) may experience reduced libido due to hormonal disruption, while men with low testosterone—sometimes linked to testicular or pituitary problems—may also report diminished interest in sex (Johns Hopkins Medicine – Sexual Dysfunction).

Persistent changes in sexual desire can manifest as a lack of interest in intimacy, less frequent sexual activity, or a diminished sense of sexual satisfaction. These shifts are often gradual, making them easy to overlook or attribute to stress, fatigue, or relationship issues. It’s helpful to pay attention to ongoing patterns rather than isolated incidents. If you or your partner notice a sustained decrease in libido that affects your relationship or emotional well-being, consider discussing it with a healthcare professional. Addressing hormonal imbalances early can improve both fertility and overall quality of life (NHS – Loss of Libido).

5. Erectile Dysfunction

Erectile dysfunction (ED), defined as the persistent difficulty in achieving or maintaining an erection sufficient for sexual intercourse, can be more than just a temporary inconvenience—it may signal underlying infertility issues in men. While occasional episodes of ED are common and often linked to stress or fatigue, frequent or chronic ED can point to hormonal imbalances, circulatory problems, or nerve damage that also affect sperm production and overall reproductive health (Urology Care Foundation – Erectile Dysfunction).

For example, conditions such as diabetes, high blood pressure, or low testosterone levels are well-known causes of ED and are also associated with reduced fertility. Emotional factors like anxiety or depression may contribute as well, but when ED persists, it is essential to consider possible physical causes. Men experiencing ongoing erectile difficulties should seek medical evaluation, especially if the problem has lasted for several months or is accompanied by other symptoms (such as reduced libido or changes in ejaculation). Early intervention can help identify treatable causes and improve both sexual and reproductive health (Mayo Clinic – Erectile Dysfunction).

6. Pain During Intercourse

Experiencing pain during sexual intercourse, known medically as dyspareunia, is a symptom that can indicate a range of reproductive health problems in women. While occasional discomfort may result from temporary factors like lack of lubrication or stress, persistent or severe pain often points to underlying conditions such as endometriosis, ovarian cysts, pelvic inflammatory disease (PID), or vaginal infections (American College of Obstetricians and Gynecologists – Pain During Intercourse).

In real life, women may find themselves avoiding intimacy or feeling anxious about sexual activity due to recurring pain. Some describe a deep, aching sensation or sharp pain during penetration, while others report burning or soreness afterward. These symptoms not only affect one’s physical comfort but can also impact emotional well-being and relationships. It’s important to remember that pain during sex should never be dismissed as “normal.”

If you experience ongoing pain during intercourse, keep a record of your symptoms—such as when the pain occurs, its intensity, and any related patterns. Openly discussing these concerns with a healthcare provider is crucial for accurate diagnosis and appropriate treatment (NHS – Painful Sex (Dyspareunia)), which can help restore comfort and protect fertility.

7. Testicular Pain or Swelling

Testicular pain or swelling can be a significant warning sign of issues that may impact male fertility. The testicles are responsible for producing sperm and testosterone, and any discomfort, swelling, or lumps in this area should not be ignored. Common causes include infections such as epididymitis or orchitis, varicoceles (enlarged veins within the scrotum), and physical blockages that can interfere with sperm production or transport (Urology Care Foundation – Testicular Pain).

For example, men might notice a dull ache, sudden sharp pain, or visible swelling on one or both sides of the scrotum. Sometimes, these symptoms are accompanied by redness, warmth, or a feeling of heaviness. Infections or blockages can lead to long-term damage if not addressed promptly, potentially resulting in decreased sperm quality or quantity. In rare cases, testicular pain or swelling can also signal testicular cancer, which requires immediate evaluation (American Cancer Society – Testicular Cancer Signs and Symptoms).

If you experience persistent or severe testicular pain, swelling, or notice any unusual lumps, seek medical attention right away. Early diagnosis and treatment are essential for preserving fertility and overall health.

8. Changes in Hair Growth

Abnormal hair growth patterns in women, medically known as hirsutism, can be a telling symptom of underlying hormonal imbalances that affect fertility—most commonly polycystic ovary syndrome (PCOS). Hirsutism is characterized by excessive, coarse hair growth in areas where men typically grow hair, such as the face, chest, back, or abdomen. This occurs when the body produces higher-than-normal levels of androgens (male hormones), disrupting normal ovulation and menstrual cycles (Mayo Clinic – Hirsutism).

Women may notice that hair becomes thicker and darker on the upper lip, chin, or sideburn areas, while other areas of the body may also be affected. This pattern is different from the fine, light “peach fuzz” hair that is normal for women. Sudden increases in hair growth or gradual changes over time both warrant attention, especially if accompanied by other symptoms like irregular periods, acne, or weight gain.

To monitor changes, keep track of any new or unusual hair growth, its location, and how quickly it progresses. If you observe persistent or worsening hirsutism, consult a healthcare provider for an evaluation. Early diagnosis of PCOS or related conditions can help manage symptoms and protect fertility (Office on Women’s Health – PCOS).

9. Weight Gain or Loss

Significant weight gain or loss can disrupt reproductive hormones and negatively impact fertility in both women and men. Excess body fat, particularly in women, can lead to increased estrogen production, which may interfere with ovulation and menstrual regularity. Conditions such as polycystic ovary syndrome (PCOS) are often linked to weight gain and associated hormonal imbalances, resulting in difficulties with conception (Eunice Kennedy Shriver NICHD – Infertility Risk Factors).

Conversely, being underweight or experiencing rapid weight loss can lead to decreased estrogen levels, missed periods, and anovulation (lack of egg release). In men, both obesity and being underweight can affect testosterone levels and sperm quality and quantity. For example, athletes or individuals with eating disorders may notice disruptions in their reproductive health due to extreme weight fluctuations.

If you experience unexplained or rapid changes in your weight—either gain or loss—alongside menstrual irregularities, decreased libido, or other fertility concerns, it’s important to seek guidance from a healthcare provider. Addressing underlying metabolic or hormonal issues and working toward a healthy, stable weight can significantly improve reproductive function and overall well-being (CDC – Infertility).

10. Hot Flashes and Night Sweats

Hot flashes and night sweats are hallmark symptoms of hormonal imbalance, most often associated with menopause but also possible in younger women experiencing early ovarian insufficiency (also called primary ovarian insufficiency or POI). These episodes involve sudden sensations of heat, flushing, and sweating, sometimes accompanied by a rapid heartbeat. For women under 40, such symptoms can signal that the ovaries are not producing enough estrogen, which can disrupt the menstrual cycle and reduce fertility (NICHD – Primary Ovarian Insufficiency).

In practical terms, if you notice recurring hot flashes during the day or wake up drenched in sweat at night, it’s important to track these occurrences, especially if they are accompanied by irregular periods, vaginal dryness, or mood changes. These symptoms may be mistaken for stress or other health issues but should not be ignored, particularly if you are trying to conceive. Bringing a detailed record of your symptoms to your healthcare provider can support early diagnosis and intervention.

Early ovarian insufficiency may be managed with hormone therapy or other treatments to support reproductive health and improve quality of life (Mayo Clinic – Primary Ovarian Insufficiency).

11. Absence of Ejaculation

The inability to ejaculate, known as anejaculation, is a condition where men are unable to release semen during orgasm. This can be partial (delayed or reduced ejaculation) or complete (no ejaculation at all) and is a significant factor in male infertility, as it prevents sperm from reaching the egg. Underlying causes include nerve damage from diabetes or spinal cord injuries, prostate surgery, certain medications (such as antidepressants or blood pressure drugs), psychological stress, or congenital abnormalities (Urology Care Foundation – Anejaculation).

Men experiencing an absence of ejaculation may also notice a lack of pleasurable sensation during orgasm or the phenomenon of “dry orgasm,” where orgasm occurs without semen emission. In some cases, retrograde ejaculation occurs, where semen enters the bladder instead of exiting through the penis, often noticed as cloudy urine after orgasm (Mayo Clinic – Retrograde Ejaculation).

If you observe ongoing issues with ejaculation, it’s crucial to consult a healthcare provider promptly. Early evaluation can identify treatable causes and improve the chances of conception, as well as address any related health concerns. Timely intervention is especially important for men seeking to build a family.

12. Small or Firm Testicles

Testicular size and texture can provide important clues about a man’s reproductive health. Normally, testicles are oval, soft, and slightly firm but not hard or unusually small. Testicles that feel significantly smaller than average or are abnormally firm may indicate underlying problems with sperm production or hormonal imbalances. For example, conditions such as Klinefelter syndrome, undescended testicles, or damage from infections like mumps can result in decreased testicular volume and impaired fertility (Urology Care Foundation – Testicular Atrophy).

Comparatively, healthy testicles should be similar in size and have a spongy, elastic feel. If one or both testicles appear shrunken or become unusually hard, it could signal scarring or a blockage in the reproductive tract, which can reduce or halt sperm production. These changes are sometimes accompanied by other symptoms, such as a decrease in libido or the presence of a lump, which may suggest additional health concerns (American Cancer Society – Testicular Cancer Signs and Symptoms).

Men should perform regular self-examinations to check for changes in size, shape, or consistency. If you notice persistent abnormalities, seek medical evaluation promptly to identify the cause and explore treatment options to protect fertility.

13. Unexplained Fatigue

Persistent, unexplained fatigue can be more than just a sign of a busy lifestyle—it may indicate underlying hormonal imbalances that impact fertility in both women and men. Hormones such as thyroid hormones, estrogen, progesterone, and testosterone play crucial roles in regulating energy levels, metabolism, and reproductive function. For example, hypothyroidism (an underactive thyroid) can cause profound tiredness, weight gain, and irregular menstrual cycles in women, all of which can contribute to difficulties conceiving (Office on Women’s Health – Thyroid Disease).

In men, low testosterone can manifest as ongoing fatigue, reduced motivation, and decreased muscle mass, alongside a decline in sexual function and sperm quality (Johns Hopkins Medicine – Low Testosterone). If you find yourself experiencing tiredness that doesn’t improve with rest, or if fatigue is accompanied by other symptoms such as mood changes, hair loss, or menstrual irregularities, it may signal a deeper health issue.

If unexplained fatigue persists for several weeks or negatively affects your daily functioning, consider seeking medical advice. Blood tests to evaluate hormone levels can help identify treatable causes and support both your overall health and reproductive goals.

14. Frequent Miscarriages

Experiencing two or more consecutive miscarriages, known as recurrent pregnancy loss, can be an indication of underlying fertility problems in women. While a single miscarriage is relatively common and may occur by chance, repeated losses often signal issues such as chromosomal abnormalities, uterine structural problems, hormonal imbalances, or autoimmune disorders (American College of Obstetricians and Gynecologists – Repeated Miscarriages).

In real-world scenarios, couples may feel profound grief and frustration after multiple failed pregnancies, sometimes without clear answers. For example, a woman may conceive quickly but repeatedly lose pregnancies in the first trimester, which could suggest conditions like antiphospholipid syndrome or untreated thyroid disease. Structural issues such as uterine septum or fibroids may also prevent successful implantation or development (Eunice Kennedy Shriver NICHD – Miscarriage).

If you have experienced frequent miscarriages, it is important to seek specialized evaluation from a reproductive endocrinologist. Diagnostic testing—such as genetic screening, hormone assessments, and imaging studies—can help identify treatable causes. Early intervention and personalized care can significantly improve the likelihood of a healthy pregnancy in the future.

15. Abnormal Breast Discharge

Unexpected breast discharge, particularly the production of a milky fluid in women who are not pregnant or breastfeeding—a condition known as galactorrhea—can be a symptom of hormonal disturbances that affect fertility. Galactorrhea is often caused by elevated levels of prolactin, a hormone produced by the pituitary gland. High prolactin can interfere with ovulation, menstruation, and overall reproductive function (Mayo Clinic – Galactorrhea).

Pituitary tumors (prolactinomas) are a common cause of galactorrhea, but certain medications, thyroid disorders, or chronic stress can also elevate prolactin levels. Both women and men may be affected, though it is more commonly observed in women. Aside from breast discharge, symptoms may include irregular or absent periods, headaches, or vision changes if a tumor is present.

If you notice persistent, unexplained breast discharge, especially when not related to pregnancy or recent childbirth, it is important to consult a healthcare provider for evaluation. Blood tests can measure prolactin levels, and further imaging may be needed to assess the pituitary gland. Early diagnosis allows for targeted treatment, which can restore hormonal balance and improve fertility outcomes (Johns Hopkins Medicine – Galactorrhea).

16. Low Sperm Count

Low sperm count, or oligospermia, is a leading cause of male infertility. It refers to having fewer than 15 million sperm per milliliter of semen, significantly reducing the chances of fertilizing an egg. Many men with low sperm count may not notice any obvious symptoms until they have trouble conceiving with their partner. Sperm count is typically assessed through a semen analysis, a simple laboratory test that evaluates the quantity, shape, and movement of sperm (Mayo Clinic – Male Infertility: Diagnosis & Treatment).

Causes of low sperm count include hormonal imbalances, genetic conditions, varicoceles (enlarged veins in the scrotum), infections, exposure to toxins, certain medications, or lifestyle factors such as smoking and excessive alcohol use. Men may also experience other signs, like erectile dysfunction or testicular pain, but often, low sperm count is only revealed through testing.

If infertility is suspected or conception is taking longer than expected (typically after a year of regular, unprotected sex), it’s advisable for men to undergo a semen analysis. Early diagnosis can help identify treatable causes, guide lifestyle changes, and open up options such as assisted reproductive technologies (Urology Care Foundation – Male Infertility).

17. Changes in Skin (Acne or Dark Patches)

Significant changes in skin appearance, such as persistent acne or the development of dark, velvety patches (acanthosis nigricans), can serve as visible clues to underlying hormonal disorders that impact fertility. In women, these changes are commonly associated with polycystic ovary syndrome (PCOS), a condition marked by elevated androgen levels and insulin resistance. PCOS can disrupt ovulation, leading to irregular menstrual cycles and difficulties conceiving (Office on Women’s Health – PCOS).

Acne related to PCOS often appears on the jawline, cheeks, and chin, and may be resistant to standard treatments. Dark patches of skin, especially on the neck, underarms, or groin, result from insulin resistance and are another hallmark of metabolic and reproductive imbalance (Mayo Clinic – Acanthosis Nigricans). These symptoms can develop gradually and may be overlooked as simply cosmetic issues.

If you notice persistent or worsening acne, or new areas of darkened skin, especially in conjunction with irregular periods or unwanted hair growth, consult a healthcare provider. Early evaluation and management of hormonal conditions like PCOS can improve both skin health and fertility outcomes.

18. Past Sexually Transmitted Infections (STIs)

A history of sexually transmitted infections (STIs) can significantly impact fertility in both women and men, often without immediate symptoms. STIs such as chlamydia and gonorrhea are especially notorious for causing long-term damage to the reproductive organs if left untreated. In women, these infections can lead to pelvic inflammatory disease (PID), which causes inflammation, scarring, and blockages in the fallopian tubes, making it difficult for the egg and sperm to meet (CDC – Infertility & STDs).

Men with untreated STIs may develop epididymitis (inflammation of the tube carrying sperm), which can result in scarring, blockages, or even decreased sperm production. Sometimes, infections may also affect the prostate and other reproductive structures, adversely affecting semen quality and fertility. Unfortunately, many STIs are “silent” and may not show symptoms until complications arise.

If you have a history of STIs or suspect past exposure, it’s important to inform your healthcare provider when seeking evaluation for fertility concerns. Early detection and treatment of infections can prevent or minimize permanent damage. Regular STI screening and prompt treatment are crucial steps in protecting both reproductive and overall health (NHS – Causes of Infertility).

19. Prostate Problems

Prostate health plays a crucial role in male fertility, as the prostate gland produces seminal fluid that nourishes and transports sperm. Conditions such as prostatitis (inflammation or infection of the prostate) or benign prostatic hyperplasia (BPH, or prostate enlargement) can adversely affect sperm function and semen quality. Prostatitis may cause symptoms like painful urination, pelvic discomfort, painful ejaculation, and even fever, all of which can interfere with sexual function and fertility (CDC – Prostatitis).

In cases of chronic prostatitis, inflammation can alter the composition of seminal fluid, reduce sperm motility, or obstruct the flow of semen. Similarly, an enlarged prostate might block the passage of semen through the urethra or cause urinary symptoms that impact ejaculatory function. For example, men with BPH may notice a weak urine stream, frequent urination, or difficulty starting urination, which sometimes coincides with reproductive difficulties (NHS – Prostate Enlargement).

Men experiencing persistent pelvic pain, urinary issues, or discomfort during ejaculation should consult a urologist for evaluation. Early diagnosis and targeted treatment can help resolve symptoms, protect fertility, and prevent long-term complications related to prostate health.

20. Painful Urination

Painful urination, also known as dysuria, is a common symptom that can indicate infection or inflammation within the urinary or reproductive tract. In both women and men, this discomfort may result from urinary tract infections (UTIs), sexually transmitted infections (STIs), or conditions like pelvic inflammatory disease (PID) in women and prostatitis or epididymitis in men (CDC – Dysuria). These infections and inflammatory conditions can lead to scarring, blockages, or other changes that interfere with fertility.

For example, a woman experiencing painful urination along with pelvic pain or abnormal vaginal discharge may have an underlying infection that could spread to reproductive organs if not treated promptly. In men, painful urination can occur with testicular pain, urethral discharge, or ejaculation difficulties, often signaling infections that may impair sperm health or transport (NHS – Painful Urination).

If you notice persistent burning, stinging, or discomfort during urination—especially when accompanied by fever, unusual discharge, or lower abdominal pain—it’s important to seek medical attention. Prompt diagnosis and treatment not only relieve symptoms but also help protect long-term reproductive health and fertility.

21. Vaginal Dryness

Vaginal dryness is a common symptom that can signal low estrogen levels or other hormonal imbalances, both of which may impact fertility. Estrogen is essential for maintaining the health and elasticity of vaginal tissues, as well as producing natural lubrication. When estrogen levels drop—due to conditions like primary ovarian insufficiency, menopause, or certain medical treatments—women may experience dryness, itching, discomfort during intercourse, and an increased risk of vaginal infections (Mayo Clinic – Vaginal Atrophy).

Vaginal dryness can make sexual activity uncomfortable or even painful, potentially interfering with conception by reducing the chances of sperm successfully reaching the egg. Women may also notice a decrease in vaginal discharge or a feeling of tightness. Other causes include breastfeeding, certain medications (such as antihistamines or antidepressants), or autoimmune disorders that affect hormone production (Office on Women’s Health – Vaginal Dryness).

If you experience persistent vaginal dryness, especially alongside irregular periods or hot flashes, it’s important to consult a healthcare provider. Hormonal evaluation and targeted therapies, such as estrogen creams or lubricants, can help restore comfort, improve sexual and reproductive health, and support fertility goals.

22. Low Semen Volume

Low semen volume, characterized by a noticeably reduced amount of fluid released during ejaculation, can signal underlying reproductive health issues in men. Semen volume is essential for carrying and nourishing sperm as they travel through the female reproductive tract, and a significant decrease may indicate blockages in the ducts that transport semen, such as the vas deferens or seminal vesicles. Other potential causes include hormonal imbalances, such as low testosterone levels, or medical conditions affecting the prostate gland, which contributes a substantial portion of seminal fluid (Mayo Clinic – Male Infertility).

Men may notice that the volume of semen is consistently less than 1.5 milliliters per ejaculation, or that the fluid is unusually watery or thick. This can be associated with retrograde ejaculation, where semen enters the bladder instead of exiting the penis, or with partial blockages caused by infections, surgeries, or congenital abnormalities (Urology Care Foundation – Retrograde Ejaculation).

If you observe persistently low semen volume, especially if accompanied by other symptoms like difficulty urinating or reduced libido, consult a healthcare provider. Semen analysis and hormone testing can help pinpoint causes and guide effective treatment, supporting fertility and overall reproductive health.

23. Abnormal Semen Color or Consistency

Changes in the color or consistency of semen can serve as important indicators of underlying reproductive health issues that may impact fertility. Normal semen is typically whitish-gray and has a jelly-like consistency that liquefies within minutes after ejaculation. If semen appears yellow, green, pink, red, or brown, or is unusually thick, watery, or lumpy, it could signal the presence of infection, inflammation, or even bleeding within the reproductive tract (Mayo Clinic – Male Infertility).

For example, a yellow or green tint may indicate a bacterial infection such as prostatitis or a sexually transmitted infection, while pink or red semen suggests blood, which could result from infection, injury, or blocked ducts. Unusual thickness or failure to liquefy can also point to problems with the seminal vesicles or prostate, affecting sperm motility and the ability to fertilize an egg.

If you regularly notice abnormal color or consistency in your semen—especially if it’s accompanied by pain, fever, or urinary symptoms—it’s important to seek medical evaluation. Early diagnosis and treatment of infections or blockages can help resolve symptoms, restore normal semen quality, and improve fertility outcomes (NHS – Male Infertility).

24. Pain During Ejaculation

Pain during ejaculation, also known as dysorgasmia, is an important symptom that may signal underlying reproductive or urinary tract issues in men. While occasional mild discomfort might occur, persistent or severe pain should not be ignored, as it can indicate infections (such as prostatitis or epididymitis), sexually transmitted infections (STIs), prostate or seminal vesicle inflammation, or even structural abnormalities (Urology Care Foundation – Painful Ejaculation).

Men may describe a burning, stinging, or sharp pain that occurs at the moment of ejaculation or lingers afterward. This discomfort can negatively affect sexual health and may coincide with other symptoms like painful urination, blood in semen, or lower abdominal pain. For example, bacterial or viral infections of the prostate gland are common culprits, while chronic pelvic pain syndrome can also cause pain with ejaculation (Mayo Clinic – Painful Ejaculation).

If pain during ejaculation is frequent, severe, or associated with additional symptoms, it’s important to seek prompt medical evaluation. Early diagnosis and treatment can address infections or inflammation, relieve discomfort, and help safeguard fertility and overall reproductive health.

25. Breast Tenderness in Men

Breast tenderness or swelling in men, known as gynecomastia, can be a visible sign of hormonal imbalances that may impact fertility. Gynecomastia occurs when there is an increase in estrogen or a decrease in testosterone, upsetting the normal balance of male and female hormones in the body. This imbalance can result from a variety of conditions, including testicular dysfunction, liver disease, obesity, certain medications, or tumors affecting hormone production (Mayo Clinic – Gynecomastia).

Men with gynecomastia typically experience tenderness, swelling, or the development of a firm lump beneath the nipple area. This may be accompanied by other symptoms of low testosterone, such as reduced libido, erectile dysfunction, and decreased muscle mass. The presence of breast tenderness should not be dismissed as merely a cosmetic issue, as it often signals deeper endocrine disturbances that can affect sperm production and overall reproductive health (Johns Hopkins Medicine – Gynecomastia).

If you notice persistent breast tenderness, swelling, or enlargement, it is important to consult a healthcare provider for a thorough hormonal evaluation. Addressing the underlying cause can help restore hormonal balance, improve fertility, and protect long-term health.

26. Difficulty Maintaining Erection

Difficulty maintaining an erection, also known as erectile dysfunction (ED), can be a significant barrier to conception and is often a sign of underlying health issues affecting male fertility. While occasional problems with erection can be normal, persistent inability to sustain an erection adequate for intercourse may point to vascular, neurological, or hormonal problems. Conditions such as atherosclerosis (hardening of the arteries), diabetes, high blood pressure, and low testosterone levels are frequently linked to ED and may also impair sperm production or quality (NHS – Erectile Dysfunction).

Men experiencing this issue may also notice a decrease in sexual desire or other symptoms of hormonal imbalance. Psychological factors, including stress, anxiety, or depression, can exacerbate the problem but are often intertwined with physical health conditions. Lifestyle habits such as smoking, excessive alcohol consumption, and lack of exercise can further contribute to erectile difficulties.

If you consistently struggle to maintain an erection, it’s important to seek advice from a healthcare provider. Early evaluation can identify treatable causes, such as cardiovascular risk factors or hormone deficiencies, and provide practical interventions—ranging from medication to lifestyle changes—that support both sexual function and fertility (Urology Care Foundation – Erectile Dysfunction).

27. Abnormal Pap Smear Results

Abnormal Pap smear results occur when cervical cells collected during routine screening show changes that deviate from normal. While many abnormalities are caused by infections with the human papillomavirus (HPV), other infections, inflammation, or cellular changes can also be detected. Persistent HPV infection or untreated abnormalities may lead to cervical dysplasia or, in rare cases, cervical cancer—both of which can affect fertility by altering the structure or function of the cervix (CDC – Cervical Cancer Screening).

For example, chronic infections or severe cervical inflammation can cause scarring or narrowing of the cervical canal, potentially impeding the passage of sperm into the uterus. Treatments for cervical abnormalities, such as surgical procedures to remove precancerous cells, may also result in cervical stenosis or reduced cervical mucus, further challenging conception (Mayo Clinic – Pap Smear).

If you receive abnormal Pap smear results, follow up promptly with your healthcare provider. Additional testing, monitoring, or treatment may be necessary to address underlying infections or cellular changes. Timely management helps protect reproductive health and can reduce the risk of complications that may impact fertility.

28. Chronic Cough or Respiratory Issues

Chronic cough or persistent respiratory problems may seem unrelated to fertility, but certain genetic disorders, such as cystic fibrosis (CF), can impact both the respiratory and reproductive systems. Cystic fibrosis is a hereditary condition characterized by the production of thick, sticky mucus that clogs airways and leads to repeated lung infections and coughing. Importantly, this same mucus can block reproductive ducts, causing infertility in most men with CF due to congenital bilateral absence of the vas deferens (CBAVD), which prevents sperm from reaching the semen (Cystic Fibrosis Foundation – What Is Cystic Fibrosis?).

Women with cystic fibrosis may also face challenges conceiving, as thick cervical mucus can make it harder for sperm to travel through the reproductive tract, though many women with CF can still become pregnant with appropriate care. In both genders, awareness of unexplained chronic coughs, frequent lung infections, and a family history of cystic fibrosis is critical when evaluating fertility concerns (Mayo Clinic – Cystic Fibrosis).

If you have a history of chronic respiratory symptoms along with infertility, discuss this with your healthcare provider. Specialized genetic testing and reproductive counseling can help clarify underlying causes and guide treatment options.

29. Thinning Pubic or Body Hair

Thinning pubic or body hair in men can be an outward sign of hormonal imbalances, particularly low testosterone, that may affect fertility. Testosterone is crucial for the development and maintenance of male secondary sexual characteristics, including body and facial hair. When testosterone levels drop—due to aging, testicular dysfunction, pituitary gland disorders, or the use of certain medications—men may notice a gradual reduction in the density and thickness of pubic, underarm, or chest hair (Johns Hopkins Medicine – Low Testosterone).

This type of hair loss is different from male-pattern baldness, which affects the scalp. Instead, it involves less hair growth in areas previously covered or a slower rate of hair regrowth after shaving. Additional symptoms of low testosterone can include decreased libido, erectile dysfunction, fatigue, and mood changes. In some cases, genetic conditions like Klinefelter syndrome or underlying endocrine disorders can also cause these changes (NHS – Infertility: Symptoms).

If you experience noticeable thinning of pubic or body hair along with other symptoms of hormonal imbalance, consult a healthcare provider. Blood tests can help determine hormone levels, and timely treatment may restore hormonal balance and improve fertility outcomes.

30. Age Over 35 (Women) or 40 (Men)

Advancing age is a significant factor in fertility for both women and men, as natural reproductive function declines over time. In women, fertility begins to decrease more rapidly after age 35 due to a reduction in both the quantity and quality of eggs. According to the Centers for Disease Control and Prevention (CDC), women in their late 30s have a lower monthly chance of conceiving compared to those in their 20s or early 30s, and the risk of miscarriage and chromosomal abnormalities also rises.

Men over 40 may also experience decreased fertility, as aging can lead to lower testosterone levels, reduced semen quality, and increased DNA fragmentation in sperm. These changes can result in longer time to conception, higher risk of pregnancy complications, and increased likelihood of certain genetic conditions in offspring (NIH – Male Fertility and Age).

If you are over 35 (women) or 40 (men) and have been trying to conceive for six months or more without success, it is advisable to seek evaluation from a fertility specialist. Early intervention can help identify modifiable factors and optimize reproductive outcomes.

31. Family History of Infertility

A family history of infertility can be a significant factor in an individual’s own reproductive health, as many fertility problems have a genetic component. Certain inherited conditions, such as polycystic ovary syndrome (PCOS), endometriosis, premature ovarian insufficiency, or chromosomal abnormalities like Klinefelter syndrome or Y-chromosome microdeletions, can increase the risk of fertility challenges in both men and women (Eunice Kennedy Shriver NICHD – Causes of Infertility).

If your mother, father, siblings, or close relatives have experienced infertility, early menopause, repeated miscarriages, or required fertility treatments such as in vitro fertilization (IVF), you may have a greater likelihood of facing similar issues. Genetic factors may influence hormone production, ovarian reserve, sperm quality, or the structure of reproductive organs (FertilityIQ – Gene Mutations & Infertility).

Knowing your family medical history can be valuable information for both you and your healthcare provider when assessing fertility risks. If you have a known family history of reproductive challenges, consider seeking preconception counseling or early fertility evaluation. Proactive genetic testing and early intervention can help you make informed decisions and improve reproductive outcomes.

32. Exposure to Environmental Toxins

Exposure to environmental toxins such as pesticides, heavy metals (lead, mercury), industrial chemicals, and endocrine-disrupting compounds can significantly impact fertility in both men and women. These substances may interfere with hormone production, damage reproductive organs, or compromise the quality and function of eggs and sperm. For example, prolonged contact with pesticides has been linked to decreased sperm count and motility in men, while women may experience disruptions in menstrual cycles and increased risk of miscarriage (CDC – Workplace Environmental Exposures).

Common sources of exposure include agricultural work, manufacturing, contaminated food or water, and even household products such as certain plastics and cleaning agents. For instance, phthalates and bisphenol A (BPA) found in plastics can disrupt endocrine function, potentially leading to fertility problems (NIH – Endocrine Disruptors).

To reduce risk, use protective equipment when working with hazardous materials, choose organic produce when possible, avoid microwaving food in plastic containers, and read labels to limit exposure to harmful chemicals. If you suspect environmental toxins may be affecting your fertility, discuss your concerns with a healthcare provider for appropriate testing and guidance.

33. Previous Cancer Treatments

Previous cancer treatments, such as chemotherapy or radiation therapy, can have lasting effects on reproductive organs and fertility for both men and women. Chemotherapy drugs are designed to target rapidly dividing cells, which include not only cancer cells but also the cells involved in producing eggs and sperm. This can result in reduced ovarian reserve, irregular menstrual cycles, or premature ovarian insufficiency in women, and decreased sperm count or even permanent infertility in men (American Cancer Society – Fertility and Cancer Treatment).

Radiation therapy directed at or near the pelvis may damage the ovaries, uterus, testes, or other reproductive structures. The risk of infertility depends on the type, dose, and location of treatment. For example, childhood cancer survivors who received pelvic radiation are at increased risk for fertility problems later in life (National Cancer Institute – Fertility Issues in Women).

If you have a history of cancer treatment and are considering starting a family, consult a fertility specialist early. Supportive resources such as fertility preservation (egg, sperm, or embryo freezing) and counseling are available to help individuals and couples navigate reproductive challenges after cancer.

34. History of Pelvic or Testicular Surgery

A history of pelvic or testicular surgery can have lasting implications for fertility in both women and men. Surgical procedures—such as removal of ovarian cysts, treatment of endometriosis, fibroid removal, hernia repairs, or testicular surgeries—may result in scar tissue formation (adhesions) or physical blockages. In women, adhesions can obstruct the fallopian tubes or alter the shape of the uterus, making it difficult for eggs to travel or for embryos to implant (NICHD – Causes of Infertility).

Men who have undergone surgeries involving the testes, vas deferens, or scrotum may develop blockages, reduced sperm transport, or impaired blood flow, all of which can affect sperm production and quality. Signs to watch for include irregular menstrual cycles, chronic pelvic pain, recurrent miscarriages in women, or changes in semen volume and quality in men (Urology Care Foundation – Male Infertility).

If you have a history of pelvic or testicular surgery and are experiencing difficulty conceiving, discuss your surgical background with a fertility specialist. Diagnostic imaging, hormone testing, and advanced reproductive techniques can help address complications and improve your chances of achieving pregnancy.

35. Undescended Testicles

Undescended testicles, also known as cryptorchidism, occur when one or both testicles fail to move into the scrotum before birth or within the first few months of life. This is a relatively common condition in newborn boys, especially those born prematurely. If not corrected early through surgery (orchiopexy), undescended testicles remain in the warmer environment of the abdomen or groin, which can impair spermatogenesis (sperm production) due to higher temperatures (Mayo Clinic – Undescended Testicle).

Men with a history of undescended testicles are at increased risk of reduced sperm count, poor sperm quality, and infertility later in life, even if the condition was corrected surgically. This risk is higher if the testicle remained undescended beyond early childhood. Additional concerns include a greater risk of testicular cancer and hormonal imbalances (Urology Care Foundation – Undescended Testicle).

Signs to watch for include small or firm testicles, asymmetry in the scrotum, or a history of surgery for cryptorchidism. Men with these risk factors who experience fertility problems should seek evaluation from a urologist or fertility specialist for targeted assessment and treatment.

36. Varicocele (Enlarged Veins in the Scrotum)

A varicocele is a swelling of the veins within the scrotum, similar to varicose veins that occur in the legs. This condition is one of the most common correctable causes of male infertility, affecting up to 15% of all men and about 40% of men evaluated for infertility (Urology Care Foundation – Varicocele). Varicoceles can impair sperm production and function by raising the temperature in the scrotum, which disrupts the optimal environment needed for healthy sperm development.

Men with a varicocele may notice a painless or dull ache in the scrotum, visible or palpable enlarged veins (often described as feeling like a “bag of worms”), or shrinking of the affected testicle. Often, varicoceles are discovered during a physical exam or fertility workup, as they may not always cause noticeable symptoms. Over time, untreated varicoceles can lead to decreased sperm count, reduced motility, and abnormal sperm shape, all of which reduce the chances of conception (Mayo Clinic – Varicocele).

If a varicocele is detected and fertility is a concern, surgical correction (varicocelectomy) or other minimally invasive treatments can often restore normal testicular temperature, improve sperm quality, and enhance fertility prospects.

37. Delayed Puberty

Delayed puberty, defined as the absence of the development of secondary sexual characteristics by age 13 in girls or age 14 in boys, can be a sign of underlying hormonal or genetic conditions that may impact fertility later in life. In girls, this may mean a lack of breast development or the absence of menstruation, while in boys, it may involve lack of testicular enlargement or minimal growth of body hair. Causes include hypogonadism (reduced function of the ovaries or testes), congenital hormonal deficiencies, or genetic disorders such as Turner syndrome in females or Kallmann syndrome in males (NICHD – Causes of Puberty Disorders).

Delayed puberty can result in incomplete or impaired development of the reproductive system, which may hinder normal egg or sperm production. For example, individuals with hypogonadotropic hypogonadism may need hormone therapy to trigger puberty and support fertility in adulthood (Mayo Clinic – Delayed Puberty).

If puberty is significantly delayed, early evaluation by an endocrinologist or reproductive specialist is important. Timely diagnosis and targeted hormone treatments can often help achieve normal development and improve long-term reproductive health and fertility outcomes.

38. Shortened Menstrual Cycles

Menstrual cycles that consistently occur more frequently than every 21 days, known as polymenorrhea or shortened cycles, can be a sign of ovulatory dysfunction and may increase the risk of fertility problems. Regular menstrual cycles typically range from 21 to 35 days, allowing sufficient time for the egg to mature and for the uterine lining to prepare for implantation. Shortened cycles often indicate that the luteal phase—the time between ovulation and the start of the next period—is too brief, which can prevent successful implantation or reduce the chances of conception (American College of Obstetricians and Gynecologists – Abnormal Uterine Bleeding).

Underlying causes of shortened cycles include hormonal imbalances, thyroid disorders, stress, perimenopause, or conditions like polycystic ovary syndrome (PCOS). Women experiencing cycles of less than 21 days may also notice heavier or lighter bleeding, spotting between periods, or ovulation-related symptoms occurring irregularly (Mayo Clinic – Menstrual Cycle: What’s Normal, What’s Not).

If you track your periods and notice consistently short cycles, consult a healthcare provider for hormonal assessment and further evaluation. Early intervention can help identify and treat underlying causes, improving your chances of achieving a healthy pregnancy.

39. Excessive Exercise or Eating Disorders

Excessive physical exercise and eating disorders, such as anorexia nervosa or bulimia, can have a profound impact on reproductive hormones and fertility. Intense exercise, especially when combined with inadequate caloric intake, can disrupt the delicate balance of hormones necessary for ovulation in women and sperm production in men. Women may experience amenorrhea (absence of periods), irregular cycles, or very light periods as the body conserves energy and reduces reproductive function in response to stress and low body fat (NICHD – Causes of Amenorrhea).

Men may also see a decline in testosterone levels and sperm quality due to overtraining and nutritional deficiencies. Eating disorders that result in rapid weight loss, malnutrition, or severely restricted diets can suppress the release of gonadotropin-releasing hormone (GnRH), which is essential for normal reproductive function in both sexes (National Eating Disorders Association – Infertility and Eating Disorders).

If you engage in high-intensity exercise, are underweight, or have a history of disordered eating, and are experiencing fertility problems, consult a healthcare provider or reproductive specialist. Restoring balanced nutrition and moderating exercise routines can help normalize hormone levels and support reproductive health.

40. Chronic Stress

Chronic stress can have a significant impact on reproductive health by altering hormone levels and disrupting the normal function of the hypothalamic-pituitary-gonadal (HPG) axis, which controls fertility-related hormones. Elevated levels of stress hormones like cortisol can suppress the release of gonadotropin-releasing hormone (GnRH), leading to irregular menstrual cycles, missed periods, and reduced ovulation in women. In men, chronic stress may decrease testosterone production and impair sperm quality, reducing fertility potential (NICHD – Chronic Stress and Infertility).

The effects of stress are often subtle and may be attributed to other lifestyle factors, but persistent anxiety, sleep disturbances, or mood changes can serve as important clues. Real-world examples include couples experiencing delays in conception during times of job loss, family conflict, or emotional distress. Left unaddressed, ongoing stress can create a cycle of frustration and further impair reproductive health (CDC – Infertility: Stress and Infertility).

To manage chronic stress, consider incorporating relaxation techniques such as mindfulness meditation, regular physical activity, adequate sleep, and counseling when needed. Seeking support from friends, family, or mental health professionals can also enhance emotional well-being and support fertility goals.

41. Abnormal Uterine Shape or Fibroids

Structural abnormalities of the uterus, such as congenital malformations or the presence of uterine fibroids, can significantly interfere with a woman’s ability to conceive and maintain a pregnancy. Common structural problems include a septate uterus (where a wall divides the uterine cavity), bicornuate uterus (heart-shaped), or unicornuate uterus (one-sided). These conditions can hinder sperm from reaching the egg, prevent proper implantation, or increase the risk of miscarriage (American Society for Reproductive Medicine – Congenital Uterine Anomalies).

Uterine fibroids—benign growths of muscle and connective tissue—are another frequent cause of infertility. Depending on their size and location, fibroids can distort the shape of the uterus, block the fallopian tubes, or alter blood flow to the uterine lining. Symptoms may include heavy menstrual bleeding, pelvic pain or pressure, and reproductive difficulties. Some women with fibroids experience no symptoms until they try to conceive (American College of Obstetricians and Gynecologists – Uterine Fibroids).

If you have a history of abnormal periods, recurrent miscarriages, or difficulty getting pregnant, consult your healthcare provider. Imaging tests such as ultrasound or hysterosalpingography can help diagnose structural abnormalities, and treatment options are available to improve fertility outcomes.

42. Low Levels of Luteinizing Hormone (LH) or Follicle Stimulating Hormone (FSH)

Luteinizing hormone (LH) and follicle stimulating hormone (FSH) are critical regulators of reproductive function in both women and men. Produced by the pituitary gland, these hormones control the menstrual cycle and ovulation in women, and stimulate sperm production in men. Low levels of LH or FSH—often due to disorders of the hypothalamus or pituitary, such as hypogonadotropic hypogonadism—can disrupt ovulation, impair egg maturation, or halt sperm production, leading to infertility (Johns Hopkins Medicine – Understanding Hormone Testing for Infertility).

Women with low LH or FSH may experience irregular or absent menstrual periods, anovulation (lack of ovulation), and difficulties conceiving. Men may present with low sperm counts, reduced libido, or diminished muscle mass and energy. These symptoms can be subtle and are often discovered only during fertility evaluations.

Lab testing for LH and FSH is done via blood samples, typically measured at specific times in the menstrual cycle for women or as part of an infertility workup in men. Identifying hormonal deficiencies allows for targeted therapies, such as hormone replacement, to restore reproductive function and enhance fertility prospects (Mayo Clinic – FSH Test).

43. Poor Sperm Motility

Poor sperm motility, also known as asthenozoospermia, refers to a reduced ability of sperm to move efficiently. This is a crucial factor in male fertility because sperm must be able to swim through the female reproductive tract to reach and fertilize the egg. If sperm movement is slow, weak, or abnormal, the chances of successful conception drop significantly (Mayo Clinic – Male Infertility).

Sperm motility is typically assessed through a semen analysis, which measures several parameters, including the percentage of sperm that are actively moving and the quality of their movement. Normal motility is defined as at least 40% of sperm showing active, forward progression. Factors contributing to poor motility include varicocele, infections, exposure to toxins, smoking, certain medications, and underlying genetic or hormonal issues (Urology Care Foundation – Male Infertility).

Men with poor sperm motility may not have any outward symptoms, making laboratory testing essential in the infertility evaluation process. If poor motility is detected, addressing lifestyle factors, treating underlying medical conditions, or utilizing assisted reproductive technologies can help improve fertility outcomes.

44. Frequent Urinary Tract Infections (UTIs)

Frequent urinary tract infections (UTIs) can have serious implications for reproductive health and fertility, especially when infections are recurrent or left untreated. In women, repeated UTIs can cause inflammation and scarring in the urinary tract and nearby reproductive organs, such as the bladder, urethra, and even the fallopian tubes if infections ascend, potentially leading to pelvic inflammatory disease (PID). PID can result in blocked or damaged fallopian tubes, making it difficult for the egg and sperm to meet and increasing the risk of infertility (CDC – Pelvic Inflammatory Disease (PID) Fact Sheet).

Men with chronic or recurrent UTIs may develop infections in the prostate (prostatitis), epididymis (epididymitis), or testes, which can lead to scarring, blockages, or reduced sperm quality. Symptoms of UTIs include frequent and painful urination, lower abdominal pain, cloudy urine, and sometimes fever. Untreated infections can cause lasting damage to the reproductive tract and compromise fertility (NHS – Urinary Tract Infection (UTI)).

If you experience frequent UTIs, consult your healthcare provider for thorough evaluation and preventive strategies. Early treatment and management are essential to minimize complications and protect long-term reproductive health.

45. Absent Cervical Mucus

Cervical mucus plays a vital role in conception by creating a welcoming environment for sperm, helping them survive the acidic conditions of the vagina, and facilitating their movement toward the egg during ovulation. Normally, around the time of ovulation, cervical mucus becomes clear, stretchy, and slippery—similar to raw egg whites—which is ideal for sperm transport. If cervical mucus is absent or consistently scant, it can make it difficult for sperm to reach the egg, significantly reducing the likelihood of pregnancy (NHS – Signs of Ovulation).

Absent or dry cervical mucus may result from hormonal imbalances, such as low estrogen, side effects of certain medications (for example, antihistamines or fertility drugs), or medical conditions like polycystic ovary syndrome (PCOS) and thyroid disorders. Women may notice vaginal dryness, discomfort during intercourse, or simply a lack of the usual mid-cycle mucus changes (Mayo Clinic – Vaginal Atrophy).

If you are trying to conceive and observe little or no cervical mucus, consult your healthcare provider. Evaluating hormone levels and reviewing medication use can help identify and address underlying causes, potentially restoring optimal conditions for conception.

46. Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on or within the ovaries and are relatively common during a woman’s reproductive years. While most ovarian cysts are benign and resolve on their own, the presence of multiple or persistent cysts—especially as seen in polycystic ovary syndrome (PCOS)—can significantly disrupt normal ovulation and affect fertility. In PCOS, the ovaries often contain many small, immature follicles that do not mature or release eggs regularly, leading to irregular or absent menstrual cycles and reduced chances of conception (Office on Women’s Health – PCOS).

Symptoms of ovarian cysts may include pelvic pain, bloating, heavy or irregular periods, and sometimes pain during intercourse. However, many women with cysts experience no noticeable symptoms until they have difficulty getting pregnant. In addition to PCOS, other types of cysts, such as endometriomas (related to endometriosis) or functional cysts, can also interfere with normal ovarian function (Mayo Clinic – Ovarian Cysts).

If you suspect ovarian cysts or have irregular cycles, consult a healthcare provider for an ultrasound and hormone evaluation. Early diagnosis and targeted treatment can help restore ovulation and improve fertility outcomes.

47. Difficulty Achieving Orgasm

Persistent difficulty achieving orgasm, known as anorgasmia, can be a sign of underlying psychological or physiological issues that may also impact fertility. While occasional problems with orgasm are common and often related to stress or fatigue, consistent trouble reaching orgasm may be linked to hormonal imbalances, nerve damage, pelvic surgery, certain medications (such as antidepressants), or chronic illnesses like diabetes (Mayo Clinic – Anorgasmia).

Psychological factors—such as anxiety, depression, unresolved relationship issues, or a history of trauma—can also play a significant role. In women, pelvic floor dysfunction, endometriosis, or vaginal dryness may contribute, while in men, erectile dysfunction or premature ejaculation may be associated. Difficulty achieving orgasm can lead to frustration, decreased intimacy, and reluctance to engage in intercourse, indirectly affecting the chances of conception (NHS – Anorgasmia).

If you experience ongoing problems reaching orgasm, consider keeping a symptom diary and discussing your concerns with a healthcare provider or sexual health specialist. Identifying and addressing the underlying causes—whether medical, psychological, or relational—can improve both sexual satisfaction and fertility prospects.

48. Swelling in the Scrotum

Swelling in the scrotum can be a significant indicator of underlying conditions that may impact male fertility. This swelling may be caused by infections such as epididymitis or orchitis, fluid accumulation (hydrocele), varicoceles (enlarged veins), or blockages within the reproductive tract. Infections often result from bacterial or viral pathogens and may present with redness, warmth, and pain in addition to the swelling. Such infections can damage the epididymis or testes and impair sperm production or transport (Urology Care Foundation – Scrotal Swelling).

Blockages caused by trauma, previous surgeries, or congenital abnormalities may also lead to scrotal swelling and interfere with the passage of sperm, reducing fertility. In some cases, swelling is painless and discovered incidentally, while in others, it is accompanied by discomfort, heaviness, or fever. Persistent swelling can sometimes be a sign of a varicocele, which is a common, correctable cause of male infertility (Mayo Clinic – Varicocele).

If you notice sudden or persistent scrotal swelling, seek prompt medical evaluation. Early diagnosis and treatment of infections or blockages can help preserve fertility and prevent long-term complications.

49. Abnormal Vaginal Discharge

Abnormal vaginal discharge—characterized by changes in color, consistency, odor, or volume—can be a sign of infection, inflammation, or an imbalance in the vaginal flora. Healthy vaginal discharge is typically clear or white, odorless, and varies in amount during the menstrual cycle. Unusual discharge, such as yellow, green, gray, frothy, or foul-smelling fluid, may indicate infections like bacterial vaginosis, yeast infections, or sexually transmitted infections (STIs) such as chlamydia or gonorrhea (CDC – Vaginal Discharge).

Such infections can cause inflammation of the cervix, uterus, or fallopian tubes, potentially leading to pelvic inflammatory disease (PID), which is a major cause of infertility in women. Other symptoms may include itching, burning, pelvic pain, or pain during intercourse. Imbalances in the vaginal microbiome can also affect the ability of sperm to survive and reach the egg (Mayo Clinic – Vaginitis).

If you notice persistent or unusual changes in your vaginal discharge, seek evaluation from a healthcare provider. Early identification and treatment of infections or imbalances can protect reproductive health and support fertility.

50. Failure to Conceive After 12 Months of Unprotected Sex

The clinical definition of infertility is the inability to achieve pregnancy after 12 months of regular, unprotected intercourse in women under 35, or after 6 months in women over 35. This benchmark reflects the normal time frame in which most healthy couples—about 85%—will conceive. If conception does not occur within this period, it may signal underlying issues such as ovulatory disorders, low sperm count or motility, blocked fallopian tubes, uterine abnormalities, hormonal imbalances, or unexplained infertility (CDC – Infertility).

Both male and female factors contribute to infertility, and in some couples, a combination of subtle issues in both partners may be present. Environmental exposures, lifestyle habits, age, and medical history also play a role in fertility potential. Early evaluation is particularly important for women over 35 and for couples with known risk factors, such as a history of pelvic infections or testicular problems (NICHD – Infertility: Condition Information).

If you have been trying to conceive for a year (or six months if over 35) without success, seek assessment from a reproductive specialist. Timely diagnosis can identify treatable causes and improve the chances of building a family.

Conclusion

Recognizing the early signs and symptoms of infertility in both women and men is crucial for improving the chances of successful treatment and building a family. Delaying evaluation can reduce options and may complicate underlying conditions. If you notice any persistent symptoms or have been unable to conceive after 12 months of unprotected sex (or 6 months if over age 35), seek timely medical advice from a healthcare professional or fertility specialist. Initial screening—such as hormone testing, semen analysis, and pelvic ultrasound—can help identify treatable causes. Taking proactive steps and consulting reputable resources, such as the RESOLVE: The National Infertility Association, empowers individuals and couples to make informed decisions about their reproductive health.

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