The Sexuality, Intimacy, and Menopause Program is one of the only clinics of its kind in the country. By combining both medical and psychological interventions, it is designed to help women who experience sexual dysfunction after cancer. Sexual dysfunction after cancer is common; however, sexual side effects often go untreated after having successfully treated a patient’s cancer. Our doctors look to manage not only the physical issues, but also any psychological concerns that may arise. Founded by Elena Ratner, MD, MBA, associate professor of Obstetrics, Gynecology & Reproductive Sciences and co-chief for the Section of Gynecologic Oncology, and Mary Jane Minkin, MD, clinical professor of Obstetrics, Gynecology & Reproductive Sciences, the clinic began nearly a decade ago. Psychologist Dwain Fehon, PsyD, associate professor of Psychiatry and chief psychologist of Psychiatric Services at Yale New Haven Hospital, is a vital member of the team. He and his staff provide essential emotional care that helps improve our patients’ relationships and personal health. Many women have concerns related to intimacy and menopause because of cancer surgery or treatment. Our specialists consult with patients to address the difficult physical and emotional aspects of cancer care and treatment, and create a personalized care plan for each patient. We have developed a unique focus on menopause management for cancer survivors and “previvors”—healthy women who have their breasts or ovaries removed because of a genetic risk of developing cancer. What types of patients do we see? Women who experience: Changes in sexual function as a result of chemotherapy, radiation, or surgery for cancer Menopause symptoms as a side effect of cancer treatment Early menopause or sexual changes after surgery for cancer risk reduction What we provide: Menopause symptom management Resources for cancer survivors on maintaining sexual health Access to complementary and supportive services Access to individual and couples counseling What to expect from an appointment: Our team will first discuss each patient’s medical and cancer history, as well as what type of treatment they have had. They will be asked about symptoms of menopause and sexual problems, such as hot flashes, night sweats, changes in sexual desire, painful intercourse, vaginal dryness, or changes in mood or sleep patterns. Depending on their symptoms, patients may have a gynecologic exam. The team will then discuss options for symptom management and improving their sexual health. They will also have the opportunity to talk about emotional and relationship issues affecting their life. Women are welcome to bring their partners to the appointment.

Patients often hesitate to discuss miscarriages, or spontaneous pregnancy losses. While one miscarriage might prompt a doctor's visit, experiencing two or more losses warrants a thorough examination for underlying reproductive issues. Yale Medicine’s Recurrent Pregnancy Loss Program assembles experts from various fields to provide comprehensive and compassionate care to patients facing this condition. We utilize cutting-edge technologies for diagnosis and tailor individualized treatments to address the root cause. Recurrent pregnancy loss is defined as two or more failed pregnancies, including those confirmed via pregnancy blood test or ultrasound. Miscarriage is relatively common, affecting 15% to 20% of known pregnancies within the first 20 weeks. However, experiencing two or more consecutive losses, which affects 1%-3% of pregnancies, may indicate underlying genetic, physiological, or anatomical issues. Anatomic abnormalities in the uterus, such as fibroids , polyps, adhesions, or the presence of a septum dividing the uterine cavity, can lead to pregnancy complications. Hormonal disorders, like uncontrolled diabetes or thyroid issues , can also contribute to recurrent pregnancy loss. Additionally, chromosomal abnormalities in embryos, autoimmune conditions, infections, and lifestyle factors, such as smoking, drug use, caffeine and alcohol consumption, toxin exposure, and obesity, may play a role. Our multidisciplinary team works closely with patients to identify potential contributing factors while offering emotional support during this challenging time. Initial assessments include a thorough review of medical history, physical examinations, specialized ultrasounds, and consultations with specialists, such as reproductive endocrinologists, maternal-fetal medicine specialists, reproductive immunologists, geneticists, and pathologists. We employ advanced diagnostic techniques, including genetic testing and analysis of fetal tissue, to pinpoint underlying causes. Our team includes psychological counselors, dietitians, and experienced nurses who provide comprehensive support throughout diagnosis and treatment. At Yale Medicine, our Recurrent Pregnancy Loss Program combines compassionate care with state-of-the-art genetic analysis. Following a definitive diagnosis, we offer customized treatment options, which may include surgical interventions to address anatomical abnormalities, in vitro fertilization (IVF) , or a genetic screening of embryos. Even in cases where a specific cause cannot be identified, the outlook remains positive, with the majority of subsequent pregnancies proceeding normally. Throughout the process, we remain dedicated to understanding the root cause of difficulties and providing empathy and reassurance to patients facing recurrent pregnancy loss.

Our Reproductive Endocrinology & Infertility Division specializes in aiding patients facing challenges with their reproductive abilities . We are committed to diagnosing conditions and guiding each patient through the available treatment options to help them realize their dreams of starting or expanding their family. We focus on diagnosing and managing endocrine disorders and other chronic conditions that hinder conception or the maintenance of pregnancy. Additionally, we assist patients in preserving their fertility before undergoing cancer treatments. Our expertise extends to supporting individuals without partners, same-sex couples, and transgender individuals in overcoming barriers to parenthood. With its globally recognized reputation, our academic health center is known for cutting-edge therapies and exceptional success rates. Our state-of-the-art facility is staffed by approachable clinicians, many of whom are esteemed experts in fertility treatment. Our clinicians deliver compassionate and personalized care tailored to our patients’ individual needs throughout their journey. Several of our clinicians have held or currently hold leadership positions in prestigious professional organizations, such as the American Society for Reproductive Medicine (ASRM) and the Society for Reproductive Investigation (SRI), underscoring our commitment to excellence in the field of reproductive medicine. Our clinicians have contributed to over 1,000 scientific publications, significantly advancing the field. They have also authored the seminal reference book Speroff's Clinical Gynecologic Endocrinology and Infertility , which guides clinicians in providing comprehensive care to patients with infertility and reproductive disorders. With decades of experience treating patients and helping them achieve pregnancy, our clinicians are also dedicated to advancing research in their specialized areas. Their findings have led to the development of new diagnostic tests, surgical procedures, and innovative technologies, shaping and advancing the field of assisted reproductive technology. As research is integral to our practice, patients can access clinical trials conducted at our facility. Recognizing the emotional complexities associated with infertility, our clinicians offer empathy, support, and a celebration of successes, guiding patients through their challenges. Financial coordinators are available to clarify health insurance eligibility and costs, ensuring transparency and minimizing unexpected fees. The Yale Medicine Reproductive Endocrinology & Infertility Division offers specialized programs including: Endometriosis Program: We diagnose and treat endometriosis , addressing pelvic pain and infertility to improve pregnancy outcomes. Fertility Center: We offer an array of individualized treatment options for both women and men looking to start a family. Our physicians, staff, and scientists share our patients’