Q: How can I turn around my sexless marriage?

Why would some couples remain celibate?  Isn't sex supposed to be part of the pleasures of love and marriage?  Yet, approximately 10-15% of marriages may experience long stretches of time without sex.  A smaller number of couples never consummate the marriage.  Most of us assume that sex is a very important part of being a couple.  It forms one of the building blocks of lasting love.  The other building blocks include shared values and interests, and commitment.

But before you shake your head or raise your brow as you wonder why anyone would skip the sex part, please keep this idea in mind:  Every relationship is unique in its details and management of unhappiness.  As in Woody Allen's movie "Husbands and Wives," what one couple will not accept, another agrees to incorporate in the relationship.   And if both parties are happy to remain celibate or tolerate long lapses, then there is no relationship problem! 

However, problems arise when one partner is unhappy about the lack of sex. There are many reasons for lack of sex.  Here is a list of the top reasons and solutions.

1. Physical and health problems.  Low testosterone in both partners, painful intercourse for the woman, injuries, cardiovascular disease, and physical limitations are amongst the most common health reasons that couples have infrequent sex or none at all.  

Solutions:  I always counsel couples to begin with a physical examination to rule out medical reasons.  Seeing a doctor can help you avoid blame and anger. Be sure to tell your physician about your sexual concerns.  A woman's painful intercourse, for example, can be caused by uterine or ovarian cysts or vaginal dryness due to hormone changes.  Post-menopausal women often experience a dip in their sexual desire.  This decrease is normal, but you don't have to" live with it."  Make sure you tell your physician about all your medications since they might have unexpected side effects.

2. Mental health issues.  Depression, anxieties, phobias, and other mood disorders can disrupt the desire for sex.  Depression is an especial spirit and soul robber.  I know that our culture still stigmatizes mental health problems, but don't live your life for other people!

Solutions:  Get help now.  Make an appointment with a psychiatrist who can prescribe medication and treatment. 

3. Recent major stresses and lack of time.  Loss of loved ones, changing or losing jobs, relocating, work deadlines or illness in family members are some of the top stressors that can put your sex life on hold.  These events require a great deal of emotional energy.  They seem to actually "take up space" in your brain, and soon, sex is the last thing on your mind. 

Solutions:  Don't despair.  There's most likely nothing "wrong with you."   Even chronic stressors such as caring for an elderly parent can allow for intimate time.  But you have to make a commitment to including it.  Some of my clients, for example, promise not to let a month go by without sex.  Sit down with your partner and review your calendar to see where you can schedule sex.  Now some of you, at this point, might be rolling your eyes at the thought of planning sex.  You worry that it might take the fun out of it.  But the brain is a very flexible organ.  When it knows that sex is on the agenda, it adapts very well.  Just heading for the bedroom or embracing passionately can be enough to signal the brain for sexual arousal.

4. Religious beliefs.  Some people believe that sex is only for procreation, and that avoiding sex is the only way to avoid pregnancy.  These ideas do seem like deal-breakers.  Yet, if one of you is unhappy about the use of birth control or the lack of sex, then you have to be stuck in "all or nothing" sex. 

Solutions:  Some couples with strong religious beliefs about sex engage in "everything but intercourse" sexual activities. Talk to your partner about whether you each can accept different kinds of sexual expression.  Some of my clients had a "soul-talk" with each other and realized that they were good and religious people even though they didn't practice all the non-sexual tenets of their beliefs.  For example, some did not go to church every week, while others didn't celebrate every holiday or observe other parts of their religion.  Several of these couples, after realizing that they had already made personal religious adjustments, were then able to become more flexible about using birth control.  There is no right and wrong because your religious beliefs are very important and very personal.  If you and your partner cannot develop a satisfactory-enough solution, seek pastoral counseling.

5. Substance abuse.  Alcohol can impair sexual performance, and illegal substances such as marijuana can dull the desire as well.  Don't take chances with your mental and physical health.  Keep a clean path for sexual pleasure.

Solutions: Get used to having sexing without using substances. Get help immediately or do an intervention whenever there is alcohol and drug addictions.

6. Negative sexual experiences or feelings about sex.  A history of childhood sexual abuse or rape can seriously impair sexual desire and sexual comfort.  But you don't have to let the past completely affect your present.

Solutions:  Get professional help with someone who specializes in sexual trauma.  You don't have to suffer or live in fear.

7. Lack of sexual satisfaction and performance.  Some couples forego sex because it is unsatisfying to them.  Men might struggle with erectile dysfunction or premature ejaculation.  Women might not be able to have orgasms or sexual desire.  Other couples might not have any of these problems, but one of the partners does not like the other's sexual style or methods.    

Solutions:  Talk it out-with kindness.  If you are having performance issues, then seek professional help from someone with advanced training in sexual matters. If you don't like your partner's technique, show your partner what you like.  Be kind, don't criticize.  Make a game of it such as playing "School" where you teach each other what you like.

8. Disrespectful or dangerous sexual behavior by a partner.  No one should put up with demeaning, frightening or dangerous sexual demands.  You don't have to participate in your partner's sexual style of beatings, suffocations, drugs or any other behaviors that demean or hurt you.  Partners who are addicted to porn often ask their partners to fulfill their pornographic fantasies.

Solutions:  Avoiding sex to avoid harmful and hurtful behavior is not necessarily a bad idea.  You must protect yourself in any way you can.  However, if you want to have healthy sex with your partner, it can be very frightening to rock the relationship boat by complaining-especially if your partner has anger issues.  I strongly recommend that you go alone to consult with a professional who knows about domestic violence and sexual issue.

9. Anger at your partner.  Anger is never a good ingredient for sexual pleasure. If you and your partner are having disagreements or if your partner has emotionally hurt you, it's easy for those feelings to turn you off to sex.  Many couples play out their relationship anger in the bedroom by withholding sex.  Don't make your bed your battleground. 

Solutions:  Work out productive solution-oriented skills.  Instead of getting trapped in playing an unproductive game of History where you review what you or your partner said or didn't say, play it forward by moving directly to a solution.  And, instead of fuming, tell your partner that your feelings are hurt.  Speak up before you turn off sexually.  If you cannot manage these changes, seek professional help from a couples counselor.

10. Affairs or porn addictions.  Having an affair is a sure way to drain sexual desire from your existing relationship.  And few partners can or will participate in the sexual behaviors of pornography.  These issues are especially difficult to address since they have the power to break the relationship.  Yet, at least a third of couples who have experienced affairs recover.

Solutions:  Once again, seek counseling.  If you suspect an affair, some couples hit the issue straight on while others focus on improving the relationship first.  Talk to a couples and marital expert and explore either alone or together to develop the best strategy.  Many affairs are symptoms of unhappiness and not the discovery of the love of your life.

Best of luck!

Dr. LeslieBeth Wish, ED.D., MSS is a noted psychologist and licensed clinical social worker, specializing in relationships.  For her book about women and love, she welcomes women to take her 17-20 minute online research survey at www.lovevictory.com.