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Sexless Marriage: 8 Causes & Tips to Deal With It

Published: September 30, 2022 Updated: March 6, 2023
Published: 09/30/2022 Updated: 03/06/2023
Headshot of Kimberly Panganiban, LMFT
Written by:

Kimberly Panganiban

LMFT
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is a Sexless Marriage?Definition
  • Causes of a Sexless Relationship8 Causes
  • How Important Is Sex In a Relationship?Importance
  • How to Address Your Sexless Relationship With Your PartnerTalk About It
  • Tips to Rebuild Your Sex Life5 Tips
  • When to Seek Professional HelpGetting Help
  • When to Walk Away From a Sexless MarriageWalking Away
  • Final Thoughts On Sexless MarriageConclusion
  • Additional ResourcesResources
  • Sexless Marriage InfographicsInfographics
Headshot of Kimberly Panganiban, LMFT
Written by:

Kimberly Panganiban

LMFT
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD

We need to feel close to our romantic partners both emotionally and physically. This kind of intimacy comes in many forms, sex being one of them, but many couples report being in a sexless marriage. This doesn’t necessarily spell disaster for the relationship, though. There are ways to improve intimacy and feel close to your partner again.

Is your relationship a source of frustration or disappointment?

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What Is a Sexless Marriage?

While there’s not a universal sexless marriage definition, it refers to a marriage with little or no sexual activity between partners (less than 10 times per year).1,2
It’s important to note that what people define as sexual activity varies. Ultimately, the number of sexual encounters is less important than your satisfaction and happiness in the relationship.

Is a Sexless Marriage Normal?

Many people in sexless relationships report feeling alone with the issue. However, an estimated 15% of married couples have not had sex in the past six months to a year.3
According to Dr. Robert Epstein, 10-20% of romantic relationships in the U.S. are sexless, which accounts for an estimated 40 million people.4
In other words, if you are in a sexless marriage, you are not alone.

Dr. Michael Stokes, a certified sex therapist and professional consultant at Between Us Clinic“A sexless marriage can mean something different to each person. Most times, when people refer to being in a sexless marriage, they mean sex is very infrequent or in fact does not happen within their marriage. This is not uncommon. I find many of the couples who come to see a sex therapist often wait years until they can’t continue in the marriage this way. This creates a sense of urgency for the client and/or couple to work on their sex life immediately,” says Dr. Michael Stokes, certified sex therapist and professional consultant at Between Us Clinic

It’s common to believe that men want more sex and women want less. While this does occur, it’s not uncommon for it to be the other way around. Jen Gunter, an obstetrician and gynecologist practicing in California states, “Our society seems almost built on the erroneous idea that all men want sex all the time…I want women to know that if they are on the wanting end for sex, they are not alone.”5

8 Causes of a Sexless Relationship

If you and your partner aren’t having sex, I encourage you to question where there is a reason, including health issues,unmatched libidos, life transitions, communication issues, other relationship issues, hormone changes, mental health issues, and medication side effects.

Here are eight potential causes of a sexless relationship or marriage:

1. Health Issues

If you or your partner are dealing with health concerns, this may impact your desire (or ability) to have sex. Several medical conditions, including diabetes, cancer, cirrhosis of the liver, and heart disease are known to reduce libido.6 Some conditions even impact physiology in a way that can make sex difficult, painful, or impossible.

2. Unmatched Libido

Difference in sexual desire is one of the most common causes of sexlessness in a marriage. Usually, it’s not the fact that a couple has different levels of desire but rather how they manage these differences that leads to a decline in sex.

The person who wants it more feels rejected and unloved, often leading to a decline in initiating. The partner who wants it less feels guilty for not wanting it more. These feelings lead to distance in the relationship, which exacerbates intimacy issues.

3. Life Transitions

We all face challenges in life that impact our health and happiness. During these times, it is normal for sexual desire to decrease as we focus on getting through the struggle and re-establishing our balance.

Life transitions include:

  • Job loss
  • Financial issues
  • Grief (loss of a loved one or other significant loss)
  • High stress (due to work, a move, family issues, etc.)
  • Childbirth
  • Infertility
  • Menopause

4. Communication Issues

If you and your partner are experiencing difficulties with lack of communication, this is going to impact your connection and closeness. It is difficult to have sex with your partner when you are feel distant and disconnected. Emotional connection is a prerequisite to sex, especially for women.

Stokes states, “The most common reason for a sexless marriage is a lack of communication. So many people are uncomfortable talking about sex so they fall into a routine of sex that seems manualized and not satisfying. The idea of telling their partner they want to have sex or they want to try something different in the bedroom is too overwhelming, so they simply do not.”

5. Other Relationship Issues

Other relationship challenges may lead to a decline in sexual intimacy as well, including feeling alone in your relationship, infidelity, addiction, lies, emotional affairs, or other betrayals. If there is an issue of trust in the relationship, it is hard to be vulnerable and therefore difficult to engage in sexual activity.

6. Hormone Changes

Estrogen, progesterone, and testosterone all affect sexual desire and arousal.7 If your hormones become imbalanced, it may lead to a decline in libido.

Hormone fluctuations can occur for many reasons, including:7

  • Pregnancy
  • Menopause
  • Age
  • Menstruation
  • Stress
  • Medications
  • Environment

7. Mental Health Issues

Mental health concerns have also been linked to a decline in sexual desire and arousal.8 Specific issues can cause changes in brain chemistry that decrease sexual desire and impair one’s ability to engage in sexual activity, especially if someone has a history with sexual trauma or relationship post traumatic stress disorder (PTSD).

Mental health issues include:9

  • Depression
  • Anxiety
  • Schizophrenia
  • PTSD
  • Eating disorders
  • Personality disorders

8. Medication Side Effects

Medications are sometimes necessary to treat physical health or mental health conditions; however, they can impact our hormones and disrupt our level of sexual desire and arousal. Medications that affect sex drive often have mechanisms that affect the biologic or hormonal mediators of libido.10

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Choosing Therapy partners with leading mental health companies and is compensated for marketing by OurRelationship, Ritual, BetterHelp, and Online-Therapy.

How Important Is Sex In a Relationship?

So, how important is sex in a relationship? The importance of sex in a relationship is determined by the people who are in the relationship. If it’s a concern for one person, it’s a concern for the relationship. If, however, a lack of sex is not bothersome to you and your partner, it’s not an issue.

Exploring Other Forms of Intimacy 

Sex is an obvious and positive way to express intimacy. That said, physical and emotion intimacy in a marriage are crucial for the relationship to flourish, as well as lay the groundwork for a healthy sex life. Other forms of physical intimacy include hugging, kissing, snuggling, holding hands, and playful touch.

Emotional intimacy is created by building a strong friendship. This includes knowing each other, expressing appreciation for each other, and being there to support each other. When you focus on fostering emotional intimacy and other forms of physical intimacy, sex is more likely to occur. If not, you will both still feel a great sense of satisfaction in the relationship.

How to Address Your Sexless Relationship With Your Partner

If your sex life has been waning or is non-existent and you want this to change, talk to your partner about your concerns. It’s imperative that you approach them gently and avoid criticism. If your partner feels blamed, criticized, or attacked, they will have a hard time hearing you.

The best way to ensure that you bring up your concern gently is by using what Dr. John Gottman (who coined the Four Horsemen of the Apocalypse in a relationship) calls the Softened Start Up.11
In this approach, share how you feel, what the issue is, and your positive needs.

For example, you might say, “I am feeling sad that our sex life has declined. I would love it if we could talk about this and explore ways to connect more physically.” Or, “I have been missing you and I would love it if we could figure out a way to reconnect physically.”

5 Tips to Rebuild Your Sex Life

Once you have an open conversation about your feelings, if you both decide to try rebuil

Stokes advises, “I would encourage couples to start by talking about this in an open way. This can be difficult, but necessary. If talking about this on your own is not working, it might be time to talk to an AASECT Certified Sex Therapist who can help assess the problem and facilitate interventions that can help towards their goals.”

Here are five tips to rebuild your sex life:

  1. Make time to talk about sex outside of the bedroom: share what you like, desire, fantasize about, etc. Talking openly and honestly about sex is key to having a good sex life.
  2. Increase your physical affection: sex starts long before you are in the bedroom. Small acts of romance and affection throughout the day will help you feel more emotionally connected and enhance your desire for physical connectedness.
  3. Take the pressure off: when orgasm is the objective, it can put pressure on the act and impede pleasure. Instead, shift the focus to being present and engaged regardless of the “outcome.”
  4. Try new things: get an informative book about sex, buy some toys, find ways to spice things up, and keep it interesting
  5. Schedule sex: if it’s hard to find time to be intimate due to busy schedules, make sex a priority by carving out specific time

When to Seek Professional Help

If you and your partner have tried to get your sex life back on track but are feeling stuck, it may be time to work on finding a couples therapist to help you move forward. If your partner is willing to attend, marriage and couples counseling and/or sex therapy may be beneficial as well. If your partner isn’t willing to attend, seeing a therapist individually can still be useful.

How to Find a Therapist

You can search an online therapist directory for licensed marriage and family therapists (LMFT). You could also ask people you know and trust, including a primary care provider, for their recommendations.

When to Walk Away From a Sexless Marriage

The decision to divorce and end a marriage is a painful choice that only you can make for yourself. Some signs that it may be time to walk away include an infidelity one partner can’t get over, incompatible sexual interests, or an unwillingness to address intimacy issues.

If you’re unsure whether you want to continue the relationship, consider discernment counseling, a short-term process that helps couples determine whether they want to divorce.

Stokes encourages, “Walking away from any marriage is a difficult and individualized decision. There is not one particular point in time that warrants you to leave. I encourage couples to continue to communicate, be vulnerable with one another, and work as a team. Your decision to walk away should be your decision.”

Here are four reasons to consider walking away from a sexless marriage:

  1. Your partner isn’t willing to work on intimacy issues or make any changes despite you sharing how important it is for you
  2. The lack of sex has led to infidelity that one partner can’t get over
  3. You and/or your partner realize you have incompatible sexual interests and neither is willing to compromise
  4. You are no longer in love

Final Thoughts On Sexless Marriage

Couples should understand and expect that there are going to be ebbs and flows in their sex life throughout the course of their relationship. While sex is often an important aspect of romantic relationships, it’s not the only way to share intimacy. As long as you’re both willing to work on it, there are ways to stay connected emotionally and physically and maintain a healthy, happy relationship.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

BetterHelp (Online Therapy) – Relationships aren’t easy – a licensed therapist can help. Live sessions can be done via phone, video, or live-chat. Plus, you can message your therapist whenever you want. Visit BetterHelp

Online-Therapy.com (Online Couples Therapy) – Do you and your partner want to work together to have less arguments and better communication? Are there children involved and being caught in the crossfire? Do you love each other but are having a rough time operating as one unit? Couples therapy can help. Get Started

Ritual (Relationship Guidance) – Ritual provides guidance to individuals working to improve their relationship, or couples working jointly. Ritual combines video sessions led by a relationship expert, with short online activities. 14-day money-back guarantee. Try Ritual

OurRelationship (Free Couples Course) – OurRelationship has been proven to help couples improve communication, intimacy, and trust. 94% would recommend it to a friend. Get Started

Mindfulness.com (App) – During a disagreement, controlling one’s anger can be difficult, particularly if your partner starts yelling. Mindfulness can prevent one from saying and doing things that lead to regret. Free 7-Day Trial

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp, Online-Therapy.com, Ritual, OurRelationship, and Mindfulness.com

For Further Reading

  • Helpful Books for Sex and Intimacy
  • Best Books About Marriage
  • Sex Therapy Books
  • MHA
  • NAMI support groups
  • MentalHealth.gov

Sexless Marriage Infographics

What Is a Sexless Marriage? Causes of a Sexless Relationship Tips to Rebuild Your Sex Life

When to Seek Professional Help for a Sexless Marriage

11 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Kim JH, Tam WS, Muennig P. Sociodemographic Correlates of Sexlessness Among American Adults and Associations with Self-Reported Happiness Levels: Evidence from the U.S. General Social Survey. Arch Sex Behav. 2017;46(8):2403-2415. doi:10.1007/s10508-017-0968-7

  • Denise A. Donnelly (1993) Sexually inactive marriages, The Journal of Sex Research, 30:2, 171-179, DOI: 10.1080/00224499309551698

  • Parker-Pope, T. (2009, June 3). When Sex Leaves the Marriage.  The New York Times. Retrieved from https://well.blogs.nytimes.com/2009/06/03/when-sex-leaves-the-marriage/

  • Suszynski, M. (2011, September 8). Are Sexless Marriages and  Relationships Normal? Everyday Health. Retrieved from https://www.everydayhealth.com/sexual-health/are-sexless-marriages-and-relationships-normal.aspx

  • Gunter, J. (2018, March 10). When the Cause of a Sexless  Relationship Is — Surprise! — the Man. New York Times. Retrieved  from https://www.nytimes.com/2018/03/10/style/sexless-relationships-men-low-libido.html

  • Bussey, A. (2021, July 25). What are the medical causes of low  libido? Healthily. Retrieved from https://www.livehealthily.com/healthy-sex-life/medical-causes-of-low-libido

  • Eske, J. (2019, April 5). What to know about female sex hormones. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/324887

  • Phillips, R.L. & Slaughter, J.R. (2000, August 15). Depression and sexual desire. American Family Physician, 62(4), 782-786 aafp.org/afp/2000/0815/p782.html

  • Balon R (ed): Sexual Dysfunction. The Brain-Body Connection. Adv  Psychosom Med. Basel, Karger, 2008, vol 29, 89-106. Retrieved  from https://www.karger.com/Article/Pdf/126626

  • Knudsen, D. (2010). How Medications Impact Libido. Women’s  Health, 26(3) Retrieved from https://www.pharmacytimes.com/view/lossoflibido-0610

  • Gottman, J.M. & Silver, N. (1999). The Seven Principles For Making  Marriage Work. New York, NY: Three Rivers Press.

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: November 5, 2021
    Original Author: Kimberly Panganiban, LMFT
    Original Reviewer: Kristen Fuller, MD

  • Updated: September 30, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.

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Headshot of Kimberly Panganiban, LMFT
Written by:

Kimberly Panganiban

LMFT
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is a Sexless Marriage?Definition
  • Causes of a Sexless Relationship8 Causes
  • How Important Is Sex In a Relationship?Importance
  • How to Address Your Sexless Relationship With Your PartnerTalk About It
  • Tips to Rebuild Your Sex Life5 Tips
  • When to Seek Professional HelpGetting Help
  • When to Walk Away From a Sexless MarriageWalking Away
  • Final Thoughts On Sexless MarriageConclusion
  • Additional ResourcesResources
  • Sexless Marriage InfographicsInfographics
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