When I do couples therapy a very common complaint is that the sex is infrequent or nonexistent. Over a period of time this tends to erode a couple’s sense of connection. It also tends to breed resentment and anger.

Why do couples stop having sex, and what can you do to prevent this?

There are a number of reasons that can cause couples to stop having sex.

1. Anger and resentment in the relationship

A big reason is unresolved anger or resentment in the relationship itself. Most couples don’t want to have sex when they’re angry. (Angry sex or makeup sex seems to be relatively rare amongst most couples.) Often the anger or resentment issues are long-standing, and feel unresolvable. The couple feels distant from one another, and as a result stops being affectionate or sexual.

The solution to this problem is talking. Talking calmly and non-defensively in order to resolve problems and eliminate resentments. Clearing the air on a regular basis is essential for couples happiness. If you can’t do it yourself, get some couples counseling and learn the skills for resolving conflict.

2. Mediocre or boring sex

Another reason couples stop having sex might seem very obvious — the sex isn’t very good. Perhaps there are sexual problems such as erectile difficulties or difficulties having orgasms. Or perhaps the sex is just mediocre and routine. Perhaps sex is too much work.

The antidote to this problem is to work on improving the quality of sex and touching. There are a number of exercises that couples can do to improve their ability to please one another. One such exercise is called sensate focus. In this exercise couples take turns touching one another all over the body, while the recipient of touching give us feedback about what feels good. The purpose of this exercise is to learn where and how to touch your partner in order to give them the most pleasure.

Verbal communication is also essential for improving the quality of sex. Most couples talk about everything other than sex. It’s difficult for couples to communicate what they like and don’t like sexually. But without this communication the couple is driving blind, and the most likely outcome is going off the cliff.

If couples cannot achieve this on their own, then a few sessions of focused sex therapy can be very helpful. During these sessions the couple learns how to talk about sex comfortably, and troubleshoots issues that are preventing them from having good sex. Typically sex therapy is brief therapy — less than 10 sessions. Unless you have a fabulous sex life, a few sessions of sex therapy, learning how to communicate sexual desires, fantasies, turn-on’s, and turn-offs, is highly recommended.

3. Issues with initiating sex

Another reason couples stop having sex is issues with initiation. Initiating sex is a very delicate balance. When one person approaches the other, there is tremendous potential for hurt and rejection. If one person suggests sex, and the other turns it down, this often leads to resentment and finally avoidance.

Other initiation issues include one person doing all of the initiating, with the other partner never initiating. Or perhaps neither person is initiating sex, instead waiting for the other to initiate. If neither person initiates obviously there will be no sex.

Initiation issues are complex. One general rule of thumb is that as much as possible, partners should never reject a sexual initiation. If absolutely necessary, then the rejection should be as kind and gentle as possible, and include a rain check suggestion. Something like, “I’d really love to honey, but my stomach is killing me. Can we make love tomorrow night instead?”

The reason for this guideline is that very few people will persist after multiple sexual rejections. Couples who have a healthy sex life typically will almost always say yes to sex, even if they are tired or stressed. They may negotiate different sexual activities, or even suggest having sex the next morning or night, but they rarely say no. Saying no often usually leads an eternal no.

4. Failure to make sex a priority

Sex is a very important component of relationships, yet many couples fail to make it a priority. Couples allow work, children, exercise, socializing, television, Internet, and housework to dominate their priorities so completely that they don’t have time for sex. This is a huge mistake. Sex is one of the basic glues that hold couples together. A failure to make the romantic and sexual relationship a priority often leads to divorce.

Couples should figure out a way that they can consistently have private time in order to have sex. Perhaps this might mean even scheduling sex, which most couples resist as being unromantic, but is often essential when people are very busy. Perhaps Wednesday night is date night, and the prime focus is to connect and to make love. Sunday morning might be another time to schedule. If couples work close each other, perhaps a noontime meeting at a hotel or at home might be fun.

Turn off the TV or computer and talk, cuddle, and get close. Make having sex a priority even if it means scheduling sex. Yes scheduled sex is a little bit less romantic, but it reminds me of a famous comedian’s line, “Sex without love is an empty experience, but as empty experiences go it’s pretty good.” Paraphrasing this a bit, we get “Scheduled sex is a less romantic experience, but as less romantic experiences go it’s pretty good!”

5. Excessive masturbation to pornography

This is primarily a problem with men. Some men turn to Internet pornography and masturbation when they are not having consistent sex in their relationship. There’s nothing wrong with masturbation, but there are some serious issues that can develop. One issue is that middle aged men do not have infinite sexual potential, so if they are masturbating frequently, they will have very little left over for their wife or partner. Their libido for their partner will be low. Or when their partner wants to have sex, they will be unable to because they have just masturbated that afternoon. (Obviously this is less of an issue for young men.)

The other issue with Internet pornography is that typically the women that are depicted are young, slender, and extremely beautiful. They may be of a different race or color than the man’s actual partner. For a man with a middle-aged partner, the contrast between the perfect bodies he sees in pornography in his own partner’s less than perfect body will be jarring. This may cause loss of desire.

A similar issue is that in porn women do many sexual activities that most women have little interest in such as anal sex, threesomes, orgies, or sex in public. A man whose sexual norm calibration is based on pornagraphy will will greatly out of sync with his actual partner.

The solution to this problem is to first impose a temporary moratorium on masturbation and Internet porn. Stop for 30 days. This will allow your libido for your partner to recover. During that 30 days focus on any of the other problems with sex and address them. Schedule sex at a frequency that is comfortable for both of you. Once you are reliably and consistently having sex again, there will be less need to masturbate. Also you can schedule your masturbation sessions so that they do not interfere with scheduled partner sex.

6. Failure to attend to personal hygiene or appearance

Once couples have been together for a while they often get lazy about their hygiene or appearance. They may not brush their teeth before kissing, or showering before being close. Both partners may walk around the house wearing sweat pants and sweatshirt. Lingerie disappears out of the relationship. People put on weight and don’t maintain their fitness.

All of these things can cause problems in the bedroom. I often hear from men or women that when they married their partner they were very attractive, but they’ve let themselves go, and they are no longer so attractive. Men complain that their wives come to bed in sweats and gym socks instead of naked or in lingerie.

These are difficult issues to discuss with a partner. There is potential for very hurt feelings when one person tells the other that their weight gain has made them less attractive. Or that their breath in the morning is deadly. Or that when they walk around in their granny nighty, it’s not in the least sexy. Obviously approaching these issues with tact and sensitivity is essential. Some are obviously easier than others. It’s easy to change one’s sleep apparel. It’s fairly easy to brush one’s teeth. As all of us who are middle aged know, weight loss is more difficult.

7. Failure to address sexual dysfunction

Another issue that can get in the way of having sex is a failure to address sexual problems. Many men suffer at least intermittent erectile difficulties. Many women have difficulty having orgasms, or difficulty lubricating adequately. Shame and embarrassment about these issues often leads people to avoid having sex with their partner.

Depending on the problem, there are good solutions available. Men with erectile difficulties can often benefit from either sex therapy to address issues of anxiety and performance, or erectile disorder medications such as Cialis, Viagra, or Levitra. Of these drugs I usually recommend Cialis, as it is long-lasting (lasts up to three days), and relatively side effect free. Often a low dose of Cialis such as 5 or 10 mg can greatly improve a man’s ability to get and maintain an erection. This restores confidence, and also makes sex relatively worry free.

On the female side, difficulties in orgasm can because by issues of anxiety or inhibition, or simply issues of sexual technique and stimulation. Unfortunately there is no medication that improves female sexual functioning, but sex therapy can be very helpful. Lubrication is often an issue, and few people realize that lubrication is the female equivalent of an erection. With aging comes less lubrication, and this can often make sex painful or difficult. The solution to this problem is incredibly simple — use artificial lubrication. There are a variety of lubrication products on the market, some are water-based, and some are silicon-based. Both are good. Use lubrication liberally, and sex will feel better and be more fun.

8. Forgetting that foreplay starts long before the bedroom.

Oprah has a wonderful saying that foreplay starts early in the morning when a man unloads the dishwasher. The well-known marriage researcher John Gottman has found that men who do more housework typically get more sex. Many couples forget that foreplay starts first thing in the morning. And never stops and healthy happy sexual marriages. Showing kindness, concern, consideration, affection, respect, admiration — all are forms of foreplay. Specifically, compliments that focus on someone looking sexy or handsome or beautiful or hot get the motor running. With modern technology we can flirt even more effectively. Sending a sexy text during the workday can lead to a much more pleasant and fun evening. (Just be sure that text has some subtlety so your work phone doesn’t create problems for you with your boss.)

In similar ways, physical touching and affection can turn up the heat later in the bedroom. A quick but passionate kiss in passing. A squeeze of the bottom. Caressing and sexual touch can be normal parts of your affectionate repertoire even outside the bedroom. (Try not to scare the children or the dog!) Remember, everything can be foreplay.

So there it is — why couples stop having sex and what you can do about it. Don’t settle for a lack of sex or mediocre sex. Follow these guidelines and you can start having consistent and pleasurable lovemaking. If you need help, seek out a skilled psychologist who has specialty experience in doing sex therapy. Generalized couples therapy, although useful for other types of problems, does not usually help with sexual difficulties. Questions to ask a potential sex therapist are:

1. What is your training in sex therapy?
2. What is your approach to sex therapy? Can you give me an idea of the typical session?
3. How long does sex therapy with you typically take? (If the person says a year or two then you should probably find someone else. Most sex therapy is brief therapy.)
4. Finally, when you meet with the sex therapist, do they seem comfortable and direct talking about sex? Do they use direct language for sexual activities and sexual parts, or do they beat around the bush? If the sex therapist is not more comfortable than you are talking about sex, it is unlikely that they can be of much help.

Now I’ve got to go meet my sweetie for some crazy hot……never mind!  🙂

Copyright © 2010, 2011 Andrew Gottlieb, Ph.D. /The Psychology Lounge/TPL Productions