How to Fix a Sexless Marriage | Ultimate Guide for Couples & Therapists

Sexless marriages are more common than most people realise, yet they remain one of the hardest issues for couples and therapists to address. Conversations about sex often get avoided, minimised, or deferred indefinitely, leaving resentment, disconnection, and confusion to grow. This guide offers 12 therapy-based strategies for repairing sexless marriages. You’ll learn why these patterns develop, how to address the emotional and cultural barriers that keep couples from connecting, and practical tools for restoring intimacy.

Sexless Marriages: Why Honest, Practical Therapy Matters

This article is for therapists who want to address one of the most difficult and most ignored issues in the therapy room: sexless marriages. ⁽¹⁾

That said, if you’re reading this as part of a couple in a sexless marriage, stick with me. Much of what I share will be just as useful for you in understanding the dynamics at play and taking practical steps to restore intimacy.

I won’t claim to know who or what is driving this so-called gender war, but I will say this: If I wanted to disconnect men and women, destroy trust between them, and dismantle family values, I’d do exactly what’s being done: saturate the culture with fear and contempt. Pit the sexes against each other. Push divisive ideologies into classrooms and headlines. Demonise men and masculinity, sexualise women, and glorify hyper-individualised, over-sexualised singledom over mature, monogamous partnership.

These narratives shape how boys see themselves, how girls grow up expecting to relate to men, and how couples regard each other behind closed doors. ⁽²⁾ ⁽³⁾

Gottman research confirms that when couples absorb cultural narratives of contempt between genders, trust and sexual connection collapse. ⁽⁴⁾

Put all that together and you’ve got the perfect recipe for disconnection: lonely, fearful, lost individuals who are easy to distract, sell to, manipulate, and control. Instead of turning to each other for guidance, they turn to screens and the state. ⁽⁵⁾

Whether you share my suspicion or not, surely we can agree this division is a tragedy, and that it must be countered with love, understanding, generosity, and unity. One of the most powerful ways to restore stable unity is through sexual bonding in long-term monogamous relationships. Trust, pleasure, oxytocin, and the deep reassurance of physical intimacy are nature’s way of building and sustaining partnership, resilience, and cooperation. ⁽⁶⁾ ⁽⁷⁾

Sex helps couples stay together. And when couples stay together, they form strong family units which are the foundation of a strong, cohesive society. ⁽⁴⁾ ⁽⁸⁾

Which makes it all the more striking that sex remains one of the most avoided topics in therapy. When it’s ignored, couples can leave without ever addressing the very issue that could have rescued their marriage. ⁽¹⁾ ⁽⁹⁾

So, to the elephant in the therapy room: why does sex so often get ignored?

Why Sex Gets Ignored in Couples Therapy

While plenty of therapists do address sexual intimacy directly, which is wonderful, research and client experience suggest that for a large proportion of couples, it remains a neglected topic. ⁽¹⁾ ⁽⁹⁾

We’ll address communication breakdowns, trust issues, parenting challenges, or emotional safety in painstaking detail. However, all too often sexual intimacy is relegated to the margins, treated as a secondary concern, or left out altogether. ⁽¹⁰⁾

Therapists may feel reluctant to talk about sex because they feel uncomfortable talking about it themselves, which we’ll discuss later. Others might worry about coming across as intrusive or feel unequipped to offer practical steps once the topic is raised. ⁽¹¹⁾

And yet, the skills needed to talk about sexual intimacy, in general terms at least, active listening, validating emotions, and helping couples articulate needs are all skills that therapists already use daily. So, it’s not a separate discipline so much as the application of familiar skills.

In cases where the scope or complexity of a couple’s sexual issues does exceed our expertise, then collaborating with or referring to other specifically trained professionals is recommended. ⁽¹¹⁾

But in the majority of cases, therapists are more equipped than they think.

The bigger risk is avoidance. We collude with avoidance when we quietly let couples sidestep the sex conversation. If you’re afraid to raise it because it stirs anxiety, that’s exactly why you must. Growth for couples, and for us as practitioners, only happens when we lean into the discomfort we’d rather avoid. ⁽¹¹⁾

And if you’re wondering how widespread the problem really is, let’s look at the reality of sexless marriages.

The Reality of Sexless Marriages today

In the U.S., 15–20% of married couples are in a sexless marriage, commonly defined as having sex fewer than 10 times per year. ⁽¹²⁾ ⁽¹³⁾

Another large UK survey by Relate, Mumsnet, and Gransnet revealed that 29% of couples describe their relationship as “sexless,” with 20% reporting very infrequent sex and 8% reporting none at all. ⁽¹⁴⁾

And this trend has only accelerated over time. Compared to a generation ago, sexual frequency has collapsed across the Western world. For most of the 20th century, married couples averaged roughly weekly sex.

Since the 1990s that rate has halved, and every decade since has shown further decline. We are witnessing a dramatic cultural shift. ⁽¹²⁾ ⁽¹³⁾ ⁽¹⁵⁾ ⁽¹⁶⁾

It’s also safe to assume the prevalence is massively underreported. My professional experience certainly suggests so. Shame, embarrassment, or fear of judgment keeps couples from discussing sex openly, so when marriages dissolve, sexlessness is often masked by vague terms like “irreconcilable differences.” Although the legal paperwork might not say, “We stopped having sex,” for many, that’s the root of the collapse.

And in practice, it is often men who carry this suffering most acutely. Not always, but in the vast majority of cases I see. Many tell me that previous therapists never even raised the subject, leaving them feeling as though their pain was trivial or overblown. Simply acknowledging that their distress makes sense, and that their desire for sexual connection is both healthy and normal can bring profound relief.

On the other side, many wives tell me they simply had no idea how much sex meant to their husbands on a deeper emotional level. Once that’s spelled out, the shift can be dramatic: effort increases, intimacy returns, and in some cases, marriages transform almost overnight.

The point isn’t to pit men and women against each other, but to highlight that education and empathy can close a painful gap of misunderstanding. When sex is understood as an emotional need rather than a trivial want, the whole dynamic changes. ⁽¹⁾ ⁽¹⁷⁾ ⁽¹⁸⁾

I’d go as far as to say we are in the midst of a sexless marriage crisis, and that the consequences of this widespread breakdown in marital cohesion are potentially very serious for society. ⁽⁴⁾ ⁽⁸⁾ ⁽¹⁵⁾

For us therapists, this raises an urgent responsibility: how do we help couples confront the issue directly, reconnect sexually, and protect their long-term bond? Before we get to that, there are three important provisos to keep in mind.

Three Provisos Before Intimacy Work in Sexless Marriages

1. Trauma, pain, or ongoing concerns

At intake, therapists should delicately screen for trauma, unresolved pain, or medical issues that may affect sexual intimacy. Where trauma is severe, intimacy work may be inappropriate until safety and stability are established. However, in many cases, healing can still be supported within a loving sexual relationship, provided that intimacy is safe and paced sensitively. ⁽¹⁹⁾ ⁽²⁰⁾ ⁽²¹⁾ ⁽²²⁾

When pain or medical issues are present, intimacy may need to be adapted. Focusing on non-penetrative practices, gradual reintroduction, or collaboration with medical professionals. The task for the therapist is to discern when intimacy can aid healing, and when it risks harm. ⁽²³⁾

It’s equally important to state clearly that if a relationship has become toxic or abusive, the priority is not more sex but restoring respect and safety first. The guidance that follows is intended for couples whose primary struggle is sexlessness itself rather than severe relational dysfunction. ⁽¹⁹⁾ ⁽²²⁾

2. Is Sexlessness a symptom or a cause?

We often assume sexlessness is a symptom of a troubled marriage, and sometimes it is. But longitudinal research consistently shows that changes in sexual satisfaction often precede shifts in overall relationship satisfaction, sometimes more strongly than the reverse. In other words, sexual withdrawal doesn’t always follow relational breakdown. In many couples, it emerges as its own phenomenon and then triggers emotional distance and conflict later. ⁽¹⁾ ⁽¹⁸⁾ ⁽²⁴⁾

This matters because it shapes the therapeutic strategy. If sexlessness is a cause, sexual reconnection can be a powerful primary intervention. If it’s a symptom, emotional repair must come first.

Many therapists unconsciously assume low sexual frequency is always driven by resentment or poor communication. In reality, withdrawal can originate from hormonal shifts, responsive desire patterns, avoidant attachment, shame, cultural scripts, medications, or simple habituation over time. ⁽¹⁵⁾ ⁽¹⁶⁾ ⁽²⁵⁾ ⁽²⁶⁾ ⁽²⁷⁾ ⁽²⁸⁾

These factors can reduce sexual engagement even in otherwise loving relationships and become the relational problem if left unaddressed.

Key questions to explore

• How do they each explain why sex declined?
  When asked separately, do their explanations focus on external or physiological factors, or on relational hurts and grievances?
• How was the sex before it changed?
  Was it connected, playful and functional, or was it avoidant or strained?
• Was the decline sudden or gradual?
  Did it taper off slowly over time with growing relational tension, or did it stop abruptly, for example, after childbirth, trauma, menopause, a job change, or major lifestyle shifts? ⁽²⁵⁾ ⁽²⁶⁾ ⁽²⁸⁾ ⁽²⁹⁾
• What has happened to affection and goodwill since sex declined?
  Has everyday warmth, humour, and affection faded at the same time, or has it lingered for a while even after sex tapered off? ⁽¹⁾ ⁽³⁰⁾
• How symmetric is the distress?
  Is one partner bothered while the other is relatively unconcerned, or are both aligned that it’s a problem?
• What happened when they tried?
  Have they attempted to re-introduce intimacy? Did warmth and affection increase, stay the same, or backfire?

A previously healthy or functional sexual connection that suddenly drops off often points to cause. A sexual dynamic that deteriorated alongside growing contempt usually points to symptom. Similarly, cause-driven cases often show lingering affection and clear external triggers, whereas symptom-driven cases show parallel declines in emotional warmth and sexual connection.

A useful litmus test is to suggest, if both are willing, a trial period of intentional intimacy. If warmth returns and conflict eases, sexlessness was likely a cause. If efforts stall because resentment remains, it’s probably a symptom. ⁽¹⁾ ⁽²⁴⁾

Sexual connection is often the most reliable pathway back to warmth, which is why this test can be so revealing. The aim isn’t to assign blame, but to clarify whether sexual reconnection can serve as a primary intervention or whether it must wait until emotional repair is underway. Whichever way it goes, partners need to face it together if the process is to succeed.

3. Assessing Willingness to engage in Therapy

Therapists need to establish whether both partners are genuinely prepared to work as a team to restore intimacy. If one partner has no interest in engaging sexually at all, then this significant roadblock must be the initial focus.

Some partners may initially say “no” simply because they don’t fully grasp the significance of sex. In these cases, the educational material that follows about the emotional, relational, and even physical importance of intimacy can often shift their perspective. There is still hope if resistance is due to misunderstanding rather than outright refusal. ⁽¹⁾ ⁽¹⁷⁾ ⁽³¹⁾

If both are willing to engage in the process, then we can proceed into the deeper work. If the answer remains no, even after education, then the couple may be fundamentally misaligned, and therapy must shift towards clarifying whether their relationship can survive without sexual connection at all.

Once willingness is established, the next step is helping couples see that their struggles may be influenced by external factors. Even motivated partners will have been saturated by cultural narratives that distort how they view sex, desire, and each other.

Cultural Influences on Sexual Connection

For men, popular narratives reduce male sexuality to a purely physical urge or a sign of immaturity. Something to be joked about or mocked. Rolled eyes and phrases like “men only want one thing,” or depictions of husbands as sex-obsessed in sitcoms can create shame around expressing their needs, as though wanting sex makes them shallow or emotionally detached. ⁽³²⁾

Meanwhile, some women in sexless marriages may be affected by very different messaging. Many grow up in cultures where women’s sexual desire is downplayed, or their desirability is linked to their age or physical attractiveness. If sexual intimacy fades, they may internalise it as evidence of being undesirable, unattractive, or somehow “not enough.” ⁽²⁵⁾ ⁽³³⁾

These cultural narratives make communication almost impossible for both men and women.

Then there’s porn: novelty on demand that rewires the brain, blunts dopamine, and teaches partners to expect constant escalation. It turns sex into a performance, a commodity, or even an act of aggression, and thus real intimacy can feel dull by comparison. ⁽³⁴⁾ ⁽³⁵⁾

And pervasive screen use only amplifies the same effect: more stimulation, less human connection. I call this modern phenomenon digital captivity, in which couples are increasingly isolated even when they’re in the same room. ⁽³⁶⁾

Added to this is the rise of individualism, reinforced by popular “experts” who position personal happiness as the ultimate life goal. Rather than encouraging loyalty, generosity, and resilience, many modern self-help gurus promote partner-blaming frameworks, such as the proliferation of “narcissist checklists” and rigid boundary enforcement strategies, while neglecting the equally vital skills of self-reflection, accountability, and personal growth.

The way through is to help couples see these influences for what they are: destructive cultural imports, not spiritual truths. Sometimes that means a complete media detox is needed. Step away from the porn, outrage media, and endless scrolling, and replace them with pro-marriage material and in-depth spiritual work. ⁽³⁴⁾ ⁽³⁶⁾

The test for couples around these influences is simple:

Is this good for my marriage or bad for it?
If it’s bad, disregard.

The Emotional Significance of Sexual Intimacy

Many of both men and women’s insecurities play out within the sexual arena, as well as deeper psychological and emotional issues. Issues of self-worth, confidence, and feelings of guilt and shame. Long-standing issues related to the masculine and feminine are here to explore should the couple be guided skilfully to do so.

It is true to say that we can really explore who and where we are if we have the courage to show up sexually. It is a way of understanding both where we have been, and also where we might like to go, and who we might like to become.

Therapists must therefore create space for couples to explore what sex represents not just physically, but psychologically, emotionally, and relationally.

• Is it a way to feel desired?
• A space for vulnerability?
• A source of playfulness?
• A way to reconnect?

Couples really do regulate each other’s physiology, and measurably so, through touch, affection, and sexual intimacy. That’s part of what makes secure attachment so powerful. But secure attachment isn’t the same as dependency. Sex should never become an emotional pacifier, demanded by one partner to soothe their distress. True intimacy honours both interdependence and individuality: we can comfort each other, but not at the cost of freedom, respect, or genuine desire. ⁽⁶⁾ ⁽³⁷⁾ ⁽³⁸⁾

When couples understand this balance, they can begin replacing negative assumptions with empathy and respect. This allows them to turn towards each other’s differing desire levels with interest and compassion. If both partners are invested in the process, there are many practical ways to restore intimacy with intention, and much scope for growth and development both as individuals and as a couple.

It’s also worth remembering that desire discrepancy is the norm in long-term relationships, not the exception. The task isn’t to remove the gap, but to navigate it with curiosity, generosity, and teamwork. ⁽²⁵⁾ ⁽³¹⁾

If couples don’t get the chance to explore and honour this deeper significance, intimacy can too easily be relegated to the side-lines. And when sex is neglected, the fallout is rarely confined to the bedroom, as we’ll see.

Consequences of Sexual Neglect in Marriage

The consequences of sexual neglect are far-reaching. Emotional connection begins to dry up and, without physical intimacy, feelings of isolation become the norm. Often when sex disappears, so do the hugs, casual touches, and everyday warmth that sustain closeness. ⁽¹⁾ ⁽³⁰⁾

A familiar cycle follows: one partner feels rejected, the other pressured, and over time that cycle destroys kindness and communication. When sexual needs go unmet for long periods, irritability, withdrawal, and even hostility can emerge. Not necessarily as signs of abuse or a fundamentally broken relationship, but as the predictable fallout of feeling repeatedly unwanted. ⁽²⁵⁾ ⁽³¹⁾

As David Schnarch observed, these small cruelties can harden into “normal marital sadism”: covert tests, withholding, and using sex to punish or control. Naming this pattern matters, because once couples see it, they can stop the hidden games and take responsibility for their part in the dynamic. ⁽³⁹⁾

Left unaddressed for long enough and what the Gottman’s refer to as the Four Horsemen can take up residence in the marital home: Criticism, Contempt, Defensiveness, and Stonewalling. Once these horsemen take up residence, they can be terribly hard to evict. ⁽⁴⁾

Small irritations escalate, affairs become more likely, and health suffers. Stress, anxiety, depression, and worse outcomes across the board for both partners. ⁽¹⁾ ⁽⁴⁰⁾ ⁽⁴¹⁾

Eventually the relationship itself weakens, and both people feel more like housemates than lovers. No amount of chore charts, date nights, or communication drills can repair this if the erotic disconnection at the heart of the relationship remains unaddressed.

And the impact doesn’t stop with the couple. It often pollutes the entire family environment.

How a Sexless Marriage Impacts Children

When parents nurture a loving, connected, and sexually fulfilling relationship, their children benefit profoundly. ⁽⁸⁾ ⁽⁴²⁾

Longitudinal Gottman studies show that children in affectionate, sexually connected homes develop stronger emotional regulation and better conflict-resolution skills as adults. ⁽⁴²⁾

Children growing up in these homes witness affection, respect and playfulness modelled daily. They feel the love between parents as palpable and consistent, and they thrive under those conditions. ⁽⁴²⁾

Conversely, when a marriage turns cold or platonic, children feel that too. An absence of warmth, strained silences, or the lack of affection is registered. A home marked by emotional or sexual disconnection can subtly shape a child’s understanding of relationships, often in ways that linger into adulthood. ⁽⁴²⁾

So, by addressing sexual intimacy with couples in therapy, we’re helping create healthier emotional environments for children too.

Intentional Intimacy as a Therapy Tool

Assuming safety, trauma, and willingness screens are clear, this is where prioritising sex, even when desire isn’t spontaneous becomes essential. Couples who make space for intimacy on purpose are intentionally protecting and sustaining the bond that keeps them close. ⁽¹⁾ ⁽¹⁷⁾ ⁽³¹⁾

Even small habits like cuddling before sleep, showering together, or exchanging affectionate messages can create the conditions where desire naturally re-emerges. Many couples worry that scheduling sex feels forced, but research shows the opposite: when partners choose to be sexual before they feel desire — a point consistent with Rosemary Basson’s model of responsive desire, which is particularly relevant for women, desire usually follows. ⁽⁶⁾ ⁽⁷⁾ ⁽²⁴⁾ ⁽³⁰⁾

This is about creating the conditions for genuine desire to reawaken, rather than waiting endlessly for it to appear by magic. So, it is this intentionality, as a catalyst for rekindling desire, that makes all the difference.

In every other part of a loving relationship, we extend ourselves: making a meal when we’re tired, listening when we’d rather be doing something else, showing up when it’s inconvenient. Sexual intimacy should be no different, and research supports this. Studies on sexual communal strength (the motivation to meet a partner’s sexual needs) show that when individuals prioritise their partner’s well-being, both sexual and relationship satisfaction improve. ⁽⁷⁾ ⁽⁴³⁾ ⁽⁴⁴⁾

Of course, sexual generosity, which I’m all for, isn’t the same as obligation. I often hear men say, “I pay the bills, help with the chores, and look after the kids, so sex should be part of the deal.” While that kind of transactional framing may express genuine pain, it also kills erotic connection. Generosity works best when it’s mutual and emotionally honest.

At this point it’s worth mentioning Erich Fromm’s insight from The Art of Loving: that sex without genuine love only magnifies loneliness. Nobody with an ounce of self-esteem wants unwilling or disinterested sex, nor should anyone want to give it. What makes sex nourishing isn’t the act itself, but the spirit in which it’s offered. And in this context, we can apply Fromm’s four tenets of love: care, respect, responsibility, and knowledge. Intentional intimacy, then, is about creating an erotic bond that honours each partner’s individuality while also uniting them.

Regular, satisfying sex is consistently linked to greater well-being, better physical health, and happier, more resilient relationships, with research suggesting a “sweet spot” of at least once a week for many couples. ⁽⁴⁵⁾

Couples who manage multiple times per week rarely do so by accident or because they are overwhelmed by a burning desire. It happens because they choose to make it so. Seen this way, being deliberate about sex is an act of mature love: a conscious practice of giving and receiving, of showing up for each other erotically as reliably as you show up for each other practically or emotionally. There are no losers in this dynamic. Therapists can help couples see intentional intimacy not as a chore, but as an expression of care, generosity, and responsibility toward the relationship.

Yet even with the best intentions, couples will face real-world challenges, so goodwill alone often isn’t enough.

Common Barriers in Repairing Sexless Marriages

Even when couples want to reconnect sexually, there are often genuine obstacles standing in the way. Discussing these openly can help couples feel less “broken” and more understood.

Some of the most common barriers include:

• Physical health and medication: Conditions such as diabetes, cardiovascular issues, hormonal changes like menopause, or chronic illness can reduce desire or mean that sex becomes physically uncomfortable. Certain medications, particularly SSRIs, are also well known to dampen libido and orgasmic response. ⁽²³⁾ ⁽²⁶⁾ ⁽²⁷⁾ ⁽²⁸⁾ ⁽⁴⁶⁾
• Mental health and stress: Anxiety, depression, or stress often impact desire and make the vulnerability required for intentional intimacy feel overwhelming. Even everyday stress from jobs, finances, or parenting can dominate a couple’s time, leaving little space or energy for intimacy. ⁽²⁸⁾ ⁽⁴⁷⁾
• Attachment patterns: How partners relate emotionally often shows up in their sex life. Anxiously attached partners may use sex to seek reassurance, which can feel pressuring to the other. Avoidantly attached partners may withdraw from intimacy altogether, leaving their partner feeling unwanted. When these patterns collide, both can end up feeling misunderstood, rejected, or unsafe in approaching sex. ⁽³⁷⁾ ⁽³⁸⁾
• Lifestyle factors: Bad sleep, poor fitness, unhealthy diet, alcohol use, recreational drugs, and screen or social media overuse all play a role in energy, mood, and availability for connection. ⁽³⁶⁾ ⁽⁴⁸⁾ ⁽⁴⁹⁾ ⁽⁵⁰⁾
• Relationship dynamics: Resentment, unresolved conflict, or emotional distance can lead to sex feeling unsafe or transactional. When kindness and communication are in short supply, desire and willingness often plummet. Even if a lack of sex triggered these problems in the first place, they must be addressed in order to move forward. ⁽¹⁾ ⁽⁴⁰⁾
• Body image and self-esteem: Many people struggle to feel desirable, particularly after major life transitions such as pregnancy, aging, or illness. Without an adequate level of confidence and self-esteem, it’s hard to approach sex with openness. ⁽³³⁾
• Time and opportunity: Especially for parents, logistics can be the biggest barrier. Exhaustion and lack of privacy often push intimacy to the bottom of the priority list.

These aren’t excuses, but they are realities. Couples often blame themselves or each other when the problem is actually multi-layered. As therapists, it’s important we help couples make sense of their situation in a balanced and nuanced way so that they can co-create strategies to remove these barriers as best they can. Sometimes that means involving other professionals such as a GP for medication reviews, a physiotherapist for pain issues, or an endocrinologist for balancing hormones.

In other cases, individual therapy may be recommended if one partner is struggling with issues such as trauma, anxiety, shame, or low self-worth that need focused attention before full sexual reconnection is possible. ⁽²³⁾ ⁽²⁷⁾ ⁽⁴⁶⁾ ⁽⁵¹⁾

Identifying barriers is of course only the first step. Without clear strategies, naming them can actually leave couples feeling stuck or even more hopeless. What makes the difference is giving them practical, therapist-led approaches that normalise the conversation, reduce shame, and make sexual reconnection feel not only appealing, but safe and achievable.

12 Therapy Strategies to Repair Sexless Marriage

1. Ask early and ask often
   Include sexual satisfaction in your initial assessment, just as you would trust, communication, or emotional safety. Don’t wait for clients to raise it because many never will, often out of fear of rejection or shame. By asking early, you normalize the conversation and give permission for honesty. If trauma, pain, or abuse becomes apparent at this stage, pause intimacy work and shift toward a trauma-informed or medical pathway before continuing. ⁽¹⁾ ⁽¹⁹⁾ ⁽²²⁾ ⁽⁵¹⁾
2. Screen for willingness
   Establish whether both partners are genuinely prepared to work as a team to restore intimacy. If reluctance stems from misunderstanding rather than refusal, education can shift perspective. Without willingness, therapy needs to shift from repair to reality-testing: can this marriage survive without sex? ⁽¹⁾ ⁽³¹⁾
3. Differentiate symptom versus cause
   Clarify whether sexlessness is driving the couple’s difficulties or reflecting them. Ask about timing, impact, and attempts at repair. If disconnection in the bedroom came first, intentional intimacy may be the catalyst for repair. If it followed betrayal or hostility, emotional healing must come first. ⁽¹⁾ ⁽¹⁸⁾ ⁽²⁴⁾
4. Normalize the conversation
   Treat sexual intimacy as a standard part of relational health, not a taboo subject. Return to sexual intimacy regularly, weaving it into ongoing discussions about trust, safety, or connection. By revisiting the topic, you dissolve shame, prevent avoidance, and model that intimacy is never off-limits or too awkward to address. ⁽¹⁾ ⁽¹¹⁾
5. Hold balanced space
   Create an environment where both partners can share their needs, frustrations, and fears without fear of ridicule or dismissal. Pay attention to attachment patterns: anxious partners may approach sex seeking reassurance, while avoidant partners may withdraw. Naming these patterns can be immensely helpful and promote awareness and positive change towards a more secure attachment. ⁽³⁷⁾ ⁽³⁸⁾
6. Encourage a relationship reset
   When resentment or anger has built up, guide partners to consciously release old grievances. Without this reset, intimacy can feel unsafe or inauthentic. Clearing the slate allows couples to see each other with fresh eyes and opens the door to reconnection. ⁽⁴⁰⁾
7. Challenge unhelpful narratives
   Expose cultural myths that damage intimacy, such as “men’s needs are shallow,” or “desire dies with age.” Reframe desire as normal and valuable and encourage couples to step away from divisive media toward pro-marriage, pro-intimacy perspectives that strengthen unity. ⁽²⁵⁾ ⁽³²⁾ ⁽³³⁾
8. Identify and address barriers
   Explore obstacles like health, medication, mental health, lifestyle, or body image. Many problems are multi-layered, not personal failings. By tackling barriers together and resisting blame, couples create space for intimacy to return. Where one partner is struggling with deeper issues such as trauma, shame, or anxiety, recommend individual therapy alongside couples work if helpful. ⁽²³⁾–⁽²⁹⁾ ⁽³¹⁾ ⁽³³⁾ ⁽³⁶⁾ ⁽⁴⁶⁾–⁽⁵¹⁾
9. Refer when needed
   If issues go beyond your scope, connect clients with reputable resources. That might mean a certified sex therapist, a GP for medication review, or a dietician. ⁽²³⁾–⁽²⁹⁾ ⁽⁴⁶⁾ ⁽⁵¹⁾
10. Promote intentional intimacy
    Encourage couples to see sexual connection as a shared practice, sometimes spontaneous, sometimes planned. Introduce the idea of sexual generosity: just as we show up in other areas of love when it is inconvenient, we can extend the same care in intimacy. ⁽⁶⁾ ⁽⁷⁾ ⁽²⁴⁾ ⁽⁴³⁾ ⁽⁴⁴⁾
11. Build lasting habits
    Help couples create small, sustainable rituals of affection. Cuddling before sleep, regular check-ins, playful moments, fun dates, and affectionate touch. These habits make intimacy feel natural, and over time create conditions where desire can return. ⁽³⁰⁾ ⁽³¹⁾
12. Track progress and celebrate wins
    Reinforce not just increases in sexual activity, but also growth in affection, responsiveness, laughter, and trust. Highlighting small successes helps couples feel momentum and reminds them that change is possible and rewarding. ⁽³⁰⁾ ⁽⁴⁵⁾

What Couples in Sexless Marriages Can Do Now

The most important step is agreement. The reality is that if one partner desires sex, a completely sexless relationship almost never remains healthy in the long run. Denial of that fact almost always leads to resentment, frustration, and eventual breakdown. The relationship can only move forward if both see intimacy as essential and commit to tackling obstacles together rather than in isolation. Without teamwork, there is no path forward. ⁽¹⁾ ⁽¹⁸⁾ ⁽³¹⁾

But if both partners agree that intimacy matters and are willing to work as a team, then progress is entirely possible. You can begin applying many of the strategies outlined here on your own: calm, low-pressure conversations about what sex means to each of you, making intimacy a joint responsibility, becoming intentional, removing barriers, and setting aside regular weekly check-ins to keep the conversation alive. ⁽⁶⁾ ⁽⁷⁾ ⁽³¹⁾ ⁽⁴³⁾–⁽⁴⁵⁾

Once that foundation is laid, full repair is entirely possible and, dare I say it, exciting, playful and rewarding!

If it feels too difficult to manage between you, that’s when bringing in a pro-sex therapist like me can make all the difference.

So those are some first steps couples can take on their own. But ultimately, much of this work still comes back to us as therapists, and our willingness to hold the space for these conversations ourselves.

Therapist Self-Reflection in Sexless Marriage Work

As therapists, our own comfort with sex and sexuality inevitably shapes how we work in practice. If we feel awkward, hesitant, or judgmental, our clients will pick up on it. If we avoid intimacy in our own lives, we are more likely to sidestep it professionally too. ⁽¹¹⁾

That is why reflecting on our personal beliefs, experiences, and blind spots is essential. The next step is not about what we ask of couples, but about what we ask of ourselves.

• What messages about sex did I internalise from my family, culture, or faith background?
• Which clients do I feel most hesitant to bring this topic up with, and why?
• Do I experience discomfort, embarrassment, or judgment when sex is discussed in my own life?
• How do my personal experiences of intimacy, pleasure, or avoidance shape my professional stance?
• Could my own relationship use a sexual spruce-up?

Exploring these honestly can reveal blind spots that impact our practice, and this self-awareness is critical if we are to be effective in this space. ⁽¹¹⁾

Our clients need us to be present, unflinching, and safe when the conversation turns to intimacy. If we collude with avoidance, we fail our clients. If we are paralysed by sexual anxiety, we cannot help them face theirs. ⁽¹¹⁾

Training programs and supervision should include explicit guidance on addressing sexual intimacy, ensuring therapists are equipped to handle these discussions with confidence and care. ⁽²²⁾ ⁽⁵¹⁾

As therapists, we have a responsibility to bring it into the room early, openly, and without apology. Because when we do, we’re not just helping couples have more sex; we’re helping them rebuild affection, restore trust, and reignite the vitality that brought them together in the first place. ⁽¹⁾ ⁽⁴⁵⁾

In a world where men and women are too often cast as opponents, our role is to help couples rediscover partnership. Sexual connection isn’t the whole of marriage, but it is one of its most unifying forces. When couples are bonded emotionally, physically, erotically, they become stronger than the narratives that try to pull them apart. ⁽⁴⁾

Intimacy is the glue of families, and families are the bedrock of culture. Every time we help a couple turn toward each other, we’re offering resistance to a culture that profits from mistrust, disconnection, and collapse. This work is about preserving the trust between men and women and, by extension, the foundation every healthy society is built upon. ⁽⁸⁾ ⁽⁴²⁾

Final Thoughts on Repairing a Sexless Marriage

If you found this helpful, make sure you subscribe to my newsletter so you don’t miss my next article, and I’d love to hear your thoughts in the comments. If you’re a couple, what would you want a therapist to understand about sex in your relationship? Your feedback really helps me improve my content and approach.

And just a quick word to any therapists reading:

My channel is growing fast, and what that tells me is that there’s a real hunger out there for therapy that takes a holistic, unflinching approach to sex in marriage. Couples are actively looking for help, to the point I can’t keep up with demand on my own. So, if you’re a like-minded therapist who wants to be part of this movement, I’d love to hear from you.

Whether that’s joining my brand on a referral basis (you can find all the details on the Work for Me page, or connecting for some informal supervision, support, or one-to-one coaching, just get in touch.

I genuinely believe this is an exciting time. There’s a growing appetite for therapy that’s grounded, pro-intimacy, and unafraid to tackle the sexual dynamics that make or break relationships. And I’m only at the very beginning of this journey, so if you’re interested, now’s a brilliant time to get involved.

And if any couples need some support, you can book a one-to-one session with me.

If you enjoyed this article, and I hope that you did, then you might also enjoy this one where I discuss why marital sex is on the decline.

Thanks for reading. I’ll see you next week.

In the meantime… to yourself and to others, tell the truth.

Jump to Comments

Recommended Reading on Sexless marriages

References

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