Skip to main content

By Sharon Avesar, MFTI – 

It may feel difficult to discuss why we have stopped having sex.

Sex is arguably one of the most important factors in understanding the health of a relationship. Ironically, because it is so important, couples will go several sessions of therapy (if not months) without ever bringing it up. I often see that when couples are experiencing sex that is less-than-fulfilling, they feel anxious or fearful around bringing up their sex life. Sex, by its nature, is provocative. This means that it is intended to provoke. It is understandable that coming into couples therapy and discussing your sex life, or even reading about your sex life, may bring up challenging feelings. I hope you find solace in knowing that my intention is to help shift your sex life to a place where you and your partner feel excitement, playfulness and joy. Couples will often skirt around sex and dismiss it because it is such a scary place to go to. There are often unspoken beliefs that if sex is discussed, in detail and at length, it will reveal a sad truth about your relationship. A common belief is that if we make sex a shameless topic, something discussed in couples therapy, it will be rendered clinical, pathologized, and ultimately reveal how doomed the relationship is. Fortunately, that is often far from the truth. Your sex life is not static. It can be dramatically shifted and healed, but first we need to take the topic out of the proverbial shameful closet and into the daylight (or the therapist’s cozy lamplight). My aim is to debunk some myths about sex, help couples get closer sexually, and help move our fears and anxieties around sex into excitement and joy.



But why have we stopped having sex?

Alas, despite the ready availability of Viagra, tantric workshops and massage oils, there is no easy answer to this question. There is no one sexual or psychological theory that can account for every possible root cause for sexual problems in a relationship. Therefore, it is important for a couples therapist to spend time understanding the dynamics of your sex life. This means actually talking about sex. Although some might engage in locker room talk or gossip with their friends, for such an important topic, we seldom discuss it explicitly with our partner. A couples therapist can relieve the awkwardness and discomfort in this discussion. Once the actual dynamics around sex are discussed, we can begin to diagnose. At this point, different theories or prescriptions can be made. The following are some of the main reasons that [good] sex is not happening in your relationship and what can be done to address it.

  1. 1.  Physical and/or psychological factors, such as antidepressants, addictions (including porn), stress, insomnia, depression, undiagnosed or untreated medical conditions. All of these very real social, environmental, mental, and/or physiological factors play a role in our libido. Often they are not the sole reason for dampening one’s sex life, but they often compound existing issues.
  2. 2.  Lack of a secure and intimacy base: Often times, one or both partners will experience insecurity in the relationship. The causes may be specific to each duo but can often range from internal factors (such as loss of self-esteem, or sexual desirability) to external ones (miscommunication among partners, lack of intimacy, one partner threatening to leave, cheat, etc.). More often it is a mix between internal and external factors. Here, working with each partner’s attachment style is crucial (I recommend the book Attached by Amir Levine and Rachel Heller to individuals struggling with these dynamics). This work is often done with a skillful therapist, either in individual or couples therapy. These painful patterns often feel like a fundamental lack of security in one or both partners. When one’s nervous system is activated, they may unconsciously have a physiological and emotional response to their partner that is adversarial rather than trusting. Their body will react to their partner as it would react to a predatory animal. Because this threat response is the opposite of what we need when engaging sexually with our partners, understanding and healing this dynamic will be essential. If this relationship pattern sounds familiar, finding an EFT (“Emotionally Focused Therapy”) therapist might be the best fit. In addition, Sue Johnson’s book Hold Me Tight is an excellent book that focuses on these challenges.
  3. 3.  Children. Caring for young children is often a challenging experience for many couples and may affect their sexual intimacy. Although there are several explanations for this phenomenon, couples therapy can help. Children take up a lot of the couple’s time and energy. Furthermore, the desire to be good parents might force parents into a mindset that the children’s needs come before their own. Psychotherapist Esther Perel describes the importance of carving out erotic time between the parents. She believes that if the parents are having an erotic connection, they will be less needy with their children, in turn, promoting greater long-term health in the child. In essence, parents who take time for each other will be happier and more satisfied with each other. The child then reaps the many rewards of living in a happy household. Here, a couples therapist can help one or both parents plan how to have erotic and guilt-free time together.
  4. 4.  Deep love but no eroticism: This is often a scary conundrum for a couple. They may deeply love each other, do almost everything together, find their partner attractive and have respectful dialogue, but find their sexual connection has faded (or is lacking altogether). The thought of talking about sex might be incredibly frightening, because of fear of it ending the relationship. This is often very far from the truth, because sex lives can often improve dramatically. Partners can come to understand and work through any relationship insecurity (as discussed above), and can learn how to achieve differentiation. This idea is that comfortable space, mixed with authentic vulnerability, can allow for both partners to see each other in new and often sexy ways. Before this is possible, it is usually necessary to first establish a feeling of safety and security. Esther Perel’s book Mating in Captivity, or David Schnarch’s book Passionate Marriage might be helpful reads on this subject.  

As each of these reasons for not having sex are complex in themselves, they also can overlap. This does not mean that your sex life is doomed, but rather that we are human, with issues that cannot be compartmentalized. Furthermore, by healing one area, the others may begin to align as well. This means that we don’t have to only focus on our issues before we get a better sex life, but rather they can be done in tandem. Imagine for a moment: as areas of strife and struggle begin to heal, erotic energy may return to your relationship, enriching your sex life, and leading to vitality and aliveness.  


  • I absolutely love Well Clinic! From the beginning, my husband and I felt like we were in a comfortable and safe space.

    Our couple’s therapy bridged gaps in our relationship and helped us understand each other that much more.

    Ivette B

  • Well Clinic is an oasis, especially for busy professionals like me.

    It’s a relaxing and safe space, nothing like the stuffy or drab offices you’d expect when going to a therapist.

    Brianna S

  • Well Clinic’s inviting and professional design makes me feel comfortable and at ease, which probably benefits the work I am doing.

    In fact, it doesn’t really feel like a therapy clinic at all, which I find awesome.

    Jim M


Send us a text! We're here on weekdays from 9am - 9pm.