Why Couples Stop Having Sex— And What to Do About It | Jen Joseph, Certified Sex Therapist
If sex has quietly disappeared from your relationship, you're not alone. In my work as a sex therapist, the "sexless" or near-sexless relationship is one of the most common issues couples bring to my office — and one of the most painful. There's often a thick layer of shame around it, as though a lack of sex means something is fundamentally broken about you, your partner or your relationship.
It doesn't. But it does mean something. And the sooner you understand what's actually driving the sexual distance between you, the sooner you can do something about it.
What Counts as a "Sexless" Relationship?
The clinical definition is fewer than ten sexual encounters per year — but honestly, that threshold matters less than how you feel about the frequency of sex in your relationship. If one or both of you is unhappy with how little sex you're having, that's what counts. Whether you haven't had sex in three months or three years, if it's causing distress in your relationship, it's worth taking seriously.
Why Do Couples Stop Having Sex?
There's rarely one single reason. In my experience, sexual distance in long-term relationships almost always has multiple layers — and understanding those layers is the first step toward addressing them. Here are the most common culprits I see:
Desire Mismatch Has Gone Unaddressed
One of the most common paths to a sexless relationship isn't a sudden drop-off — it's a slow erosion driven by unresolved desire mismatch. One partner wants sex more than the other. The higher desire partner initiates, gets turned down, feels rejected and eventually stops trying. The lower desire partner feels guilty, then relieved, then disconnected. Over time, the gap widens until sex isn't really on the table anymore for either of you.
If this sounds familiar, I've written about desire mismatch specifically — from the perspective of both the lower desire partner and the higher desire partner.
The Pressure-Rejection Cycle Has Taken Over
This is one of the most destructive dynamics I see in couples who've stopped having sex. It works like this: one partner initiates, the other declines, the initiating partner feels hurt or rejected and responds in a way — consciously or not — that signals their disappointment. Maybe they withdraw, go quiet, make a sarcastic comment or simply seem deflated for the rest of the evening. Over time, the partner being asked for sex starts to dread the initiation itself — not because they don't love their partner, but because the stakes feel so high and the aftermath of a "no" feels so costly.
Eventually, to avoid the whole painful cycle, sex simply stops being initiated at all. And both partners quietly suffer in the silence.
Sex Has Become Performance-Oriented
When sex becomes goal-oriented — focused on orgasm, on "successful" performance, on doing it right — it often stops being something either partner looks forward to. Anxiety creeps in. For penis owners, this might show up as erectile difficulties or concerns about lasting long enough. For vulva owners, it might look like difficulty with arousal or orgasm, or a sense of going through the motions. When sex feels like a test you might fail, avoidance becomes a natural — if unconscious — response.
Unresolved Conflict and Emotional Distance
You cannot feel emotionally unsafe with your partner and simultaneously feel turned on by them. It just doesn't work that way for most people. When there's unresolved conflict, a history of ruptures that haven't been fully repaired, or a general atmosphere of criticism, contempt or emotional distance in the relationship — sex is usually the first thing to go.
If you and your partner have been coexisting more like roommates than lovers, the sexual disconnection is almost certainly not the root issue. It's a symptom of a deeper emotional disconnection that needs to be addressed directly.
Life Got in the Way — and You Never Found Your Way Back
Sometimes couples stop having sex because of a genuinely difficult season of life — a new baby, a major illness, a career crisis, a loss, a period of extreme stress — and simply never find their way back to each other sexually once that season passes. What started as a practical pause becomes a new normal. And the longer the drought continues, the more charged and awkward the prospect of restarting feels.
This is incredibly common and deeply understandable. Life is demanding. But if months have turned into years and neither of you has addressed it directly, it's worth asking: are you waiting for it to fix itself? Unfortunately, it usually doesn't.
Sexual Shame and Sex-Negative Beliefs
Many of us grow up with deeply internalized messages that sex is shameful, dirty, dangerous or simply not something good people want too much of. These beliefs don't disappear when we enter adult relationships — they go underground. They can show up as discomfort talking about sex, avoidance of anything that feels "too much," difficulty asking for what you want or a vague but persistent sense of guilt around sexual pleasure.
If shame is part of what's keeping sex off the table in your relationship, addressing it — with the help of a good sex therapist — can be genuinely liberating.
A History of Sexual Trauma
For many people, a history of sexual trauma is a significant — and often unspoken — factor in sexual avoidance and low desire. Trauma doesn't always announce itself clearly. Sometimes it shows up as a vague discomfort with sex that's hard to explain, a tendency to dissociate or "check out" during physical intimacy, a strong aversion to certain types of touch or simply a deep sense that sex feels unsafe even with a loving, trustworthy partner.
If sexual trauma is part of your story — or your partner's — it's important to understand that the avoidance isn't a personal rejection and it isn't a choice. The nervous system is doing exactly what it was designed to do: protect you from what it perceives as danger. No amount of willpower or good intentions overrides that response on its own.
A few things worth knowing if trauma is in the picture:
If you're a trauma survivor who hasn't yet done dedicated trauma work, I'd strongly encourage starting there before diving into sex therapy. Working on your sex life while unprocessed trauma is still active can feel overwhelming and counterproductive. A good trauma therapist can help you build the internal foundation that makes sexual healing possible.
If you have done trauma work and are now ready to address the sexual impacts, sex therapy can be a genuinely powerful next step. Working with a trauma-informed sex therapist — someone who understands both the relational dynamics at play and the body's trauma responses — can help you and your partner navigate intimacy in a way that feels safe, gradual and genuinely healing.
And if you're the partner of a trauma survivor, your patience, willingness to learn and commitment to creating safety matter more than almost anything else. Couples sex therapy can help you both understand what's happening and co-create a sexual relationship that works for both of you — rather than one person simply enduring and the other feeling perpetually shut out.
Physical and Medical Factors
Low testosterone, pelvic pain, hormonal changes during perimenopause and menopause, chronic pain, illness, medication side effects — all of these can have a very real impact on sexual desire and function. If you or your partner have noticed a significant change in desire or arousal that doesn't seem to have a psychological explanation, it's worth ruling out any medical factors with your doctor or gynecologist before assuming it's purely a relationship or psychological issue.
So What Can You Actually Do About It?
Here's the good news: a sexless relationship is not a death sentence for your partnership. I've worked with many couples who felt completely hopeless about their sex lives and went on to create something genuinely satisfying. But it does require both partners to be willing to talk honestly about what's happening — and that conversation is often the hardest part.
Start Talking About It — Specifically
Vague reassurances ("we should have more sex") don't move the needle. What actually helps is getting specific. What does each of you want? What are each of you worried about? What has gotten in the way? What would need to be different for sex to feel good again?
These conversations can feel vulnerable and uncomfortable — especially if you've been avoiding the topic for a long time. That discomfort is worth pushing through. Talking about sex, it turns out, is one of the most important skills for actually having a good sex life.
Rebuild Physical Intimacy Gradually
If sex has been absent for a long time, jumping straight back into it can feel like a lot of pressure for both partners. Consider rebuilding physical intimacy more gradually — starting with non-sexual touch, flirtation, making out with no expectation of it going anywhere further. De-coupling physical affection from sex can help both partners feel safer and more relaxed, which is actually a prerequisite for desire to emerge.
Take Pressure Off the Table
If the pressure-rejection cycle has been operating in your relationship, one of the most powerful things you can do is agree — explicitly — to take all pressure off sex for a defined period of time. This doesn't mean giving up on your sex life. It means creating enough safety and breathing room that desire has a chance to naturally resurface, rather than continuing to be crushed under the weight of expectation and disappointment.
Address the Relationship, Not Just the Sex
If emotional distance, unresolved conflict or trust issues are driving the sexual disconnection, focusing exclusively on the sex won't get you very far. The relational issues need attention first. A good couples therapist can help you rebuild the emotional foundation that makes physical intimacy possible again.
Seek the Support of a Couples Sex Therapist
There's only so much you can do on your own, especially when the patterns are entrenched and the conversations keep going in circles. A certified sex therapist brings something a self-help book can't — the ability to work with both of you in real time, ask the questions that actually get to the root of things and help you navigate the dynamics that are keeping you stuck.
If you've been living in a sexless or nearly sexless relationship and you're ready to do something about it, I'd encourage you to reach out sooner rather than later. The longer sexual distance is left unaddressed, the more layers it accumulates — and the more work it takes to unwind.
That said, it's never too late to start. I've seen couples turn things around after years of sexual disconnection. What it takes is honesty, willingness and the right support.
If you're ready to take the first step, I offer a free 15-minute phone consultation to help us figure out together whether sex therapy or couples therapy is the right fit for where you are. I work with individuals and couples throughout California and Oregon — including Portland, San Francisco, Los Angeles, San Diego and the Bay Area — all online.
Schedule your free consultation here.
Jen Joseph is an AASECT Certified Sex Therapist, licensed psychotherapist and seasoned couples therapist working with individuals and couples throughout CA & OR — including Portland, the San Francisco Bay Area and Los Angeles. To learn more, visit jenjosephtherapies.com.