Yes. This is actually one of the most common reasons couples reach out to a sex therapist. When physical intimacy disappears from a marriage, it’s usually a sign that something else is going on, and sex therapy helps you figure out what that is.

A sexless marriage doesn’t happen overnight. It creeps up slowly. One of you is too tired, the other stops initiating, and before you know it, months have passed without any physical connection. You’re sharing a bed but living like roommates. If this sounds familiar, you’re far from alone.

Therapists typically define a sexless marriage as having sex fewer than ten times a year. But honestly, the number doesn’t matter as much as how it’s making you feel. Some couples are fine with infrequent sex. Others feel rejected, lonely, or completely disconnected from their partner when intimacy drops off.

If the lack of sex is causing problems in your relationship, that’s what matters. Not whether you hit some arbitrary threshold.

There’s almost never one single reason. Usually it’s a pile of things that stack up over time.

Life gets busy. You’re both exhausted from work, kids, responsibilities. By the time you get to bed, the last thing on your mind is sex. And after enough nights of being too tired, it becomes the new normal.

Resentment builds. Small frustrations that never get addressed turn into walls between you. It’s hard to want to be intimate with someone you’re quietly angry at. Even if you can’t pinpoint exactly why you’re frustrated, your body knows, and it shuts down.

Sometimes there are physical reasons. Hormonal changes, medications, pain during sex, or health issues can tank your desire. These things are common and fixable, but people rarely talk about them because it feels embarrassing.

And sometimes desire just works differently than it used to. Early in relationships, you feel that spark without trying. But in long term partnerships, desire often becomes responsive. It shows up after you start connecting physically, not before. If you’re both waiting to feel turned on before making a move, you could be waiting forever.

Sex therapy helps you understand what’s actually happening underneath the surface. The missing sex is usually a symptom of something else, whether that’s emotional distance, communication problems, unresolved conflict, or past experiences affecting how you relate to each other now.

One approach that surprises a lot of couples is that the therapist might suggest taking sex completely off the table for a while. No pressure, no expectations. This removes the anxiety that’s built up around intimacy and gives you space to reconnect in smaller ways first.

You start with the basics. Holding hands. Sitting closer together. A longer hug before bed. Small physical gestures that don’t lead anywhere. These rebuild the comfort and warmth that got lost somewhere along the way. When sex eventually comes back into the picture, it feels more natural instead of forced.

The other big piece is learning how to actually talk about sex. Most couples have never had a real conversation about what they want, what’s working, what isn’t. They assume their partner should just figure it out, or they’re too uncomfortable to bring it up. Getting better at these conversations changes everything.

Sex therapy works best when both people are willing to show up and try. That doesn’t mean you both have to be equally excited about it from day one. It’s normal for one person to push for therapy while the other drags their feet. But you both need to be open to the process.

If your partner isn’t ready yet, you can still work on this individually. Sometimes one person starting therapy is what eventually brings both people to the table.

This isn’t a quick fix. Rebuilding intimacy takes time and consistent effort from both of you. It won’t happen in a few sessions.

It also won’t solve problems that go deeper than the bedroom. If there’s betrayal, emotional abuse, or fundamental incompatibility, those things need attention too, sometimes through marriage counseling alongside or before sex therapy.

And no therapist is going to tell you how often you should be having sex. The goal isn’t to hit some magic number. It’s to create a sexual connection that actually works for both of you.

You’ve stopped having sex and one or both of you feels hurt or frustrated about it. Conversations about intimacy go nowhere or turn into fights. You feel more like roommates than partners. You miss what you used to have but have no idea how to get back there. You avoid physical touch entirely because the pressure around sex has become too much.

If any of this sounds like your situation, sex therapy is worth considering.

Our practice works with couples in Philadelphia who are dealing with exactly this. If your marriage has gone quiet and you want to rebuild the connection, schedule a consultation to talk about what’s been going on.

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