Dear Dr. G,

I am in my mid-fifties and recently attended a medical check-up.

The doctor gave me an all-clear following a thorough blood test and scans.

During the medical consultation, I was asked when was my last sexual intercourse and whether I face any issues with sexual dysfunction.

I wasn’t expecting such direct questioning and told the doctors all we are fine in the bedroom, and not facing any difficulties.

This is actually far from the truth. The fact is my wife and I have not had sex for at least five years, at least since the onset of her menopause.

I also confess, apart from my wife being disinterested, my libido has also diminished over the years, and the erectile rigidity also disappears accordingly.

I am somewhat worried about the risk of my sexless life and would like to put Dr. G on the spot for some clarification.

Is sexless marriage common? How do couples manage with a sexless relationship?

Will couples drift apart without sex?

I also read somewhere the risk of not ejaculating can be significant, some even describe association with infection and cancer of the prostate. Is that true?

Finally, I often read your articles on the benefit of sex. Can you give some tips on how to reignite the magic after five years of a sexless life?

Yours truly,

Sexless Samuel

The decrease in sexual frequency to the state of a sexless marriage is known as marriage blanc. In the medical viewpoint, the definition of a non-sexual marriage is broadened to sexual intimacy that is fewer than ten times per year. A marital union, where little or no sexual activity between the spouses is well documented in western literature. According to the United States National Health and Social Life Survey in 1994, completely sexless marriages are reported to be around 2%. The survey also identified around 20% of the married respondents had sex less than ten times a year. This statistic is consistent with the Times report identifying 15-20% of American couples who confessed to having sexless relationships.

Closer to home, several countries including Japan, Singapore and Hong Kong are well-known to have publications on couples placing sexual relationship lower down in the priorities of life. One study from Hong Kong conducted an anonymous population-based telephone survey on 2,846 married couples between the ages of 25 to 59. The study revealed around 5% of respondents between the ages of 25 to 44, admitted to sexless marriages. The prevalence increases to 17% for couples between the ages of 45 and 59. The causes were noted to be poor spousal relationship and diminishing libido. Association of poorer mental health indicators and lower quality of life were also reported in couples living sexless lives.

In reality, the frequency of sexual intercourse is clearly multi-factorial. Sexual hormones, such as testosterone and estrogen determine sexual desire. As the levels of such hormones diminish with age, this will in turn diminish the interest in intimacy, especially in menopausal women. In addition to hormonal influence, the emotional dynamics between couples are also crucial to engage in regular intimacy. This is clearly related to other issues such as work-life balance and the placement of sex amongst other priorities of life. In the modern urban lifestyle, it is not uncommon for couples to accept a sexless marriage due to a busy lifestyle and different work schedules. Work and childcare can lead to stress and chronic fatigue. The acceptance of sex being low in life’s priorities is inevitable.

In the court of law, a blank and null marriage of non-consummation is commonly used as grounds for divorce. The causes of sexless marriages usually stem from one partner. One partner had their feelings hurt, being neglectful or stop communicating are the three most common reasons for the dampening of the sexual passions. Naturally, the lack of communication can lead to distrust, anxiety and misunderstanding which impair sexual intimacy. Adultery can also be a cause of sexless marriages as one’s extra-marital affairs can reduce sexual interest towards their own spouse. Understandably, the discovery of the affair can understandably cease all sexual contact within the relationship.

The benefit of sex is well documented for both men and women; these include lowering of blood pressure and stress. The additional benefits of frequent ejaculations in men are also well reported to reduce the risk of prostate cancer and prostatitis. On the contrary, the health risks associated with sexless life is not as well studied. Although some experts in Taiwan have reported long-term lack of ejaculation in men can lead to adversity such as chronic prostatitis and cancer, however these reports are based on small anecdotal observations.

In many Asian conservative relationships, sexual taboo and oppression in upbringing bring a negative perception of harmful impact of frequent sex. When such mentality persists into a marriage or relationship, sex may only serve the purpose of procreation and be lower in priority for recreation. This may result in “excuses” of placing other priorities of life in place of sex. The sexual aversion or disparity in sexual needs can eventually lead to conflicts and distrust. In reality, the re-ignition of a sexual relationship is like courting and should not take much effort. However, the benefit in physical and mental health for frequent sex is simply overwhelming. One American country singer who famously said: “Love is the ice cream sundae, with all the marvellous coverings. Sex is the Cherry on top!” Dr. G is often put on the spot by couples entrapped in a sexless marriage. His advice is: “Your marriage and love is an ice cream sundae with all the coverings. Treasure the cherry on the top, before the ice cream melts away.”

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