Dear Dr G,I am a 57-year-old man who has been married for thirty years.Although my wife is nine years younger than I am, she was rarely sexually inclined, even in the early days of our marriage.In recent years, my wife has been experiencing perimenopausal symptoms, and our intimacy has also been diminishing rapidly.It’s nearly the halfway point of 2026, and I really cannot recall when we last had sex.Although this has affected me deeply, my wife and I do not like to talk about the subject, as we both find the conversation embarrassing and awkward.Truthfully, I am not keen on masturbation.Therefore, I often find the lack of sex both depressing and frustrating.After reading about the protective effects of sexual activity against prostate cancer, I began to wonder whether a lack of ejaculation could harm my health.I take this opportunity to put Dr G on the spot for clarification.What exactly constitutes a sexless relationship, and how common is it?Knowing how sex can enhance bonding in couples, what are the reasons people have sexless relationships?What sort of physical or psychological impact can sexlessness have on health?Finally, how do I get out of this sexless relationship?Yours truly,Sexless Sean Sexual intimacy is widely recognised as an important component of many romantic relationships, contributing not only to physical pleasure but also to emotional connection, relationship satisfaction, and overall well-being. It is important to recognise that not all sexless relationships are problematic. Some couples mutually agree that sexual activity is not a priority and maintain strong emotional bonds through companionship, affection, shared interests, and mutual support. The critical factor is whether both partners feel comfortable and fulfilled with the arrangement. A lack of sexual contact is commonly referred to as a sexless relationship. While there is no universally accepted definition, researchers generally describe a sexless relationship as one in which sexual activity occurs fewer than ten times per year. Research suggests that sexless relationships are more common than many people realise. Population studies from North America and Europe estimate that approximately 10% to 20% of married couples are living in sexless marriages. Surveys have also demonstrated a gradual decline in sexual frequency across many developed and developing countries over recent decades, particularly among younger adults. While sexual activity naturally fluctuates throughout the lifespan, prolonged periods of sexual inactivity are becoming increasingly recognised as a significant relationship and public health issue. The causes of sexless relationships are often multifactorial and involve a complex interaction of biological, psychological, relational, and social influences. One of the most common contributors is relationship conflict. Persistent disagreements, unresolved resentment, emotional disconnection, and breakdowns in communication can erode intimacy over time. Physical health conditions are another important factor. Chronic illnesses such as diabetes, cardiovascular disease, obesity, arthritis, and cancer can directly impair sexual functioning or reduce energy levels and interest in sexual activity. Hormonal disorders, including thyroid disease and low testosterone levels, may significantly diminish libido. Women undergoing menopause often experience vaginal dryness, discomfort during intercourse, and hormonal fluctuations that can affect sexual desire. Sexual dysfunction itself can become both a cause and a consequence of a sexless relationship. Erectile dysfunction, premature ejaculation, difficulties achieving orgasm, and pain during intercourse often lead individuals to avoid sexual encounters due to embarrassment, anxiety, or fear of disappointing their partner. Over time, this avoidance can become entrenched, creating a self-perpetuating cycle in which sexual activity becomes increasingly infrequent. The psychological impact of a sexless relationship can be profound, particularly when the absence of sexual activity is unwanted. Individuals who desire greater intimacy often report feelings of loneliness, rejection, frustration, sadness, and diminished self-worth. Repeated experiences of sexual rejection may lead some individuals to question their attractiveness, desirability, or value within the relationship. Over time, these feelings can contribute to anxiety, depressive symptoms, and a general decline in psychological well-being. The emotional distress associated with unmet intimacy needs may be especially significant when a lack of affection, emotional support, or open communication accompanies sexual inactivity. When sexual activity declines significantly, couples may experience reduced relationship satisfaction, increased conflict, and greater emotional distance. Although many factors influence relationship stability, studies consistently demonstrate an association between sexual satisfaction and overall relationship quality. The physical health implications of sexless relationships are more complex. The absence of sex itself is not inherently harmful, and many individuals lead healthy and fulfilling lives without sexual activity. However, sexual activity has been associated with several health benefits, including improved sleep quality, reduced stress, temporary reductions in blood pressure, enhanced mood, and increased release of hormones such as oxytocin and endorphins. Sexless relationships are relatively common and arise from a wide range of biological, psychological, relational, and social factors. While some couples thrive without sexual activity, an unwanted absence of intimacy can significantly affect emotional well-being, relationship satisfaction, and overall quality of life. Understanding the underlying causes and addressing them with empathy, communication, and appropriate support can help couples navigate these challenges and foster healthier, more fulfilling relationships. As relationship expert Esther Perel has said, “Sex is not something you do; sex is a place you go.” Couples facing sexless relationships often look to Dr G for a solution. His view is: “When sex is going nowhere, it’s definitely time to do something to reignite the sparks of love!”
