- Sexual problems are often the tip of the iceberg for unaddressed issues in a relationship.
- Common causes are stress, drops in oxytocin, low libido, performance pressure, and unresolved problems.
- Determining and fixing the underlying problems is a key to resolving intimacy issues.
I would suspect that many therapists would agree that low frequency of sexual intimacy is, like affairs, a tip of the iceberg of other underlying problems in a couple’s relationship or with one of the partners, and often both. Issues such as differing needs and expectations, priorities, and power, are often played out in the bedroom. While other problems often bring couples into therapy, sometimes sex is the front-burner concern.
Sometimes the problem is about technique and satisfaction, but more often about the larger relationship: “Sex is my way of feeling connected, and now I feel we’re more roommates.” Or, “I don’t understand why we’re not having sex as often and worry if there is something wrong in our relationship that I don’t know about.” Or, “I think there must be some problem with me, but I’m not sure what it is or how to change it.”
Here are five common causes for decreased intimacy and some solutions:
1. Natural drop in oxytocin
Oxytocin is what helps us bond in a relationship—to our newly born child, or to our new love. At the beginning of a love relationship, oxytocin is high, and with it comes a strong desire for sex. But all this changes a few months later; oxytocin levels naturally drop: Evolutionary-wise, it’s time to go back to work, build a family, and stop with all this distraction.
Solution: When this happens, couples worry about why they drop: Is something wrong with us and the relationship? Sometimes, maybe, but not usually—nature is taking over.
Atop the list of what I hear from partners about why they’re not interested in sex is stress: They are preoccupied, and their heads are somewhere else. And if they tend to internalize and hold this all in, it worsens.
Solution: While your instinct is to withdraw, this is a time to branch out. Your partner is wondering what is happening and likely making up irrational stories that blame you or them—time to let them in. Let them know what is going on in your head—this in itself is intimacy—and take it a step further and let them know what you need, whether it's more space for a while, or more nonsexual affection. That said, often engaging in sex, even if you don’t feel like it, will kick in your endorphins and help you feel less stressed.
3. Low libido
It’s not uncommon for partners to have different libido levels, though this is often masked by the oxytocin bump in the beginning. Once partners go back to their baselines, the differences become more apparent and create problems.
Solution: As with stress, research has shown that engaging in sex, even if you don’t physically feel like it, can increase endorphins and help break a negative cycle, which, in turn, can help ramp up your system. But, that said, many physiological factors impact libido—depression, low hormone levels or natural hormonal changes, and the side effects of other medications—time to consult with your physician.
4. Performance pressure
OK, maybe you haven’t had sex for a while due to work travel, stress, or illness. It's time to get back on the horse, but the big date night turns into a disaster. Why? Too much performance pressure, too high expectations. What should be easy and enjoyable feels like putting on a Wagnerian opera. This can quickly turn into a downward spiral, especially for guys who develop chronic ED, where worrying about performance increases performance anxiety, leading to a self-fulfilling prophecy.
Solution: It's time to slow it down, go back to basics, and reboot the psychological and physical system. Start with sensate focus exercises, descriptions easily found online, to take no-pressure baby steps to get back online.
5. Unresolved relationship issues
For those couples that tend to make up after an argument but never go back and resolve it, or bite their tongues and hold in their anger and resentment, this sweeping of problems under the rug can eventually take its toll. Individually, it can lead to depression and shut-down numbness or periodic acting out that gets too quickly dismissed: I’m sorry, it was the alcohol talking. On the relationship level, it can lead to using distance to avoid conflict—We both withdraw, leading to less verbal or physical intimacy. Or it leads to tunnel vision and focus on pet peeves: My partner isn’t attractive or not good in bed. This essentially turns the issue into an emotional garbage can for all the other problems in the relationship.
Solution: Time to talk about the elephants in the room, the problems swept under the rug. The lack of intimacy isn’t the problem but a symptom of a relationship problem. Focus on and fix the relationship.
Because sex is often one of the first aspects of a relationship to be affected when there are other physical, psychological, and relationship issues afloat, you can use the state of your sexual relationship as a barometer to measure the overall health of the relationship. The key is to do just that—not hope that things will somehow get better, but, instead, sort out the underlying problems and take action. As they say, if you keep doing the same thing, you’ll keep feeling the same way.
Taibbi, R. (2017). Doing couple therapy. New York: Guilford.