Tell Me About It: My fiance never wants to have sex

Q I am in my mid-30s and am generally very happy; my wedding is set for mid-summer and all would be well except that my fiance and I have no sex. We have been going out for eight years and initially everything was good. I hardly noticed that there was a slacking off of intimacy until it was months since the last time we made love. When I speak to my partner, he says that he is under stress at work and not to put pressure on him – he says that when we are married it will all get sorted. However, I am feeling very unattractive and unloved, and I don't know if this is a sign that we shouldn't be together. I really love him, but what if this doesn't change and we have difficulty having children? I'm very confused and don't know where to turn.

A In my experience there are two points at which couples may stop having sex: one is after the birth of the first baby and the other is often the point of commitment. There is growing evidence that men can suffer from lack of desire, and this can come in two forms, the first being a total loss of libido and the other is loss of desire for their partner but not loss of libido in general. Both cause great suffering and unless help is sought, can lead to relationship difficulties and sometimes break-ups.

The causes of this condition are many and varied. Often couples can be over-familiar and lose that sense of mystery that triggers sexual excitement – people often describe this as a type of brother-sister relationship. In some cases commitment triggers a vision of the other person as a parent-type figure and this can make sex a taboo.

Some men may have repeated experiences of having intimacy problems and move on to another relationship when this arises. This is often an unconscious response not readily accessible to the couple. Both people can then create habits around this that add to the problem; for example not putting pressure on their partner for fear of causing upset, or hiding their feelings to avoid conflict. It is important to note that some medications might affect libido, as can some illnesses.

The effects of a no-sex relationship can be problematic. Men often question their identity and masculinity, and, in common with a stress response, adopt an avoidance stance. This means they might avoid situations where they have to face the problem, going to bed later than their partner, creating distractions or even becoming depressed. The more there is pressure to feel desire, the more stressed and withdrawn the person might become. Their partners may feel rejected, abandoned and frustrated, and so the relationship can suffer in the long term. Some partners try to protect their partners from upset by not speaking about the issue, and so the problem becomes normal and difficult to tackle.

In some instances, men may experience desire with porn or with another woman. In this situation there is the added difficulty of secrecy and hurt, and the woman can begin to question her allure. It is very difficult to talk honestly and openly about such painful things – yet intimacy depends on it.

Intimacy comes in many forms, and sex or intercourse is only one of them. The starting point is a willingness to let the other person fully in to your deepest places, and this requires courage, faith and honesty.

An occasion or crisis often forces us into action and the desire to have a child is often the starting point for looking for help. You clearly love your partner and want to spend your life with him – surely that allows you to trust that the relationship is robust enough to take a challenge.

The starting point is having this conversation openly, and this may be facilitated by being away from home or out for a long walk. Start by saying, “I need to talk to you about something important. I am worried that sexually we are not as active as earlier in our relationship.” Going with your partner to your GP will show that it is a joint venture and not his need to be “fixed” alone.

Once physical problems have been ruled out, sessions with a psychotherapist or counsellor working in the area of intimacy is advised.

Often this means individual and joint sessions, looking at sexual messages received and exploring what desire entails for each person. Homework is often given and a practical and light approach taken to the interventions.

Trish Murphy is a psychotherapist. Her book The Challenge of Retirement is published by Orpen Press.

Kate Holmquist is on leave