Q: Hello, I am just beyond the point of frustration. My wife and I have been married 5 years. We were together for 3 years before our wedding. It has now been 4 years since she has had sex with me. I have pleaded with her, asked to go to a therapist, see a doctor, still she refuses…she just says she doesn’t know why she just doesn’t feel like it. I love my wife very much, but I want to make love to her. She says I will live… and I know that is true, but there is still that feeling of closeness and that love for one another. I don’t know if you can help, but I thought I would at least try. Thank you.

A: Four years is a long time to be patient. Sex certainly isn’t the most important part of a relationship but it is important. And sometimes it seems to grow in importance if one of the partners is not satisfied. It is quite common for couples to have different attitudes and appetites for sex but the fact that so much time has gone by and that your wife refuses to get help concerns me. There may indeed be underlying issues such as past sexual abuse, a hormonal problem, unresolved issues affecting her beliefs about intimacy but the problem cannot be fixed if it is never addressed. I understand that you still love your wife but I hope you can find a way to get her to address the problem. You are in a tough spot though because the more you bring it up, the more resistant she may become. I would start by strongly requesting marital therapy. You may even want to go ahead and make an appointment and go by yourself until she will join you – this not only shows your commitment but you may get some needed support. As much as possible, keep your discussions to trying to understand her feelings and to you expressing yours. Try to stay away from anger if you can. I hope you and your wife can work through this together.