My wife has lost all interest in sex. We haven’t made love for three years – and she won’t get help

My wife and I are in our 50s and healthy, although she suffers from anxiety. Our sex life used to be enjoyable, but since the birth of our daughter, who is now a teenager, it has gradually diminished. For the last three years it has been nonexistent. I still have a sexual appetite but my wife tells me she has lost all interest in sex. She has said several times that she will seek help from a therapist but never does and doesn’t seem motivated to do so. She seems very uncomfortable even talking about sex, to the extent that I have become wary of bringing it up. Our sexless marriage seems to suit her fine – we are great friends and enjoy each other’s company. However, I feel frustrated at the lack of discussion about what happened to our sex life and feel resentful that something that used to be a core part of our relationship has just disappeared. Should I just accept that we will no longer have sex or should I persevere with trying to get her to seek treatment?

Persevere. The exact reason for your wife’s lowered libido is unknown, and there are certain factors that should be understood for both your sakes. Anxiety can certainly be a contributing element, as can depression, stress, hormonal imbalance, body image issues, relationship factors and certain medications and medical problems. One red flag is your use of the words “great friends”. Who you see yourself to be in the context of your partner is important; I’m sure it is very painful for you to be a “friend” rather than a “lover”. Seek help, trying not to allocate blame but rather be her partner in engaging her in an effort to improve the quality of life for both of you.

• Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

• If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.

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