I only say that I'm tired

Some relationships just don't lend themselves to healthy sexual expression. Lots of women avoid sex when they have been betrayed by or become afraid of their partners, or when communication habits or physical distance have built walls a couple just can't climb over.

Many women avoid sex because of some experience in their past. They may have experienced physical, sexual, or emotional abuse, or they may have problems with attachment or rejection. 

Depression and anxiety experienced by one or both partners can wipe out sexual expression, too.

Sharing our sexuality can bring a lot to a good relationship. But it can't fix a bad relationship. And it's impossible to build intimacy in a relationship that doesn't feel emotionally or physically safe.

If you're in an unsafe relationship, please get help. The National Domestic Violence Hotline is one way to find it quickly.

If you're in a relationship that needs some work, start with a good couples counselor.

If your history is hurting you, a good counselor can help a great deal.

Start with healing your situation, and let intimacy follow on healing.

Dig deeper by exploring the related conditions listed at right, or choose another statement that sounds like you.

Avoiding sex? Here are some possible causes:

Body Image
Most of us have worked all our lives to develop a good body image—what a complicated concept!

Worry about STI
At midlife many of us are dating, some of us starting to date again after many years with the same partner.

Vulvodynia (VVS)
Pain in any part of your vulva—the mons, outer or inner labia, the clitoris or vestibule—that cannot be attributed to any other cause, is called vulvodynia. 

"It's like hitting a wall," say our patients with vaginismus. This is a condition in which the involuntary muscles of the vagina go into vaginal spasm.

Deep Pelvic Pain
Deep pain with penetration, especially with thrusting, is often caused by pelvic problems, and should be explored with your doctor if it is persistent.

Sexual Trauma
Sexual trauma is, unfortunately, a history too many of us share. Every two minutes, in the U.S. alone, a woman is raped.

Physical/Emotional Distance
By midlife many of us have been in our relationships for decades, have endured ups and downs together.

Sexual Confusion
Some women reach midlife without ever experiencing strong arousal or satisfying sex.

Physical Limitations
Midlife comes with aches, pains, limitations. We don't bounce the way we used to. Some of us have lost strength in our limbs. 

Helpful reminders

Understand the recipe
Talking about sex
Seeking care and advice