I am a woman in my 30s who has been in a relationship with my partner (also a woman) for almost four years. Our sex life has never been amazing, but we love each other deeply and when we do have sex it is good. But the frequency is low – we are intimate once every couple of months and she never initiates sex. We recently married and during our week’s honeymoon had sex once. I’m at the end of my tether with frustration and sadness that she doesn’t seem to want to sleep with me. I’ve tried to talk to her about what’s going on and she is generally dismissive, putting it down to our busy lives. When I brought up the honeymoon and the fact that I was rejected numerous times during a week when we were both relaxed, she didn’t have a response. Is it time to see a sex therapist? I do not want a sexless or low-sex marriage. I love my wife very much, and I don’t doubt that she loves me, but it’s really starting to affect the way I feel about myself. I could wear the hottest outfit or nothing at all and she still wouldn’t make a move. What can we do to change things?

A good sex therapist could certainly help. An imbalance of sexual interest between partners can be a source of enormous frustration for both. It can create resentment, anger and even lead to a break-up. With help, you could both gain clarity about each other’s needs, reach an understanding, learn to communicate better – and have the best chance of resolving the situation. Sometimes there is a medical or psychological reason for low desire, and a sex therapist can help identify factors that require special attention. Unfortunately, many people passively accept such an impasse, which – as you have already discovered – can have a devastating effect on one’s self-esteem. You are smart to consider seeking help.

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• 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 [email protected] (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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