If you want to find the most miserable couples in any given year, Dr. Peggy Kleinplatz, medicine professor at the University of Ottawa and intimacy therapist with decades of clinical experience, knows exactly where to look. Valentine’s Day. “It’s the day where I see the most miserable couples, the most distressed couples,” she says. The red roses. The reservation. The prix fixe menu. Two people performing romance while something between them has gone very, very quiet.
The most common reason those couples are sitting in her office? Mismatched libido. The conventional wisdom around it goes something like this: one partner wants more time between the sheets, one partner wants less, and the gap between them is a fundamental incompatibility that can only be managed, never truly fixed. It is a story told so often and with such weary authority that most couples accept it as gospel.
But a growing body of research, and the therapists on the front lines of this particular crisis, are telling a different story. One that is simultaneously more complicated and considerably more hopeful. Because it turns out that what looks like a libido problem might not be a libido problem at all. And what you’ve been told about desire is probably wrong in ways that have been doing damage for years.
Nine leading intimacy therapists and relationship experts agreed to weigh in on what actually goes wrong, what couples keep getting backwards, and what genuinely fulfilling intimacy looks like when you stop trying to negotiate it like a quarterly performance review.
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It’s Not Your Libido. It’s The Sex.
There is something blaringly obvious that needs to be said louder for the people in the back. “It’s rational to have low desire for undesirable sex,” Dr. Kleinplatz says. Read that again. Slowly.
“What looks like a problem of low sexual desire might be evidence of good judgment,” she continues. “Perhaps even good taste.” Which reframes the entire conversation rather dramatically. The partner with lower desire isn’t broken, isn’t withholding, and isn’t secretly indifferent to the relationship. They may simply be a functioning human being with the entirely reasonable preference not to repeat an experience that has repeatedly failed to be worth their while.
Melina Tovar, licensed marriage and family therapist and certified sex therapist, gives it to us straight: “You wouldn’t give a vegetarian the steak on the menu and then ponder why they didn’t want or enjoy it.”
Raven O’Rourke, certified sex therapist, adds a detail that will reorient a significant number of heterosexual couples’ entire understanding of the problem: it is typical, she notes, for a woman to require twenty to forty-five minutes of foreplay to become sufficiently aroused for penetrative sex.
If that number sounds surprising, that surprise is itself the problem. “In this assessment,” she says of her clinical intake process, “I can often provide education that sheds light on the lower desire partner’s experience.” Education, note, not therapy. Just information that was never given. An easy fix!
Couples therapist Lindsey Turner adds another layer: in her experience, the issue is often less about unsatisfying sex and more about people not having the language or permission to ask for what they actually want. “When someone doesn’t have the language or the permission to voice their desire, they tend to shut down rather than push for something better, and that shutdown gets mislabelled as low libido.”
Which means that in a significant number of cases, what a couple is diagnosing as a mismatched sex drive is actually a communication problem wearing a libido problem’s clothes.
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What Happens Outside The Bedroom
The therapists are unanimous on this point: a desire discrepancy does not stay in the bedroom. It leaks. It seeps under the door and into the kitchen and the car and every loaded silence at dinner, and it starts redecorating the entire relationship from the inside.
Licensed psychologist Nicole Prause, who specialises in sexual motivation and teaches therapists about desire discrepancy, describes a dynamic that will be uncomfortably familiar to many couples. “The higher desire partner feels the lower desire partner is ‘holding out,'” she explains, “so may seek to ‘hold out’ on them in other ways. They may be less tolerant of small annoyances, or become less willing to provide small helps often requested in romantic relationships.”
The lower desire partner, meanwhile, perceives these withdrawals as punishment, which predictably makes them feel even less inclined toward intimacy. “The cycle continues as resentment solidifies a lack of interest in sex in a less caring relationship.” It is, in clinical terms, a doom loop. In human terms, it is two people who love each other making each other quietly miserable through a mechanism neither of them has quite identified.
Melina Tovar describes what she calls the pursuer/withdrawer dynamic — the higher desire partner increasing their bids for connection, physical and emotional, while the lower desire partner gradually withdraws not just from sex but from all touch, because all touch has begun to feel like a precursor to an expectation they cannot meet. At which point the couple is no longer just having less sex. They are barely touching at all. This, the therapists agree, is where it starts to get deeply damaging.
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Your Medication Might Be Running The Show
Here is a variable that most couples never think to consider, and that Dr. Wilfred van Gorp, board-certified neuropsychologist and director of Cognitive Assessment Group, would very much like them to. “Desire is not always a choice,” he says. “For multiple reasons, it’s likely that the cause of mismatched libido has more to do with a problem in the brain than within the couple’s relationship.”
The culprit is often medication. Hormonal changes, antidepressants, and other pharmaceutical interventions can dramatically suppress sexual desire in ways that neither partner recognises because neither partner has been told to look for it. Van Gorp describes treating multiple women whose sexual desire essentially vanished after beginning a new antidepressant, and whose relationships suffered the full weight of that disappearance before anyone connected the dots.
In one case, it took three to six months before the medication was identified as the cause. Three to six months of silence, confusion, assumed rejection, and accumulated quiet damage. “Ultimately, her decreased sexual drive was the result of a factor that was outside of her control,” Van Gorp notes. “And was not a choice.”
His advice is direct and should perhaps be delivered to every couple before anything else: before any conversation about attraction, compatibility, or desire, rule out the biochemical. Check the medication. Check the hormones. Check what the body is doing before deciding what the relationship is failing to do.
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The Spontaneous vs Responsive Desire Revelation
This is the piece of information that sex therapists wish was taught in schools, discussed openly before problems develop, and understood by every couple before they ever had cause to be sitting in a therapist’s office. And yet the overwhelming majority of people have never heard it.
Licensed marriage and sex therapist Elena Bahar explains that there are broadly two types of desire. Spontaneous desire, the kind that appears seemingly from nowhere, that characterises the early phase of most relationships when novelty is high, and responsive desire, which emerges in response to context. A touch. A feeling of connection. A moment of genuine presence once the pressures of the day have quieted down.
“Both responsive and spontaneous desire are common and valid,” Bahar says. “Neither is inherently healthier.” But here is the problem: our entire cultural framework around desire is built on the spontaneous model. We expect to simply want sex, the way we simply want lunch.
When that wanting doesn’t arrive on schedule, we assume something is wrong. We diagnose ourselves, we diagnose our partners, and we sit across dinner tables carrying the weight of a problem that was never really a problem at all, just a fundamental misunderstanding of how desire actually works for a significant portion of the population.
Couples understand that responsive desire is legitimate desire, that waiting to feel aroused until the conditions are right is not a character flaw or a sign of waning love; the entire dynamic of a desire discrepancy begins to shift.
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The 4 Biggest Mistakes Couples Make
Having established that the problem is almost certainly not what the couple thinks it is, let us address what they typically do about it, because the therapists are horrified all around.
Mistake number one: making it a numbers problem. “Couples tend to fixate on frequency,” says Lindsey Turner. “‘We used to have sex three times a week, and now it’s once a month.’ They try to solve it by negotiating a number, which almost always backfires. It turns sex into a chore or a debt one partner owes the other, which kills desire even further.” If you have ever found yourself in a conversation about your sex life that felt more like a math problem than an intimate discussion, you know what she’s talking about.
Mistake number two: designating one person as the problem. Nicole Prause says that “too often one person is designated as ‘the problem’ — labelling the lower desire partner as ‘frigid’ or the higher desire partner a ‘sex addict.’ A big mistake is engaging in a power struggle to try to make the other person the problem who must change.”
Melina Tovar agrees, noting that this approach is also, from a purely strategic standpoint, spectacularly counterproductive: “If I were being deemed ‘the problem’ in a relationship, that sounds like a surefire way to turn off someone’s desire pretty immediately.”
Mistake number three is what clinical sexologist Ness Cooper identifies as aiming for equality. “The notion of equality in sex doesn’t really work,” she says. “Often, we need power differences for the erotic to work. When sex is always equal, it can become boring, lacking difference, and it doesn’t allow for change.” Which is not an invitation to chaos, but a reminder that the relentless pursuit of a perfectly balanced sexual ledger tends to drain the very energy that makes intimacy worth pursuing.
And then there is what Anna Joseph, licensed clinical social worker and sex therapist, calls “ripping the band-aid.” This is when the lower desire partner forces themselves to have sex they don’t particularly want, both partners experiencing temporary relief, and the resentment, guilt, and disappointment quietly compounding beneath the surface. “Each partner gets temporary relief in thinking the problem is resolved,” Joseph explains. “But what really happens is that resentment grows.” It is a solution that is worse than the problem it thinks it’s solving.
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What Great Sex Actually Looks Like
Dr. Kleinplatz’s research on what she calls “magnificent sex” dismantles several assumptions simultaneously. Great sex, her research found, is not primarily characterised by orgasms. It is characterised by total presence and what she describes as “erotic intimacy, empathic communication, authenticity, vulnerability, risk-taking, and transcendence.” It is, in other words, considerably more interior and considerably less gymnastic than most people’s working definition.
Lindsey Turner offers the most practically radical reframe on great sex encountered in this research. “The couples with the most satisfying sex lives are ‘having sex from the minute they wake up,'” she says. They are building desire all day long, long before anyone gets near a bedroom — cuddling before getting up, kissing before work, hugging when they walk back in the door, putting their phones down, having dinner with the television off, having actual fun together.
Turner asks every couple she works with what they do for fun, without screens, for at least one hour a week. “About 90% of them give me a blank stare,” she says. “That reaction tells me exactly where the disconnection started, long before it ever shows up as a sexual issue.”
Raven O’Rourke suggests getting entirely off what she calls the staircase model: the assumption that all physical intimacy must progress through a predictable sequence ending in penetrative sex. “Your sex life is unique to you and your partner. You can design it any way that works for you.” Make out on the couch. Offer a foot massage. Send a flirty text at two in the afternoon for no reason. These are not consolation prizes for a diminished sex life. They are, in many cases, the actual architecture of a good one.
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The One Thing That Works
Across all the interviews with therapists, psychologists, and relationship experts, one thread ran consistently through every response, every framework, every clinical anecdote: communication. Not as a soft platitude, not as a well-meaning suggestion, but as the structural foundation without which everything else eventually collapses.
David Lieberman, relationship therapist, offers one of the most specific and immediately actionable pieces of advice in the entire conversation: never respond to a partner’s expressed desire with the word “why.”
“If your partner tells you they have a fantasy and you respond with ‘why,'” he explains, “the desiring partner is most likely going to have shame come about — and shame is no good for anyone.” You don’t have to say yes to anything you’re not comfortable with. But the ability to simply receive what a partner is telling you, without judgment or interrogation, creates the safety that desire requires to exist.
Caitlin Buhrmeister, couples and sex therapist, goes further still: “Assume you are wrong. Assume everything you have been told about sex for your whole life is wrong, and educate yourself on the topic.” Which sounds radical until you consider that most of us received our sexual education from peers, media, and the occasional deeply uncomfortable school lesson, none of which were particularly interested in accuracy.
Katie Dissanayake, whose work produced the Pleasure Census survey, offers a statistic that should give every dissatisfied couple considerable comfort: four in five people want more sex than they’re currently having. That goes far beyond a niche problem. “People are held back by fear, insecurity, or shame rather than lack of desire,” she says. “The sooner people can treat sex as something they’re allowed to talk about openly, the easier it becomes to find what they’re actually looking for.”
The conversation is the starting point. The willingness to have it — honestly, early, without assigning blame or demanding a number — is what separates the couples who work it out from the ones sitting in silence over Valentine’s Day dinner, each quietly convinced the other has stopped caring.
They almost certainly haven’t. They just haven’t found the words yet.
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