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updated 3/30/2006 9:44:50 AM ET 2006-03-30T14:44:50

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Q: My wife and I were married last year. I love her dearly, and would do anything to make her happy. But I don't feel that this is reciprocated.

My wife rarely initiates physical intimacy, be it sex or even a quick kiss. If there is any physical interaction, I initiate it. I hint rather often that I desire more physically. When I try to talk to her about this, she gets annoyed.

I am a good husband and stepfather to her son. I do all of the housework, cooking and laundry. I also work a full-time job and take my stepson to his sports practices. My wife also works full-time, at a job that leaves her exhausted.

I feel like our marriage is falling apart. The last thing I want to do is annoy my wife further, so now I avoid talking about this, but I feel I am ignoring my own needs and shouldn't be. What more can I do?

A: You sound like a great husband, and are certainly doing your fair share around the house. But clearly, none of this is helping when it comes to intimacy with your wife.

You are hinting at your needs and she is avoiding the topic. This tentative approach/avoidance dance is common, but it doesn’t resolve anything. You need to stop hinting and confront the issue.

Your wife’s annoyance when you broach issues of intimacy means she is choosing not to take the hint. She doesn’t want to deal with these issues, and would prefer the status quo. On your end, you are empowering her by backing off.

Being tired is an excuse. Many people work hard and get tired. Sure, there are many competing priorities in life, but you do not want tiredness to push sex to the bottom of the list. Otherwise, your spouse becomes your roommate.

For many people, lack of intimacy is a dealbreaker. It indicates a huge imbalance in the marriage, and opens the door to infidelity and divorce. It is no surprise you feel that your marriage is falling apart. It might well be.

So you must let your wife know that sexual intimacy is a vital part of marriage for you, and you do not want to commit yourself to a life of no intimacy. If you cannot work it out, the marriage is likely doomed.

Be very specific and upfront. It’s better to say “I would like to have sex twice a week” than to say “I would like to have sex more often than we do.” Being nebulous makes you hard to understand. Nobody knows if “more often” means twice a day or twice a year.

At the same time, you can be kind, empathic and understanding. Let your wife know that you don’t wish her to be miserable in the marriage, but that you yourself are miserable. You cannot endlessly ignore your needs — and I would add that these are needs you are entitled to have.

Sure, there are many sexless marriages, and if partners have matching sexual dysfunctions and have no problem with a lack of sex, that is fine for them. But it is not fine for you. You don’t say if your sex life was once good, or if your wife’s loss of interest was sudden. If so, it’s possible she has a medical problem. So you should, of course, first rule out medical problems as the reason for her lack of interest. Otherwise, if you cannot work this out by yourselves, you might want to see a certified sex therapist.

Dr. Gail’s Bottom Line: Lack of sexual interest by one spouse is a serious problem — and if you keep avoiding the topic, it can drive you apart irrevocably.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to “Today.” Her latest book, "Amazing You! Getting Smart About Your Private Parts" (Penguin), helps parents deal with preschoolers' questions about sex and reproduction. Her first book, “Becoming Real: Overcoming the Stories We Tell Ourselves That Hold Us Back,” was published in 2004 by Riverhead Books. It is now available in a paperback version. For more information, you can visit her Web site, www.drgailsaltz.com.

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