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updated 9/1/2009 1:07:38 PM ET 2009-09-01T17:07:38

Q. My husband and I took separate vacations this year. When our two kids and I returned from our vacation with my parents and siblings, my husband and I discovered that he had pubic crabs. We had not had any sexual contact for several weeks prior.

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He reasoned that he probably contracted them from a borrowed towel or a toilet seat he used when camping. He was horrified and humiliated. I couldn’t bring myself to ask, let alone accuse him of cheating, but I’ve had my suspicions in recent years and couldn’t help but wonder.

This bothers me more every day, especially since the person I suspect he has cheated with is our neighbor — a man my husband used to hang out with regularly but, strangely enough, has not hung out with since this incident.

I’m terrified that if I were to say something to him and be wrong, it would devastate him — but if I'm right, I don't know if I want this marriage to work. Please help. What should I do?

A. Assuming you really want to know the truth, there are ways to ask your husband.

Pubic crabs, or lice, can be spread several ways. Obviously, if your spouse acquires a disease involving the genitals, you are likely to be suspicious.

I have seen cases where someone believed their spouse was cheating because of a sexually transmitted disease, but some infections can lie dormant and remain undiagnosed until years after acquisition. In other words, not every STD means your partner cheated. Nonetheless, it does raise a red flag.

Fortunately, lice can be successfully treated. The bigger point is that something has occurred — similar to a change in your husband’s schedule, a recurring phone number or an unexplained credit card charge — that raises your hackles.

There are already indications you are feeling distance in your relationship. You have had no sexual contact for weeks. You went on separate vacations. While there are sometimes good reasons for these things, they tend to be signs of troubled partnerships, not healthy ones. Video: How to get your guy to tell the truth

And you have already had suspicions about your husband. So it’s not surprising you are interpreting this incident as meaningful, even though you have no proof the crab lice weren’t spread by an innocent, if infested, towel.

If you are concerned about infidelity and really want to know the truth, it is best to confront the issue rather than avoid it. Long-term suspicion will erode a relationship anyway.

(And infidelity is a separate issue from concern that your husband is gay.)

It sounds as though you are not feeling very desired sexually. So your first step is to inform your husband of this and explain your concern that something isn’t working in your relationship and that you want to discuss it so you can fix it. This allows him to talk about the subject without feeling accused by you.

Don't be accusatory, or you will put him on the defensive.

He has the chance to confirm that something isn’t working. This could be for reasons you are unaware of. There are many possibilities — maybe he has erectile dysfunction, hates his boss or worries about being laid off. Possibly he is depressed. It could be something about you that you are unaware of, something that has made him angry or turned him off. This is an opportunity to unearth a problem that is adding distance between you. It's better to do this now, before it is so late that neither of you wants to work on the problem.

But if you are right — if he is cheating, whether with a woman or a man — then this is also an opportunity to put him on notice that you are aware of something, and have that information come out, as well.

Hanging out with a same-sex friend is not a sign of a sexual relationship. Their failure to hang out currently could be due to any number of reasons. If you really think your husband might prefer to be with men sexually, I wonder if there aren't other indications that make you suspicious.

In general, I advocate that spouses should know what’s going on. If they sit around stewing and wondering, that distrust and hostility comes through and erodes a marriage over the long haul. Your relationship will likely get worse unless you clear the air.

As far as the disease situation, if you believe you are at any risk of picking up a sexually transmitted disease from your husband, you should immediately see your gynecologist about prevention or treatment.

Dr. Gail’s bottom line: Signs of a cheating spouse are easily misinterpreted. If you really want to find out the truth, begin by asking about the general state of your relationship.


Any ideas, suggestions in this column are not intended as a substitute for consulting your physician or mental health professional. All matters regarding emotional and mental health should be supervised by a personal professional. The author shall not be responsible or liable for any loss, injury or damage arising from any information or suggestion in this column.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to TODAY. Her most recent book is “The Ripple Effect: How Better Sex Can Lead to a Better Life” (Rodale). For more information, please visit www.drgailsaltz.com.

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