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updated 9/8/2009 4:54:47 PM ET 2009-09-08T20:54:47

Jennifer (name changed) didn't have sex with her ex-husband on their wedding night. "I chalked it up to fatigue," she says. But should it have been a red flag? Well, maybe.

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It's not that it didn't happen that one night that was the problem; it's that it was the first of many sexless married nights. As an engaged couple, Jennifer and her fiancé were doing it about three times a week, but once they said their vows, it quickly dwindled to about once a month — sometimes less.

Some experts call marriages that average 10 rolls in the hay per year or less "sexless," but other experts take the word more literally, like Susan Yager-Berkowitz, who coauthored (with her husband) "Why Men Stop Having Sex: The Phenomenon of Sexless Relationships and What You Can Do About It."

"If a couple is content with intimacy less than once a month, and happily married, I doubt they would refer to themselves as having a sexless marriage … and neither would we."

Dean Mason, who runs the Website, FixYourSexlessMarriage.com, agrees, "Each person defines what his or her sex threshold is."

Not in the mood — ever?
But even if there's no perfect definition for a "sexless" marriage, everyone seems to agree that they're common. Newsweek estimates that about 15 to 20 percent of couples are in one, and sexless marriage is the topic of myriad new books — like Yager-Berkowitz's — and plenty of articles and columns. Back in 2003, Newsweek's cover blared, "We're Not In the Mood," and the story hasn't gone away. This June, The New York Times reported that about 15 percent of married couples had not done the deed in the past six months to a year.

It's not a given that a couple's bedroom activity will fizzle over time — we all know a randy couple who've been married for decades — but any number of factors could start the tailspin. Psychotherapist Tina Tessina, PhD, author of "Money, Sex and Kids: Stop Fighting About the Three Things That Can Ruin Your Marriage," lists these as the most common causes of sexless marriages: one partner had their feelings hurt or got turned down too many times, one got too busy or neglectful, or one or both partners has a communication problem of some sort.

Judith Steinhart, a clinical sexologist in New York City, is yet more specific: "Problems in a marriage [like] lack of trust, anxiety, financial issues, misunderstandings, pressure from children, all can impact a couple's sexual patterns." The question, of course, is whether refraining from sex causes other problems, or if the other problems stop the sex in the first place?

"It's a cycle," says Mason. In other words, one can exacerbate the other — and before you know it, no one can remember what came first.

As for how much sex a healthy couple should be having, that varies — and is up to the couple to figure out. Tessina's best advice is at least once a week, saying that "intimacy keeps you glued together. It's what you need in order to nurture your connection to your spouse. You'll be a lot happier with each other and feel more cared about if you're regularly having sex.

Couples shouldn't feel like they have to stick to once a week during stressful or tumultuous times. And of course, there can always be an off-week — or longer. As Steinhart notes, "Sex and sexual expression change along with the longevity of a relationship, ebbing and flowing during a lifetime." But the good news, she says, is that the ebb is "natural — and you can get back to the flow easily."

But when a couple has had a long period — say, several months — without sex, it's important to address the problem, so months don't become years, Tessina says. "Some couples won't have sex for two years and then come in to my practice and ask for help. We can get to the bottom of the problem at that point, but it's more challenging. If they haven't had sex for a couple of months, that's when they really should be asking questions. That's a good time to come in and have therapy. Otherwise, anger and frustration builds, and it takes longer to fix it that way."

After a period of sexual inactivity, you and your partner can get back on the proverbial horse. The experts say that scheduling sex can work.

"I know this doesn't sound romantic," says Mason. "But with kids, work and chores, it may be the only way." Take inspiration from the Obamas and call it "date night." Think back to when you and your spouse actually were dating and try to recapture some of those spontaneous, getting-to-know-you moments.

"Remember how you connected back then and repeat that," says Tessina. "It could be a few words, a gesture, a kind of look or touch." Do new things together, go on a trip or try some thrilling activities to try to keep things fresh. "Break away from your routine as much as possible," says Mason.

It's common for spouses to have different amounts of sexual desire. If you're the spouse who's unsatisfied, it's important to communicate with your partner, compassionately.

"Say, 'We haven't had sex in a while, and I miss you,'" recommends Tessina. "Don't complain about it — that's not going to get you laid. Go for the sweetness." Choose the time of day that works for both of you; maybe set the scene with some candlelight, romantic music or whatever helps you both get into the mood. "Try to make it as easy and simple as possible to get together, and it gets easier to do," says Tessina. "In a long-term marriage, you have to pay attention to keep the sex going. It won't keep going by itself."

So can a sexless marriage be healthy?
The experts agree that a marriage without sex isn't necessarily wrong, but it can be more vulnerable than one with regular sex. Luckily, it's doesn't always take much to keep up a routine — but it does take some effort. Steinhart suggests getting back into the groove by reading erotic stories or watching X-rated movies together and opening a dialogue about each other's sexual desires. What gets each couple — and each person — back on track will vary, so explore ways to loosen up your current attitudes about sex, shake up your routine a bit and begin to talk about sex with your partner.

"The focus needs to be on giving and receiving pleasure," says Steinhart. "And letting the [sexual] feelings in."

If you're the one who doesn't want to have sex, closely examine what's going on in your life and your relationship and ask yourself why. It could be a physical condition you should see a doctor about, or it could be negative feelings toward something in your relationship — and that could be something you can get past. "Be honest with your partner," says Mason.

"Remember that it's important to your relationship to keep you partner sexually satisfied." "There are deals you can work out," says Tessina. "Maybe you can hold your partner while they masturbate."

So is a sexless marriage ever okay? Yes, says Steinhart, as long as both partners honestly feel happy and satisfied with their relationship without sexual intimacy.

"If a couple is OK with their pattern, whether it's infrequent or not at all there isn't a problem," says Steinhart. "Some would say, 'If it ain't broke, don't fix it.'" That's why it's important to keep an open dialogue with your spouse, to continue to connect on other levels and to make sure both of you are truly content with the status of the relationship. Steinhart adds, "It's not a lack of sex that's the issue, it's a discordant level of desire."

Sadly, Jennifer never really got to the bottom of why her ex stopped wanting to have sex with her. "As for theories, I came up with a slew of possible reasons, [that] he's stressed, he's busy, he's tired, he's sick, he takes me for granted, he's gay," she says.

For Jennifer, it was the lack of sex that first made her unhappy with her marriage. "The sex issues awakened me to my unhappiness," says Jennifer. "I was trying to stick it out despite the lack of sex, but there were too many other factors that disappointed me about him. I don't think it's possible for a sexless marriage to have no other problems." Apparently her husband felt similarly, as they mutually agreed to divorce.

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