Urologist Discusses Solutions for 'Sexless Marriages' to Rekindle Intimacy

Many couples struggle with a decline in sexual intimacy and a loss of closeness, a common issue that significantly impacts relationships. Urologist Rena Malik, M.D., addressed this on her channel, explaining that the fading of intimacy often stems from psychological misunderstandings rather than a lack of love.

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When couples or married partners experience a lack of sexual life, it is common and its impact should not be underestimated.

Malik identified three common pitfalls. First, the misconception that a loss of intimacy means a loss of love. She clarified that chronic illnesses like hypertension and diabetes, medication side effects, or elevated cortisol from stress can suppress libido. Second, the belief that one partner is "at fault." Malik noted that desire naturally fluctuates in long-term relationships, and the real crisis arises from a cycle of "initiation-rejection-resentment" or "rejection-pressure-avoidance."

Third, the idea that the rejecting partner has lost all desire. Malik contrasted this with media portrayals of instant passion, stating that in long-term relationships, intimacy requires intentional effort. Modern life, filled with work and digital distractions, leaves little room for "closeness." She advised couples to actively create space for intimacy, rather than passively waiting for the "feeling" to return.

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The decline in intimacy is rarely because the love has disappeared. Chronic illnesses (such as hypertension, diabetes), side effects of daily medications (such as antidepressants, blood pressure medications), or even life stress causing cortisol to rise and suppress sex hormones are the potential culprits stealing desire.

To rekindle intimacy, Malik suggested practical steps. Couples should "schedule" intimate time, treating it like any other important appointment, free from digital interruptions. She also emphasized the "action precedes feeling" principle, comparing it to going to the gym: the act of engaging in intimacy can generate desire. Communication is key; instead of blame, express longing with phrases like, "I miss you and want to be close." Finally, she urged seeking professional help for issues like pain or erectile dysfunction, noting that couples often wait six years before seeking assistance, complicating the problem.

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Every couple will experience times when their desires are out of sync in a long relationship. The real crisis is falling into the vicious cycle of 'initiation → rejection → resentment' and 'rejection → pressure → avoidance.'

Malik recommended a simple daily practice: five minutes of device-free time spent talking, holding hands, or hugging. She stressed that nurturing intimacy requires ongoing effort and shouldn't wait for a perfect moment, encouraging couples to create this dedicated space immediately.

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Modern life is filled with work, notifications, and social media; it's not that there's no desire, but there's no space left for 'closeness.'