“We haven’t been any more physical than that since Christmas 2018, and I’ve given up asking,” admits the Manchester-based solicitor. “On my birthday she proudly presented me with an expensive pair of monogrammed pyjamas – despite my only ever sleeping in boxer shorts since we met in our 20s. I felt part of me shrivel up in that moment because it so precisely summed up how she saw me: entirely sexless. I’m like a comforting old teddy bear in her bed, not a husband nor a real man.”

Despite the oft-hailed emotional and physical health benefits of regular “nookie”, a barren sex life such as Graham’s is surprisingly common. By our early 40s, one in five people in the UK have stopped having sex completely, according to a YouGov poll, a figure rising to 57% by the age of 74. And the frequency of our lovemaking declines even from as early as our 30s. In the same survey, 38% of 35- to 39-year-olds said they hadn’t been sexually active in the past week.

Some couples may be perfectly content with abstinence but if celibacy isn’t a mutual decision, it’s likely that one partner will be left hurt, feeling short-changed, and doubtful of their spouse’s feelings toward them. “The difference between sex and love,” as Woody Allen wryly noted, “is that sex relieves tension and love causes it”.

Peter Saddington is a sex and relationship therapist with Relate who reports sexless marriages as being one of the most common drivers for couples seeking counselling. “They confess that their relationship has been platonic since the birth of their last child,” says Saddington. “When I ask how old their child is, I’m no longer surprised when they say ‘18′.”

A stereotypical cliche it may be, but more than 30 years of being a therapist, Saddington admits it “more usually” is the husband most frustrated by the lack of conjugal action between the sheets. “Often she will come in saying there’s a relationship issue, but when we drill into it the crux of the matter lies in him resenting his enforced celibacy.”

Various reasons can be blamed for why sex seemingly evaporates in midlife – hormones, the emergence of health issues, stress and the day-to-day exhaustion of caring for children and/or elderly parents are frequently cited.

Graham describes his former sex life with Laura as “passionate, adventurous and even a little bit naughty”. But while raising their three (now adult) children, sex became less frequent and less fun. “The last birth was traumatic for Laura, and after that she stopped allowing me to give her oral sex, which I’d always enjoyed and I believed she did. At the same time she stopped offering it to me, and without that quid pro quo dynamic I didn’t like to push it. I yearn for that intimacy we once shared, and in turn I stopped doing little things for her I suppose, like bringing her tea in bed.

“Sex became perfunctory for Laura, it seemed like a favour she was bestowing upon me – in between the [online grocery] shop and watching The Crown. When I suggested a different position once, something previously very much part of our ‘repertoire’ she rolled her eyes and muttered ‘for God’s sake’. I felt like a pervert and it rather killed the mood. I’m afraid I sulked for a bit and she went off to the bathroom slamming the door. It felt too awkward to talk about, so we didn’t. Gradually we went from fortnightly missionary sex, to monthly, to then just special occasions … until it quietly dried up altogether.”

Talking about sex openly

Not being able to talk about sex openly is an obstacle many couples face. And unsurprisingly, older couples – whose sex education was likely limited to “the birds and the bees” typically delivered by an awkward school teacher – struggle with communication the most. In a US study, 49% of baby boomers admitted they’d never learned how to talk about sex (with 43% saying this would have led to them being more sexually confident as adults). What’s more, in a different American survey of more than 1000 women aged 18-94, more than half reported wanting to talk to a partner about sex but deciding not to. The most common reasons were not wanting to hurt a partner’s feelings (42%), not feeling comfortable going into detail (40%), and plain embarrassment (37%).

“Of course, it can be harder for older people not used to discussing sex openly together – and that’s when the safe space of therapy can really help,” Saddington says.

For Graham and Laura, behaving with a certain petulance seemed easier than actually finding the language to broach the delicate subject.

“When I was fed up I offered to decamp permanently to the spare room ‘as she had no interest in me’. Then she accused me of being ‘passive aggressive’. I stayed in the bedroom, but that night I stared at her back as she lay turned from me feeling miserable, isolated and yes – bitter.

“We don’t talk about sex now. I don’t even stroke her hair for fear it seems like I’m instigating sex. I’ve tried to love, honour and worship her – she just doesn’t want me to. She complains the menopause is making her tired, but otherwise she seems content with our situation.”

Saddington says that the impact of the menopause is “hugely significant” and “not enough discussed”. About 30% of women stop having sex (or have sex much less often) during perimenopause and menopause. And a 2019 study of more than 24,000 postmenopausal women (aged on average 64) found that only 22% were sexually active.

Dr Amy Killen, who specialises in sexual health, explains why women’s libidos seem more affected by age than men’s. “Male sex hormones gradually decline over decades, yet for women they drop off a cliff – so the impact is more noticeable,” says Killen. “At perimenopause (the five to 10 years before menopause) the three hormones oestrogen, testosterone and progesterone become erratic, which can affect mood as well as cause changes in the body.” She also points out that menopause can more generally make muscles stiff and achy, and dropping oestrogen levels can lead to weight gain. “So it’s hardly surprising sex becomes less appealing for some women,” she notes.

Saddington believes many of the problems he sees time and again in the therapy room might be softened if men were more educated on the many and various changes their partners were facing. “Remember,” says Saddington, “menopause lasts for years not months – read and talk about it together.”

The orgasm gap

Research also shows that how men and women feel about celibacy seems to change with age. “Specifically, younger men were more satisfied with celibacy than older men, whereas older women were more satisfied with it than younger women,” says senior research fellow Dr Justin Lehmiller of the Kinsey Institute.

Perhaps the simplest reason for the male sexual appetite remaining more voracious is that they just enjoy it more? The Kinsey Institute also found that across all age groups, men reported higher rates of orgasm (from 70 to 85%) than women (who rated a less earth-shattering 46 to 58%).

And there is no data available to suggest whether this is the fortunate biology of men or the unlucky fate of the women who have to sleep with them? Perhaps those who consider themselves the “poor, sex-starved victims” of a sexless marriage, may helpfully ask themselves if they’ve contributed to the collateral damage of this “orgasm gap”?

Perhaps, kind gentlemen, if every husband took the time to accomplish (and deliver) their partner’s true desires, it may actually lead to these wives wanting more sex?

The sexual satisfaction of women has been largely ignored throughout history across films, art and literature, as so memorably demonstrated by Meg Ryan in 1989′s seminal, intelligent comparison of the sexes movie When Harry Met Sally. “As a society we undervalue women’s pleasure,” says Kinsey’s Dr Amanda Gesselman. “I think emphasising mutual satisfaction, and especially open communication about sexual needs with partners, can really help increase pleasure for most people.”

Most sex therapists would argue that too much emphasis is placed on penetrative sex. In a US study of more than 3000 women aged 60 and up, 60% of survey respondents agreed that intercourse is not necessary for a satisfying sexual experience. Sex that is loving can take many different forms – with cuddling, touching, kissing and having fun being creative.

“Aging should not be a barrier to having sex,” says Killen. “It might be less acrobatic than it once was, but can be just as enjoyable.”

The good news, says Saddington, is that when both parties want to make a change and are prepared to put in the effort, the vast majority of couples can come to a good, working compromise. “When a couple truly cares about each other, it’s possible to get to a stage where one person wants to give the other pleasure – even if it’s something they are not fussed about naturally. It’s when the act of giving that pleasure in itself becomes a form of pleasure for the other person.”

This is not, he firmly emphasises, the same as saying anyone should feel obliged to “lie back and think of England”. Quite the opposite. “This would require a deep level of love, trust and intimacy that wouldn’t work unless both parties very much want to do that.”

At the end of the day, sex isn’t crucial for a good marriage to work, insists Saddington, “but it certainly helps”.

What to do

Peter Saddington has been a sex therapist with Relate for 30 years and has the following practical tips for couples to get back on track …

Rule out health issues

The first thing to check is whether this is actually a relationship issue – or are there underlying health issues, or a sexual dysfunction at the heart of it? Undiagnosed depression will kill dead libido. Erection issues can generally be resolved but should always be addressed with the GP first to make sure it’s not connected with heart problems.

Make time for yourself

For most couples, being in each other’s pockets 24/7 doesn’t bring you closer. Sometimes a man really does need to retreat to the shed or man cave, and she might need to slump in front of the television or see friends (forgive the stereotypes). Recharging the batteries – separately, as individuals – helps couples feel generally more playful about life and sex.

Put boundaries around couple time

Once you’re both more energised and not stressed, is there genuinely an opportunity to actually recognise the other person and remember you quite like them? This is necessary for any sexual relationship to follow. Parents of young children can say they’re constantly ferrying kids to music lessons, sports and swimming galas – then wonder why their marriage is humdrum. It doesn’t have to be a “date night”, but try and do the things you once liked to do together, be it a gig or a gallery. The things that give you a buzz, make you feel more interesting as a person, back when fancying each other felt natural.

Write down your worries

You don’t need to be paying for therapy to do some of the exercises we set. Try carving out an hour to write down everything that worries you, so together you can unpick the issues. You can’t solve anything until you start understanding and making sense of the other’s concerns.

Usually, there’s an overlap and you start realising: “No wonder we haven’t got any time/feeling tired/ haven’t met friends/gone out for a drink recently.”

Ditch the tracksuit and dig out your ‘pulling pants’

When working hard and getting on with life, it’s easy to stop taking pride in your appearance. But if you want to be seen differently by your partner (and for her to find you attractive) you need to put some effort in – as you probably did back when you owned “pulling pants” or a certain lucky shirt. Some grooming and smelling nice goes a long way.

Educate yourself on the menopause

This is a significantly common reason for women “going off sex” – and a marriage veering into trouble. Men need to get educated on what their partner is going through – or what lies in store. Mood swings can become exaggerated, and there’s brain fog while juggling working and caring responsibilities. Being tolerant and supportive is crucial otherwise resentment and bickering are likely. It’s not “her problem,” it’s something to be talked about and managed together.

Accept sex changes over time

It might seem different to how it was, but something that is good enough for where you are now is the thing to aim for. Back then it might have been a few times a week, but would a few times a month be acceptable?

What not to do

Become dependent on porn

Time and again I see this – when sexual desire starts diminishing, men turn to masturbation and using porn. But putting your energy into solo sex means the opportunity as a couple gets lost.

If you’re regularly using porn you start becoming less stimulated during real sex and once your erection wanes you’ll soon start avoiding sex. This is an unhelpful cycle yet common.

For those who rely on porn my best advice is to abstain. If you’re an alcoholic you cut out booze, it’s the same for porn – losing it altogether is more effective than moderation.

Be tempted to cheat

The next step on from porn is generally an affair. If you’re not getting what you need at home – emotionally and sexually – people start seeking validation elsewhere, with someone who makes them feel interesting and exciting again. It’s a no-brainer why this rarely benefits a marriage.

I’ve also worked with couples who want to “open up” their marriage – if you’re thinking about this, firm boundaries need to be discussed about how this will look first. I’ve worked with plenty of couples who have tried to improve their relationship this way – but one party falls for the third member … and that creates an altogether different problem.

Take drugs and alcohol

People can turn to both when they’re stressed, and the impact on libido and sexual performance is devastating. I’ve really noticed how much more prevalent it is for men to use marijuana, as well as cocaine and ketamine – and that’s among clients in their 40s, 50s and 60s too, not just young men. Drugs have become more readily available and used as common coping mechanisms. But things quickly get out of hand as their tolerance grows, they take more and it becomes such an ingrained habit harder to stop.

Be critical of your partner’s changing body

We all know the effects of age on our bodies, and feeling self-conscious can lead to avoiding sex. Sadly I’ve witnessed people body-shame their partner, but if someone is lacking confidence in their appearance being criticised is rarely the best motivation for getting them down the gym.

I’ve seen men get angry and resentful about a lack of sex and then make unpleasant comments about their wife’s stomach or breasts – which is incredibly insulting especially if she has used her body to nurture their children.

Therapy is supposed to be a safe space for people to talk openly but I can’t have heated arguments and accusations – if rows escalate I suggest separate sessions (in which they can offload to me) would be more helpful until joint conversations can be held respectfully.