Welcome to Ask a Cleveland Sex Therapist. Want to ask Matt a question that could be tackled in a future column? Click here. Now, onto this week’s topic.
My husband has lost desire. He’s been suffering performance issues for many years. He’s taken pills and tried testosterone therapy but didn’t tolerate it well. When he did take a pill, he achieved erection but couldn’t orgasm. It’s been several years since we last tried sex. It was difficult to get aroused when I couldn’t feel he had any passion for me. I have told him many times over the years that I need something. Even just passionate kissing would be great but he only responds with hugs and pecks. Are we hopeless? Do I need to leave my marriage if I wish to have a sex life?
- Anonymous
When people ask what I do as a sex therapist, they often expect me to tell them that I work with the kinkiest folx that have ever existed and all we do is talk about shibari and fisting. It’s like the expect my life to be an old episode of the HBO show Real Sex. While I can confirm that I do work with some very kinky clients, most of my work centers on scenarios like this one in today’s question. People just feel lost and unsure of where to go in their marriage, sex life, or personal desires. You may even be recognizing yourself or your relationship in this question and if that is the case, welcome to the club. There are a lot of us here, and honestly, the drinks are good and the water is warm. But while this stay may be safe and comfortable, it is usually not a place we want to stay too long. So, let’s talk about how we all can get back to feeling more inspired and less hopeless.
Let’s start with a very simple statement: you are not hopeless. What you are describing is actually something I see more often than people realize. Sex stuff is hard. It is emotional, it is vulnerable, and when it stops working the way we expect it to, it can feel really defeating really quickly. It also sounds like you have been trying, and I want to make sure I highlight that. You have been communicating and you have been incredibly patient over a long period of time. That matters. But if you are anything like me, it also makes sense that at some point, patience starts to turn into pain, and feeling of hopelessness starts to creep into your head. Although, I can’t help but thinking there is something underneath your request. Because it sounds like what you are really asking for is not just sex, you are asking for connection and to feel wanted by your partner again.
Let’s talk about men for a minute. As a man myself, I have experienced firsthand how sex can feel pretty tricky. The world teaches us that if you have a penis, it runs everything. That erections equal masculinity, that performance equals worth, and that sex is supposed to be easy and automatic. So, when it is not, when erections are inconsistent or orgasm becomes difficult, it can feel deeply emasculating. Not just frustrating, but shame-inducing. As you may have experienced yourself, shame is one of the fastest ways to shut someone down. When you combine that with years of messaging that men should not talk about their feelings, should not admit struggle, and should just figure it out on their own, what you often get is exactly what you are describing. Someone who withdraws. Someone who avoids. Someone who replaces vulnerability with distance because distance feels safer than failing. I wish this still wasn’t the case, but unfortunately it is. Maybe 2026 will be the year this changes, but I wouldn’t hold your breath.
What likely started as a physical challenge has now become layered with psychological weight. Performance anxiety builds. Pressure builds. The more it matters, the harder it becomes. We typically describe this as “inviting a monster into bed with you.” Overtime, many men start to disconnect from their own desire because it feels easier than facing repeated moments of not feeling “good enough.” So instead of engaging sexually, they lean into safer forms of affection like hugs and pecks. They may turn to porn because it is easier for them as they don’t have to risk rejection. Most of the time this is not because that is all they want, but because it is what feels manageable without risking shame.
But back to you, your experience matters just as much. You are sitting on the other side of this feeling undesired and alone. That sucks. It makes sense that it would be hard to feel aroused when you do not feel passion coming toward you. Sexual energy flows best when it is being reciprocated. Desire does not exist in a vacuum. It is relational. It feeds off energy, attention, and emotional presence. When those things are missing, your body is going to respond accordingly. But that is not you being broken, it is your system doing exactly what it is supposed to do. What you have now is what I call a disconnection loop. He avoids because of shame and pressure. You pull back because you do not feel desired. The distance grows, and the longer it goes on, the harder it feels to interrupt. I have seen couples come back from years of no sex, but not by jumping straight into intercourse or focusing on erections. It starts by rebuilding the safety that helped create it in the first place.
Let’s start with shifting the goal away from performance and toward experience. Passionate kissing, like you mentioned, is actually a perfect place to start. Not as a consolation prize, but as a real and meaningful form of intimacy. It means having honest conversations, not just about what you need, but about what sex has come to mean for both of you. For him, it might mean unpacking the shame and fear that has built up over time. For you, it might mean expressing the hurt in a way that invites connection instead of reinforcing distance. It also means acknowledging that this is probably not something the two of you should have to navigate alone. A good sex therapist can help slow this down, create structure, and guide both of you out of that loop in a way that feels less overwhelming. Because right now, you are both reacting to years of buildup, and that is a lot to hold without support.
As for your question about whether you need to leave your marriage, I unfortunately can’t answer that for you. What I will say is this: the question is less about whether sex exists right now and more about whether there is willingness to work toward rebuilding connection. If your partner is open, even a little, to exploring this, to having the hard conversations, to getting support, then there is a path forward. If there is no willingness at all, if the door is completely closed, then you are left making a different kind of decision about what you need in order to feel fulfilled in your life and relationships.
I truly believe you are not hopeless. I don’t think your relationship is not automatically doomed. If I did, I probably shouldn’t be a mental health professional, let alone a relationship therapist. But something does need to change, and that change does not start with better performance and jumping into sex. It starts with rebuilding safety and curiosity between the two of you. Remember, there is no real rule of thumb in knowing when a relationship has run its course. But I have learned that if one person stops learning, stops evolving, and in unwilling to change, that is usually a good sign it may be time to think of a different future for yourself.
Matt Lachman is a Licensed Professional Clinical Counselor and Supervisor, AASECT Certified Sex Therapist, and owner of Cleveland Sex Therapy, located in the heart of Gordon Square. Since opening Cleveland Sex Therapy in 2019, Matt has been dedicated to promoting sex positivity and inclusivity in his work with individuals, couples, and polyamorous relationships. When he’s not helping clients navigate their sexual and relational journeys, you can find him enjoying a cold brew at Gypsy Beans, sipping a cocktail at Luxe, or relaxing on his couch watching reruns of Happy Endings. Ask a question of your own here.
Disclaimer: The advice provided in this column is intended for generalinformational purposes only and should not be considered a substitute for professional therapy or mental health treatment. Each individual’s situation is unique, and the insights offered here may not address the complexities of your specific circumstances. If you’re experiencing challenges related to your mental health, relationships, or sexuality, I strongly encourage you to reach out to a licensed therapist or mental health professional for personalized support. You’re not alone—help is available.
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