You think about it a lot. You want it. You’re ready for it. But when you ask for it and your spouse turns you down, you feel rejected, hurt or humiliated. It’s not the end of the world if you don’t get it, but you shouldn’t do without it if you’re married. Unless you have to. And sometimes that’s the case. “It” is sex. It’s important for a marriage, but what do you do when your spouse can’t have sex?

Sex is a gift to married couples. It should be mutually satisfying and can unite a husband and wife emotionally and spiritually, not just physically. Couples who have sex regularly are happier, and lack of sex can cause problems for the relationship. But sometimes one spouse simply cannot participate in intercourse. While it may seem like you’re missing out, the good news is that there’s much more to sex than just intercourse.

This is a painful topic for many people, and this article doesn’t address those situations where one spouse has physical issues that could be resolved with help from a doctor. If you’re in a sexless marriage and aren’t certain why one (or both) spouses find sex emotionally or physically painful, talk to a doctor or counsellor.

Reasons your spouse may not be able to have intercourse

There are several legitimate reasons your spouse may not be able to engage in intercourse or may be advised by a physician to abstain. For example, doctors may advise women to avoid intercourse — usually for six weeks — after the birth of a child. Intercourse could cause injury or promote infections.

Women and men should avoid sex after surgery in many cases, and people with certain medical conditions should not participate in intercourse. According to W. David Hager, M.D., cardiovascular disease, congestive heart failure, cardiomyopathy and PE (pulmonary embolus) are some of the reasons a physician might recommend abstaining from intercourse. Paralysis may make intercourse impossible, too.

Not all reasons are physical. When one spouse is recovering from sexual trauma, she or he may need significant time for recovery.

What you might be missing when you’re not having sex

Several hormones and neurotransmitters are associated with intercourse, and some of these can affect your mood and even how you feel about your spouse.

Oxytocin, often called the “bonding hormone,” is one such hormone that is released during sex or shortly after climax. This hormone also helps mothers bond to their babies after childbirth and while nursing. It may increase in men when they become fathers, too. And the more a dad cuddles his new baby, the more his oxytocin levels increase. So if you’re new parents, cuddling with the baby can help you feel better. But you can increase your oxytocin levels by doing all sorts of things — from pleasant social interactions to petting your dog.

Dopamine, the “feel-good neurotransmitter” is also involved in sex. If you can’t have intercourse, you might be able to increase your dopamine levels naturally through touching (massage, hugging) or exercise. But exercise might also increase testosterone levels, which could make you more amorous. Even listening to music can increase dopamine.

How you can stay connected when your spouse can’t have intercourse

While you can do some of the things above without your spouse, you should definitely do other things with your spouse — even when one of you can’t participate in intercourse. Cuddling and touching can fulfill some needs, but physical interaction without intercourse is very personal. It involves many personal preferences and variables depending on your unique situation as a couple.

You stay connected on other levels to keep your marriage strong. Dr. Greg Smalley, Vice President of Marriage at Focus on the Family, says, “Things like 10 minutes per day of ‘inner-life’ conversation (talking about the highs and lows of the day), date nights when you do something new and exciting, working out together, laughing together, affection (kissing, holding each other for 10 minutes) — these things can provide similar benefits that sex provides the marriage.” Here are some other suggestions:

Build emotional intimacy. At the most basic level, this simply means building a deeper relationship with your spouse. You can start by spending time learning about your spouse’s hopes, dreams and goals. Then ask questions and listen carefully as you try to understand his or her fears and concerns. Talk with your husband or wife to understand their history and how it affects the present.

Build spiritual intimacy. Some couples may never put the words spiritual and intimacy together, but the idea is important to consider if you want the strongest marriage possible. Spiritual intimacy doesn’t have to be complicated, but it can make your marriage so much stronger. If you’re not already, start by praying together. Then move on to reading Scripture together and discussing it.

Worshipping together is another part of spiritual intimacy with your spouse. That might mean worshipping at home if a disability doesn’t allow you both to attend church services. Some options are to read Psalms together (maybe responsively) or sing together (OK, just say the words if you’re too embarrassed to actually sing). For some couples, worshipping together might be making a list of everything in God’s creation that you find beautiful or amazing.

Sex is important, but when one spouse can’t have sex, a couple can still have a strong, fulfilling marriage.

© 2020 Focus on the Family. All rights reserved. Used with permission. Originally published at

Troy Griepentrog

Troy Griepentrog is the Digital Content Manager for the Marriage team at Focus on the Family.

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