I understand, and I'm so sorry. All hope is not lost though... I've worked with couples who thought their relationship was doomed before they came in to see me. If both partners are interested in and willing to do the work, you can turn things around.

I'm so sorry to hear about your situation. Unfortunately, it sounds like you already have hit the rocks. I know this is incredibly difficult, but I would tell her that sex therapy is non-negotiable for you at this point. I would say something like, "I know we've been trying to solve this issue on our own for a long…

I understand that it feels like the best solution is to have her always initiate, but I'd try to consider the fact that this puts a lot of pressure on her as well! Now she's completely in charge of all of your sexual interactions. It's also tough to be in a position where you feel like you're not allowed to ask for…

Thanks for your kind words! I love what I do so much that I could spend all of my time helping out random internet strangers, were it not for pesky things like having to pay my bills :)

What if you masturbate together? Watching your partner masturbate is incredibly hot. Or send texts/emails to each other when you're doing it, so you still feel connected in some way. Of course, having private masturbation time is necessary too, but it can be fun to include your partner in some of it.

You can always ask him/her to initiate other ways of being physically affectionate, like holding each other or making out. Some people get intimidated about initiating because they think it has to be an all-or-nothing thing, but you can help him/her realize that there are plenty of ways to initiate.

First of all, sorry to hear about her medical situation. I'm not familiar with Chiari malformations. Has she talked to her doctor about potential sexual side effects? Does it physically affect her ability to be intimate?

Bingo! You came up as both guest and anonymous!

Hi there,

Thanks for the question!

The distinction between orgasm and ejaculation is an important one. There are lots of men who don't orgasm every single time during sex. Or it may be that he's not ejaculating very much because he has recently masturbated. Have you ever asked him about this question?

OK, so no medical changes two months ago, but what about psychological? Did you guys get into any big fights? Any significant life/work stress?

Are you aware of when you like it and when you don't? Any patterns? The more details you have, the easier it will be for me to come up with a specific phrase you could say to her.

Thanks for the question! It sounds like this may be a situation where the two of you just aren't sexually compatible. I think your best bet is to be clear and direct. Say to him, "I know this is a tough topic for us to talk about, but I'm the kind of person who really values being able to communicate about sex. I'm…

Just wanted to throw in a quick invitation to subscribe to my mailing list. It's important to me to help people create healthier and happier sex lives, and have fun doing so! I email every 1-2 weeks with my most popular articles and tips, and frequently have give-aways for free coaching sessions, sex toys and…

Just wanted to throw in a quick invitation to subscribe to my mailing list. It's important to me to help people create healthier and happier sex lives, and have fun doing so! I email every 1-2 weeks with my most popular articles and tips, and frequently have give-aways for free coaching sessions, sex toys and…

So many couples struggle with insane schedules, but I think the most important thing to remember is that you're on each other's team. You're both battling the bad scheduling together, and trying to work together to create room for a sex life that feels satisfying for you both. The more you can approach your issues…

Is he ejaculating less than half the time, or orgasming less than half the time?

I'm so sorry, but I'm not sure I understand the question. After last night, he says he only wants to masturbate? And you feel like you only want to masturbate from now on too?

Thanks for the question! Have you talked to your doctor about this issue yet?