Relationship problems can arise from sexual difficulties, but sexual problems may also be an indication of deeper problems in the relationship. Sexual difficulties can emerge at any time, but especially in times of stress and change. Sex essentially is fun and can be one of the great rewards of being together.

While one partner may use the frequency of sex to gauge how he or she is loved and valued, the other may have intimacy as the benchmark. When a couple has 'gone off' sex, it can reveal their deeper attitude to trust, love and control. Whether the problem is about unsatisfactory sex or it indicates a deeper issue needs to be explored. Emotional trust is the foundation stone of physical intimacy.

• Sex is no longer on the agenda
• Sex is difficult or painful for one partner
• Sex causes disappointment
• One partner has gone off sex
• Sex is the subject of rows and sulks

Families pass on unspoken messages about sex which can cause unnecessary distress in couples. Often individuals need to explore their own sexuality away from such pressures.

Attitudes inherited from childhood or out of ignorance can cause unnecessary misery. Cultural pressure may require a detached and analytical re-examination to allow a couple to make their own rules.

Sometimes traumatic sexual experiences from childhood or past relationships can emerge in a present relationship. With trust these can be explored and resolved.

• Physical illness
• Alcohol, drugs
• Pregnancy
• Aging or loss of self-esteem
• Anxieties and Stress
• Loss of status or change in circumstances
• Betrayal of trust

Relationship counselling can help explore the physical communication and the understanding of what sex means to two specific people. Sex may be mechanical and a way to maintain a safe distance for one person. In such cases, the partner may mourn the lack of intimacy and trust which would allow them to feel safe and enjoy sex.

Withdrawal of sex can happen when a person has no alternative way to express their anger and disappointment – so the forbidden feelings are acted out in the bedroom. Control and power are often issues in difficult sexual relationships as one partner may be unconsciously exerting the control and power they feel they lack outside the bedroom.