My husband and I haven’t had sex for months. I feel

Everything ground to a halt when I injured myself. And although the physical pain has eased, I’m still hurting

I have been with my husband since university. We are in our mid-40s now and have two children. I love him dearly and he loves me, but at the moment we are just not having sex. I had a fall recently and was in a lot of pain, and since then we’ve had nothing for three months, which is a long time for us. (I’m in less pain now but we’re still not having sex.) We communicate well and have discussed this. It doesn’t help that we both have busy jobs, which at times are particularly stressful and leave him tired. I feel undesirable, rejected and ugly. I am starting to shrink into myself and I hate it. I feel like I’m horrible and forcing him to find me attractive.

What you are experiencing is the natural result of no less than five common causes of lowered sexual desire. Fatigue is very often a contributing factor, because even when people have some level of sexual desire their bodies are too tired to take action or respond. Stress is even more likely to reduce sexual interaction because it makes relaxation and pleasure very difficult to achieve. Injury naturally leads to self-preservation responses in the patient and care-giving in the partner – neither of which creates a climate for eroticism. And the pain you experienced would have made it unlikely that sexual feelings would arise in either you or your partner.