Why You're Not Having Sex: Biology

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This is part of a series of posts about sex and desire in long-term relationships.  CLICK HERE to read the full series.

Today I want to point out the first thing I talk with couples about when they bring up desire fatigue as a concern: biology.  

There are so many easy-to-resolve ways biology can be a part of the desire fatigue it's difficult to list them all, but here are a few examples:

  • Depression medications imbalance can lead to lower libido and emotional numbness- resulting in lower desire.
  • Heart problems can make the cardio workout of sexual activity and the blood flow required for arousal and erection a challenge and sometimes even an impossibility. 
  • Digestive issues can make people feel less sexually-inclined and can negatively impact mental health thus lowering libido.  
  • Pelvic pain is FAR more common than anyone seems to realize, and this kind of pain isn't often the kind folks seek out in pain play- it usually is a desire crusher.
  • Chronic pain can be a barrier to comfort and body-mind connection, and as a result can make the body-mind connection necessary to have sex a real challenge.
  • Fatigue and stress are far too often underestimated in our culture (they impact more of us than we realize) and can make it very difficult to have satisfying sexual connection with ourselves or others.

This is just a tiny snapshot of ways physical health impacts sexual health.  Before you start thinking "there's just something wrong with me" check with your naturopath, doctor, and acupuncturist.  

I know most people rarely talk about this aspect of their health when they see a provider- but it is a critical part of your well-being, and they often have possible solutions for you.  

If you haven't already, check with your medical provider to see if there's not some assistance they can give you to improve sexual function.

If you're not willing to talk to a medical provider ask yourself why not.  If you aren't sure how they will react you might want to seek out a different provider.  

If you feel nervous and want to talk through how to have talk with them, check out this tool I created to help guide you through your conversation.  

Or give me a call, I'm happy to talk you through any challenge.

As I said, this is just one of many possible shifts you could try to make sustainable change in your sex life.  Read on in the series for more:


  1. Biology

  2. Time Scarcity

  3. Lack of Self-Care

  4. Maintenance Sex - Break Free of Obligation

  5. Lack of Inspiration - Invest in Creativity, Wonder and Awe

  6. Assumption-Making - Get Curious and Explore

  7. Initiation Hesitation - Live Courageously and Circle Back

  8. Lacking Feedback - Highlights Reel

  9. Poor Consent Practices - Talk During

  10. Sex Negativity - Don't Yuck Their Yum

  11. Routine Boredom - Fantasy Sharing, Find Inspiration

  12. Necessary Repairs - Move Past Resentment with Apology and Personal Responsibility

  13. Desire Maintenance - Invest in Your Sexiness

  14. Alone Time

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Hi!  I'm glad you're reading.  Let me know if I can help you:

  • rediscover passion in long-term relationships
  • repair trust after infidelity or dishonesty
  • move beyond jealousy, insecurity or codependency
  • resolve sexual dysfunction and disconnect
  • break unhealthy communication patterns 
  • open your relationship and practice polyamory with care

Call me for a free consultation to rethink your relationship.


Gina Senarighi, MS, MA, CPC is a communication consultant, sexuality counselor and certified relationship coach specializing in polyamory, open relationships, jealousy, and infidelity.