Dear Neil: The frequency of sex is the major problem in our thirty year marriage. My wife has always had problems with her enjoyment of sex, despite long-term and determined efforts on my part to please her.

I have tried music, presents, clothes, gifts, flowers, planning holidays, praise, acceptance, viewing sexy videos together, reading books, trying to isolate what works, and identifying things we’ve done that we would like to repeat.

She has given varying descriptions of what the sexual experience is like for her, of which the only constant is pain. She believes that any discussion on this subject beyond the superficial is abuse or harassment. Periodically she will go into a continual spiral of problems and list all the wrong, bad or hurtful experiences of the past.

How can we improve our relationship?

Christchurch, New Zealand

Dear Christchurch: From what you said, I wonder if your wife has physical pain when she has sex. If so, then of course she doesn’t enjoy making love. Perhaps she could be examined by a doctor who could assess whether or not a medical problem exists.

I don’t know what hurtful past experiences you were referring to, but I suspect those might need to be explored with your wife, along with a specific request about what she would want or need from you in order to consider genuinely letting go of her grievances and forgiving you. Might she be resentful that she no longer desires you or wants to be pleasing to you? Could she have fallen out of like or love with you? Has your relationship become distant, non-communicative or cold?

Since she is sensitive about you bringing up emotionally laden subjects, perhaps you could preface such a conversation by telling her that you love her, and that you want the best relationship you can possibly have with her. Then say you’d like to schedule an appointment in order to talk about some sensitive and emotional subjects, and that such a discussion is important to you. You’re asking for such a discussion because you don’t feel past issues have been resolved, and are therefore acting as a small drop of poison to the marriage.

Other possibilities about what could be going on: Could it be that you’re too quick or rough, or that she finds your technique lacking? Might she take an especially long time to warm up? (The rule of thumb on this subject is that men are like microwaves and women are like crock pots).

Is your hygiene acceptable to her? Have you let your body become unattractive or unappealing? Are you rude, critical or unkind to her? Do you put her down, act condescending to her or ridicule her in front of others? Are you affectionate, attentive and sensitive to her other than when you are wanting sex?

It should be acknowledged that not everyone finds sex pleasurable. There are different degrees of enjoyment, and not everyone’s experience of sex is the same. Some people tolerate sex rather than look forward to it. Some were taught—and still feel—that sex is dirty, wrong or a sin against God.

Another explanation is that your wife is withdrawing or withholding sex as a way of battling you, or trying to win a power struggle with you.