Dear Neil: I am married to a wonderful and loving wife, and I love her very much. But all is not happy with us because of our sex life. My wife says she is no longer interested in sex, and that she doesn’t want anything to do with it anymore. I have tried to talk with her, but all she says is “life has changed—like it or leave it.” Things have since become smiles and “Yes dear, everything is fine.” But should I look for a mistress?

Lost in Wellington, New Zealand

Dear Neil: While I married the sweetest woman in the world, our love life is totally sexless, due to medical problems on her part. The thought of never making love with the woman I am married to is just too much for me to bear, so I will shortly tell her that I want a divorce.

Going Without in Australia

Dear Lost and Going Without: Sex is one of the primary things most people expect from a marriage (or a committed relationship). Unless the two of you have a different agreement, marriage asks us to forsake all others and to be faithful. Since your spouse is the only other person you can be sexual with, it is up to you to take care of your wife, and it is her role to take care of you. If either of you quit your roles without the consent of the other, one spouse is likely to feel cheated and angry, and those feelings do not make for a happy relationship.

The gentleman from Australia mentions that his wife can’t have sex for medical reasons. Have you talked to her doctors about this issue? Do they have any suggestions about how the two of you can repair the problem? If the issue can be corrected, by all means go for it.

If the issue cannot be repaired, it is still each spouse’s responsibility to sexually take care of the other. Which means that even if your wife can’t have “normal” sex, that doesn’t mean the two of you can’t be sexual with each other. There are ways of being sexual other than the “normal” way. How do the both of you feel about oral or manual sex—to name two of your options? I am trying to say that her medical problems do not have to doom an otherwise wonderful marriage if the two of you might be open to some creative re-invention.

For the gentleman in New Zealand, force a conversation with your wife about what happened to her. Is she angry with you and trying to punish you? (If she is, then you have some repair work to do with her, and you cannot let her get away with saying she doesn’t want to talk about it.) You might also ask her what she would like you to do with your sexual needs and desires. Might she be open to some creative re-invention I mentioned above? And you don’t have to be all smiles, either. You could be truthful and tell her how much this hurts you, and you could ask her what she would need in order to reconsider her stance.