I am always surprised when a couple tells me they haven’t had sex in a year. This is not normal or healthy for any married relationship. However, there are times when sex is put on the back burner. This is often due to an underlying issue with one or both partners. Here are 10 reasons why that can happen, but you need to address the issue.

1) Physical problems such as hormone levels out of balance. An imbalance can cause a low sex drive. Erectile dysfunction could also be the culprit. In either case, see a physician and get checked!

2)  Birth of a baby. Most women do not have sex on their mind after delivering a baby. Libido wanes, you are exhausted, sore and overwhelmed for weeks and even months. It takes time to heal and adjust to a newborn.

3) Cancer or other serious medical treatment. Some people are very tired and lose interest in sex when fighting cancer or a serious illness. Body image can suffer as well. However, some people desire sex as a way to feel close to their partners, so it is important to talk about what the cancer or illness is doing to you physically, mentally and relationally.

4) Stressful job. Stress of any kind can shut down sexual feelings, especially when you feel something is out of your control. Work stress is one of those areas in which people feel a lack of control over their lives–too many demands, bad leadership, critical bosses, lack of resources, etc. can pile on stress and take a toll on your libido.

5) Caretaking aging parents. Caretaking stress is well documented and often leaves people exhausted and out of touch with their own needs. The demands of others can push your needs to the bottom of the list.

6) Serious financial problems. Financial stress wears on a person and often results in feeling of worry. Worry can strangle the joy out of a relationship!

7)  Don’t trust your partner because of certain behaviors or past history. A lack of trust is an intimacy killer. If someone has betrayed you, you may be reluctant to be intimate. Trust matters and needs to be rebuilt if the relationship is going to continue.

8) Feel rejected by your partner. Rejection doesn’t lead to sexual closeness. It does the opposite. Therefore, the rejection must be addressed in order for a person to re-engage in a sexual relationship.

9) Carry resentment and unforgiveness. Unforgiveness leads to bitterness. Bitterness leads to distance. If you want to turn things around, forgive to move forward sexually.

10) An absence of touch during nonsexual times. People want to be caressed and physically touched in nonsexual times. So, make an effort to touch as much and as often as possible to show affection in other ways.

If any of these reasons apply, attend to them and fix the relationship or physical issue.  You may need a therapist to address the root issue. Ignoring sexual intimacy leads to lower satisfaction in marriage and usually means something deeper is going on in a couple’s relationship. Don’t allow a long period of time to go by without having a sexual relationship. Talk through the problem and get the help you need.