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Conditions · Intimacy & Sexual Concerns

Couples sex therapy in Los Angeles for mismatched libido, sexless marriage, and the disconnection that goes with both.

Most couples don't come in saying "we have a sex problem." They come in saying they've drifted, or one of them is angry-tired, or the other has stopped reaching out. The bedroom is where the disconnection lands; it's not usually where the disconnection started.

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A couple sitting back-to-back on the bed in quiet emotional distance — the intimacy disconnection that brings couples to therapy in Los Angeles
What this can feel like

You probably recognize at least three of these.

The math

You've started counting. Two months. Three. You don't want to be the partner keeping count, and you are.

The pre-rejection

You've stopped initiating because you're tired of the answer. Then you resent your partner for not initiating either.

Mismatched libidos, mismatched stories

The lower-libido partner feels pressured. The higher-libido partner feels rejected. Neither story makes the other one feel less true.

The post-baby drift

One of you is touched out. The other is touch-starved. You're not in the same season of your bodies.

The roommate stretch

You're affectionate. You're a team. You're also no longer lovers in any meaningful sense, and you both pretend not to notice.

The shame loop

You've privately wondered if there's something wrong with one of you. There usually isn't. Most "wrong" is just two people whose desire is shaped by different things.

How therapy can help

The work isn't about the sex you're not having.

Sex-therapy work for couples is often less about technique and more about translation. Our team is AASECT-informed (American Association of Sexuality Educators, Counselors, and Therapists) and we work with the body and the relationship as one system, not two.

Early sessions usually map two things: the cycle of approach and avoidance (who reaches out, who pulls back, what each is communicating with the move), and the desire models each of you is running on (spontaneous vs. responsive desire — and the realization that they're both legitimate). Most "low libido" diagnoses dissolve when responsive desire gets named and respected.

From there, the work depends on what's underneath. Sometimes it's body grief — postpartum, perimenopause, illness, injury. Sometimes it's relational — a slow accumulation of unrepaired hurt. Sometimes it's logistical — you have not been alone in a room together for six months and you're surprised intimacy is hard. We name what's actually present, not what's clinically convenient.

For couples where one partner has never wanted sex (or wants it differently) — including ace/aro and demisexual partners — affirmative care here means working with the relationship you actually have, not the one a sex-positivity script says you should want.

A note on safety

If sex has happened or is happening without enthusiastic consent in your relationship, please tell us in your first session. That's a different clinical situation that requires different care, and we'll meet it directly.

"We hadn't talked about sex in two years. Forty minutes into session two we were laughing about it. That was the start."
— a sentence we hear often
Common questions

Things couples ask in the first session.

Is "sexless marriage" really a thing?
Clinically, yes — it's the colloquial term for couples having sex less than ~10 times per year. It's much more common than the silence around it suggests. It's also rarely the actual problem; it's the visible symptom of something else worth understanding.
Do we have to talk about graphic detail?
No. Sex therapy isn't about explicit disclosure for its own sake. The therapist will ask what they need to do the work, and not more. Most of the conversation is about meaning and pattern, not mechanics.
What if one of us is asexual or demisexual?
Affirmative — that's a real orientation, not a problem to fix. The work shifts from "how do we have more sex" to "how do we build the intimacy we both want, in the configuration that fits who we both actually are."
Is this medical?
No — we're psychotherapists, not physicians. If hormonal, urological, gynecological, or pelvic-floor issues seem present, we'll refer to physicians and pelvic-floor PTs we trust. Body and mind are connected; we work where the connection lives.
Can we do this work over telehealth?
Yes. Most couples do this work fine over video. Some prefer in-person for harder conversations; we accommodate both.
Start here

You don't have to figure this out alone.

The first session is a fit conversation, not a commitment.

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