How often a couple have sex is a problem only if they don’t agree, says Annalisa Barbieri, and you don’t

I’ve been married for 11 years; I’m in my early 30s and my husband is in his late 30s. I’m bitterly disappointed and frustrated that we very rarely have sex. When we do (once, maybe twice a year), he is interested, but it is me who initiates it. I have always had a higher sex drive and, in the last few years at least, if I don’t initiate sex, it doesn’t happen.

We have argued a lot about this because I feel our relationship has turned into a friendship. We do love each other and this is the only problem we have, but it has had a serious impact on my self-confidence. I have spoken to him about this openly every few months for years. Each time, he says he is surprised, and there’s always an excuse. He then tells me he does still find me attractive and that he will make more of an effort – and that lasts for a week. We haven’t cheated on each other; he is caring and affectionate.

I rarely feel like a woman with him. I have told him that I cannot carry on like this and that it is not fair on either of us. I’ve tried asking him whether there is something he is hiding from me: perhaps he isn’t interested in me any more; perhaps he’s gay; or interested in something sexually that he’s scared to tell me about. But he says he’s shocked and that it’s nothing like that – he’s just stressed or tired or forgets to make the effort.

I have told him I will leave if we can’t have a sexual relationship, and then he gets upset, but I don’t think he takes me seriously, otherwise something would have changed. I don’t want to leave him, but I don’t want to go on like this, either.

One of the biggest lies we’re sold as women is that men have insatiable sexual appetites that we can’t keep up with. That’s certainly not the case, and problems like yours are not unusual. But 31 is far too young to give up on your sex life. What if you want children? I wouldn’t want to tell you to leave a marriage you say you are happy with but, equally, I want you to ask yourself: what if nothing changes? Do you really want to still be in the same position in 10 years?

He needs to get checked out by a GP to establish if he has low testerone

When a couple has a problem and one of them won’t discuss it, then really, you have two problems: the inability to communicate is a killer.

How often a couple have sex is a problem only if they don’t agree. And you don’t; as a result, you’re very unhappy and it’s eroding your self‑esteem. Your husband either can’t see this or doesn’t care enough to do something about it. These are big red flags to me. I think you see a lack of sex as something that shouldn’t break up a relationship, but if it’s really important to you then it is a deal-breaker, because eventually it will overshadow everything else.

I asked Krystal Woodbridge, a sexual and relationship counsellor (cosrt.org.uk), what she thought. “Low libido can be difficult to treat,” she said. “It’s hard to treat just one half of a couple because you have one of you thinking, ‘What’s wrong with me?’ and the other avoiding sex, not motivated to change, and avoiding the issue. If there’s no communication, it’s very hard to work out. But if it’s a problem for one of you, it’s a problem for both of you.”

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“Low sexual desire,” she continued, “can be linked to repressed anger or resentment, and in these cases sex can be withheld and treated as a weapon.”

She went on to say that your husband really needs to get checked out by a GP to make sure there are no underlying health problems and to establish whether he has low testosterone. He may be asexual: not very interested in sex but interested in the romantic part of love (and crucially, interested in you, but not in the way you’d like).

If your husband has any sort of sexual dysfunction, that could lead to him avoiding sex. But I appreciate that none of this can be found out, or worked on, if he won’t talk to you.

You two need to resolve this. If he won’t discuss it , then you must think about the sort of future you want.

• Send your problem to annalisa.barbieri@mac.com. Annalisa regrets she cannot enter into personal correspondence.