パートナーが私と性交したくない — 原因と対処法

Begin immediately: schedule a single 30-minute, non-intimate conversation this week to identify medical, emotional and practical factors suppressing libido in your relationship. One person can initiate; both must commit to a calm, timed check-in focused on facts, not blame.

Keep a two-week diary that records desire levels, sleep hours, alcohol use, medication changes and major stressors; that total record will benefit any clinician or therapist. For example, starting an antidepressant or an undiagnosed thyroid issue is a common change that can reduce libido and distort daily rhythms.

Avoid accusing language and neediness during the check-in; do not pressure or demand anything. Identify missing elements that lower attraction–physical affection, shared meaning, novelty, or ongoing arguing–and agree on two small, measurable experiments to try together. Small, consistent actions such as three undistracted 20‑minute evenings per week of non-intimate touch and eye contact improve chances of reconnection and help each person feel more sexy and seen.

If progress stalls, seek targeted evaluation: request a basic hormone panel, medication review and a referral to an intimacy-focused therapist. Medical contributors are common and addressing them often leads to measurable improvement; specific problems such as premature ejaculation, pain during intercourse or endocrine dysfunction require targeted treatment rather than vague encouragement.

Practical advice: document two weeks of data; book the timed conversation within seven days; reduce alcohol and correct sleep debt; avoid arguing during check-ins; if no improvement after six weeks, book medical and therapeutic reviews. These steps offer good, concrete chances to restore desire, reduce the total emotional load and clarify whether further intervention will benefit the relationship.

Identify concrete signs he’s avoiding sex because he’s unhappy with himself

Start an honest check-in tomorrow: list three observable behaviors that show reduced interest in physical intimacy and ask him to describe feelings for each item; set a 20-minute limit and agree to no immediate problem-solving during that time.

Concrete signs: look for avoidance of closeness during routine moments (turning away when you try a hug, choosing separate sleeping spaces); touch often elicits awkward silence or statements that he feels uncomfortable; he withdraws eye contact during cuddling; he cancels dates citing low energy and postpones to “tomorrow” repeatedly; he tenses and prefers screens over small talk. Medical indicators include sudden drops in morning erections, low energy and mood swings – these can signal a testosterone change; a possible next step is a GP blood test. If ignored, these behaviors can become entrenched patterns.

Emotional patterns to look for: he tends to isolate and oscillate between neediness in messages and flat indifference; youve likely heard “I’m fine” alongside defensive humor while he does tasks to avoid real talk; he talks about being single or imagines life alone more often – these signs point to shame, poor self-worth or stress rather than attraction loss; that breakdown in communication shows up as fewer shared plans and less joint decision-making.

Practical next steps: be honest about the specific behaviors that hurt, rather than accusing character; offer three low-pressure options: a medical check for testosterone levels, a short series of counselling sessions, or weekly intimacy-focused exercises that cultivate non-sexual bonding. Design one small routine to produce oxytocin – five minutes of hand-holding or a shared walk three times a week – and track changes for two weeks so progress becomes measurable.

Set boundaries and a review: be sure to name a fair deadline, for example two weeks, and schedule a review conversation; regardless of his readiness, protect your needs and decide whether this relationship is meant to deliver the level of physical closeness and love you require. If he resists all options and stress levels remain high, seek specialised counselling to address the deeper breakdown and consider whether it’s easier to shift roles rather than wait indefinitely.

Notice behavior changes that point to lowered self-worth

Schedule a 20-minute private check-in and list exactly three observable behaviors from the past 30 days that show a drop in self-care, social engagement or assertiveness.

Record specific changes: grooming reduced from daily to twice weekly; social invitations refused somewhere between one and zero per week; saying goodbye to hobbies once enjoyed; repeated self-critical remarks that shift the internal picture of worth.

Quantify frequency for each behavior: log exact counts per week, assign a 0–5 severity score, and mark dates. A drop of 50% or more in participation or a consistent fall of two or more points on a personal-satisfaction scale is a red flag for intervention.

Express observations using neutral language and short scripts: “I notice these changes; I seek to understand your feeling, not assign blame.” Offer one concrete practice per week (15 minutes): goal-setting, mirror affirmation, and a low-pressure social outing to enjoy small wins that rebuild agency.

Check conflict patterns and relationship stage: ask about current stage and the meaning the relationship holds, then rate satisfaction on a 0–10 line. Repeated low scores often point to internal causes rather than simple fatigue; tracking produces a clearer sense of whether problems are situational or deeper.

If youve tracked no improvement after two to four weeks, refer to a therapist for assessment; online intake forms speed triage and can show exactly which interventions benefit most. Avoid vague cliché language; specific, measurable steps above emotion-only conversations produce clearer results and a fuller recovery picture, and could shorten the time to regained confidence.

Listen for self-critical language and expressions of shame

Label self-critical language immediately: mirror the phrase, name the emotion, and stop any pressure for intercourse; during that pause offer a brief validation such as “I hear you feel ashamed” and ask permission to look deeper.

Use short scripts rather than reassurance that pushes the other away: when they say “I’m broken” or “I ruin everything,” respond with a focused prompt–”What thought do you believe is causing that feeling?”–then reflect the content back. Above simple comfort, offer concrete opportunities to rebuild safety: non-genital touch, shared walks, or a five-minute check-in to stimulate closeness without expectations of intercourse or having to perform.

Track frequency and context: note if self-critical comments rise during stress, after arguments, or when one is entering a busy stretch of life; these patterns point to triggers behind withdrawal. Do not try to fix everything at once–set one achievable micro-goal per week to level up trust (example: one ten-minute cuddling window). If going forward feels hard, label the insecurity and invite a single small step rather than piling on pressure.

Use the actionable checklist above: have a short validation line ready, use one clarifying question, and offer one non-demanding physical option. Good responses simply name the feeling, avoid blaming, and harness approach behaviors into routines that rebuild love and bond while reducing the shame that is often causing retreat.

Track patterns of emotional withdrawal outside the bedroom

Keep a 30-day interaction log that records: date, time, location, trigger, observable behavior (reduced eye contact, one-word answers, leaving room, no physical touch), intensity score 0–5, duration in minutes, screen use (yes/no), porn (yes/no), and a 20–60 character note on context. Use a spreadsheet or notes app so entries are searchable; aim for 1–3 lines per entry.

Scoring rules: 0 = fully engaged; 1 = slight coolness; 3 = clear withdrawal; 5 = full shutdown. Flag a day when average score ≥3 and duration >15 minutes. Use a 7-day moving average to capture trends; mark as concerning if that average increases by ≥1 point over two consecutive weeks.

Track frequency as counts per week: list number of evenings with withdrawal, number of conversations cut short, and number of physical-avoidance events. If counts reach 3+ flagged evenings in one week or 6+ across two weeks, schedule a focused 20-minute check-in. In that meeting use brief statements that invite clarity: “I notice silence after our talks; I feel shut out; can you help me hear why?” Aim for understanding over immediate attempts to be sexy or to force satisfaction.

Record concurrent behaviors that may explain withdrawal: increased screen time, porn use, late-night gaming, alcohol use, or major stressors. Quantify these: minutes on screen per evening, number of porn episodes per week, hours worked beyond normal. Correlate these metrics to withdrawal scores; a correlation coefficient above 0.3 over 30 days signals a meaningful link worth addressing.

Design easy experiments lasting two weeks: reduce evening screen time by 30 minutes, add a five-minute non-sexual touch ritual, or institute a 10-minute post-work check-in. Measure pre/post changes in the 7-day moving average. If average moves in a positive direction by ≥0.5 points, continue that action; if it moves worse or further negative, stop and try an alternative.

Use language that lowers defensiveness: ask to hear one sentence about how days feel, avoid blame, prefer concrete requests over vague critiques, and imagine solutions together. If entries show a steady trend toward isolation, or porn use rises while conversation length falls, consider professional support after 4–6 weeks of tracked attempts.

Example entry: “2025-10-03, 19:20, living room – argument earlier; silence, turns away; score 4; duration 35; screen=yes; porn=no; note: said ‘fine’ while scrolling.” Log that, plan a 48-hour cooling period, then a short check-in asking for understanding rather than explanation. Hopefully the pattern loosens; if not, escalate to couples coaching or therapy.

Keep reviewing every two weeks, mark trends that matter, and use the data to create a shared action plan. These records help shift vague wondering into a clear sense of cause, show whether small changes deliver greater satisfaction, and give high-value evidence for any conclusion about next steps.

Ask specific health and energy questions to rule out medical causes

Schedule a primary care plus gynecologic or urologic visit in the next 4–6 weeks and bring a concise symptom log; include exact dates and short messages about energy, libido and orgasms.

• Direct clinician questions to use:

  • Energy and sleep: “Experiencing persistent fatigue on >50% of days over 3 months? Rate daily energy 0–10; any daytime sleepiness or loud snoring?”
  • Weight and metabolism: “Any unintentional weight change >5% in 6 months? Recent changes in appetite or temperature intolerance?”
  • Medications and supplements: “List prescriptions, OTCs and recreational substances started or changed in the last 3 months; ask which agents are most likely to reduce libido or orgasms.”
  • Hormonal and reproductive: “For a woman: menstrual pattern changes, vaginal dryness, pelvic pain or altered wanting during the cycle?”
  • Mood and cognition: “Request PHQ‑9 and GAD‑7 screening; report any intrusive memories, anhedonia or emotional numbing.”
  • Pain and physical barriers: “Any pelvic pain, dyspareunia, erectile difficulty or sensory changes noted around intimate moments?”

• Self-tracking to bring:

  • Daily symptom log with date, short messages (energy, mood, libido, orgasms), medication times and sleep hours; clinicians often find objective entries more informative than vague reports.
  • Note any pattern tied to doses, alcohol use or stressful dates; flag moments when feelings suddenly change or the person feels stuck.

1. Baseline tests to request if not already done:

   • TSH (typical ref 0.4–4.0 mIU/L), free T4; treat abnormal thyroid to reduce fatigue and low libido.
   • 空腹血糖、HbA1c（糖尿病の診断基準≥6.5%）、脂質パネル、CMP、CBC。
   • 朝の総テストステロン（性別特有の参照範囲）、周期的な女性のエストラジオール、プロラクチン；妊娠検査（該当する場合）。
   • STIスクリーニングと尿検査は、泌尿生殖器の症状がある場合に行う；原因不明の骨盤痛に対しては、骨盤超音波検査を考慮する。
   • 睡眠研究または一晩の経皮的酸素飽和度モニタリングは、いびき/呼吸困難の報告に基づいて睡眠時無呼吸症が疑われる場合に検討する。

• Medication and management points:
  • 処方された薬を急に中止しないでください。そのリスクを避け、性欲またはオルガスムの低下が疑われる薬の場合は、処方医と安全な減薬または代替の計画を立ててください。
  • もし抗うつ薬が関与している場合は、代替案や補助薬（例：性的副作用の少ない薬剤への変更）について話し合い、変化が気分に影響を与えるまで4〜8週間かかることを期待してください。
  • 治療可能な医学的問題（甲状腺機能低下症、貧血、コントロール不良の糖尿病）は、生化学的コントロールが開始されると、エネルギーと性機能の改善がより大きくなることが多く、その効果は数週間から数ヶ月で一般的に認められます。
• メンタルヘルスと紹介:
  • PHQ‑9 スコア ≥10 または GAD‑7 ≥10 の場合は、カウンセリングと薬物レビューが必要です。医療管理にもかかわらず感情的なブロックが残る場合は、性心理療法への紹介を検討してください。
  • もし誰かが一人で来院をためらう場合は、サポートとより明確なコミュニケーションのために、信頼できる付き添人に一緒に1回の診察への参加を招待してください。
• フォローアップ計画と閾値：
  • 治療開始後6～12週間で異常な検査結果を再確認してください。症状が改善せず、生化学的な異常がない場合は、標的治療のための性医学専門医または骨盤疼痛クリニックへの紹介を依頼してください。
  • リビドーが半分に低下するか、オーガズムがまれになる場合は、待機するのではなく評価を強化してください。早期の調査は、より良い結果を得るための機会を増やし、長引く苦痛を回避します。

もし何かおかしいのではないかと心配な場合は、日付を記録し、診察ごとにその記録を持参してください。最初の検査結果に関わらず、多くの介入が健康、エネルギー、そして親密さの感情を高めることができます。小さな変化がしばしば人をすっかり元気にし、立ち往生した気分を軽減し、共に幸せになるためのより大きな機会を生み出します。

彼が責められていると感じないように、話題を切り出すにはどうすればよいか

落ち着いて、プライベートな時間を作って話し合い、明確な要求を一つだけ提示してください。正直で非難しない、相互理解を求める対話が必要だと伝えましょう。

近さがないように感じています。また、性欲の変化を理解しようとしています。彼が不安になった場合は、一時停止して、短い散歩を提案し、これはチェックインであり要求ではないと伝えてプレッシャーを軽減してください。

過ちの列挙や、故障の分析のように読める多数の例を避けて、代わりに可能性のある原因を2、3つ提示し（ストレス、薬物、ポルノへの暴露、スケジュールの変更など）、彼の意見を求めましょう。話し方のトーンは親しみやすく、防御的にならないようにし、彼が尋ねない限りアドバイスをするのは避けてください。

彼自身の身体やルーチンに、どのような身体的または感情的な変化があるか尋ね、薬物、睡眠、アルコールとの関連について知っているかどうかを確認します。具体的な提案をして関与を促しましょう。たとえば、決まった日に簡単な実験を提案したり、5分間の触覚儀式を取り入れたり、夕方のスケジュールを変更したりするなど、小さな一歩が効果的で、プレッシャーを軽減します。

彼が反応したとき、彼の言葉を反映し、理解度を確認するために要約してください。「仕事の後で疲れて、性欲が低下しているという気持ちですか？」もし彼が防御的になった場合、彼を責めるつもりはないし、一緒に解決策を見つけたいと言うことで、状況を緩和してください。多くのカップルが、このアプローチを露骨な対立よりもはるかに脅威を感じにくいと感じています。

長いスピーチではなく、シグナルを使用する： 「今夜15分話しましょう」というテキストや、目的を明示するメモは、会話のきっかけになるかもしれません。 彼は求めない限り、リソースを引用しないようにしましょう。ハフポストの記事や短い臨床的な入門書は、後で役立つかもしれません。

フォローアップは、即興的なものよりも、短くスケジュールされたものにしましょう。週に10分のチェックだけで、プレッシャーを軽減し、効果的な習慣になります。どんな小さな一歩でも褒めてあげましょう。そうすることで、ポジティブなフィードバックは安心感を与え、さらなる関わりを容易にし、率直に言って、両パートナーにとって素晴らしいものになります。