You are not being unfair to your husband unless you affected an enthusiasm for physical union with him when you first met, whereas in truth there was none. Did you possibly not only fake occasional orgasms but also any interest in genital contact? A disgust at the mechanics of sex is common in prepubescent children whose reproductive instincts are as yet unawakened. In some people, who may have developed a strong cerebral love for their partners and may glory in their shared interests, including the bonds created by children, this immature approach may last a lifetime.

Many women, and some men, have little interest in penetrative sex in their teens but assume that, as they grow older and live with their partner, its pleasures will be revealed. There may be disappointment all round. Enjoying sharing a home doesn’t automatically extend to intimacy in the bedroom. Despite changes in both the man’s and woman’s hormone levels there may be no change in one or the other ’s approach to what Stephen Fry described as the sweatier parts of the human anatomy and more animal aspects of lovemaking.

Your problem was much more common when I started in medicine. Then the Church was a dominant influence in society and, as a result, sexual taboos were stronger and premarital experience limited. The first sexual experience many people had was only after the ring was on the finger and the bride and bridegroom were signed up for a lifetime of marital fidelity. You haven’t told us whether you had a good physical relationship with your husband to start with and whether you have had children. Some women lose their sexual appetite after having had children (for a limited time this is usual) and some men no longer desire a woman, however much they may love her in other ways, after she has had children.

In the 1950s some commentators, including Simone de Beauvoir in her book The Second Sex, said that women were initially less physical in their love life than men because the latter had a more physical upbringing. Men were playing contact sports, there was the rough and tumble of the playground, the locker-room jokes and still, at that time, the communal showers and baths. However, while adolescent boys were living close to nature their sisters were taught to be refined and controlled. Saloon-bar amateur psychologists then believed that women were in danger of always being relatively sexually unaware and unresponsive if they had been brought up without much male influence.

Many young women after the war had lived with a single war widow in a household that maintained standards but kept itself to itself. Likewise, if a young woman’s father had been emotionally distant, it was believed that she wouldn’t be a good bet for a romp in the hay. To establish an easy relationship with men a woman needed male role models in youth.

A frank talk with your husband is called for. What are his needs? Is he happy? If not, you have a problem, but there are answers. Psychotherapy for yourself might be a good point at which to start, or Masters and Johnson demonstrated the value of joint therapy. Remember that like often attracts like, the eccentric frequently appeals to the eccentric, the promiscuous to the promiscuous, and it is possible that you are both in the 10 per cent of those who have less interest than average in sex.

Suzi Godson:

Taken at face value, I’d have to say yes, you are being unfair to him. When you got married you agreed to love and to serve him his dinner; to cherish him for better or worse for wear; and to have and to uphold your side of the conjugal bargain about once or twice a week until he was too old to get it up any more. As such, your decision to deny him sex on what appear to be tenuous grounds seems a sure way to sabotage your marriage.

But, as I said, that’s at face value. Reading between the lines, I suspect there is more to this query than meets the eye. Assuming that you and your husband once enjoyed a relatively functional sex life — after all, it is unlikely that you would have married had this problem presented itself at the beginning of your relationship — something must have happened to trigger these negative feelings. Whatever the cause, whether it is unorthodox sexual demands or unsettling desires, some kind of religious confusion, or a hygiene-related obsessive-compulsive disorder, you need to get to the bottom of it because sexual intimacy should be a natural physical extension of the emotional connection between you and your husband. And if it isn’t, there is something wrong.

That “wrong” may exist within your relationship or relate to past experiences that have escaped to the surface within the safety of your marriage. The “wrong” may be physical, related to pain, ageing or low libido, or psychological. Your language — you call sex a “process” that is “dirty” and “unattractive” — suggests feelings of shame, guilt and anxiety.

Without more information, it is impossible to offer you specific advice, but I would urge you to recognise that sex has lost its true meaning for you and if you allow things to continue as they are you are jeopardising your relationship.

To change how you feel, you first need to identify the events or issues that have prompted your distaste for physical intimacy. The most effective way to do this is to see a psychosexual therapist. You can find one in your area through the British Association for Sexual and Relationship Therapy (020-8543 2707, www. basrt.org.uk) or Relate (0845 1304016, www. relate.org.uk/wantadvice). A private therapist will charge about £40 a session but at Relate you pay what you can afford, usually between £5 and £50. Or talk to your GP and find out where the nearest available NHS service is.

Like chocolate, sex is one of life’s great pleasures but, like a child who is force-fed chocolate until it vomits, people who have suffered a bad experience with sex end up being turned off the “process”. They associate it with pain rather than pleasure, fear rather than fun, and unless those associations can be broken, they can never appreciate intimacy as others do. Women who withdraw from sex usually find it difficult to express their feelings, and giving up on the sexual side of a marriage can seem easier than confronting issues or upsetting their partner.

Psychosexual therapy is a way of unravelling those confusions so that you can disconnect present behaviours from past traumas. It can be a bit of a “no pain no gain” experience at first; sometimes therapy opens a can of worms and reveals things that you or your partner haven’t previously been willing to face. However, Relate says that 93 per cent of couples who stick with the therapy report an improvement in their relationship. Good Luck.

Do you have a sexual dilemma for Suzi Godson and Dr Thomas Stuttaford?
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