Meridia Medical

Lapsing from intimacy to friendship

A patient recently mentioned that her marriage has “lapsed from intimacy to friendship”.

I have heard similar themes from many women over the years. Changing from intimacy to companionship seems to be the most hurtful.

This same patient, 42 with 3 children, went on to describe a change from warmth, intimacy and spontaneous love making to no spontaneous passion, no kisses, less hand holding to no intimacy.

“You sleep in the same bed, but lie far apart, not even facing each other. No sex. You have a functional relationship, without passion, keeping the family unit going, even being good parents. You have love but without loving.

She and others have described that the new reality is a non-intimacy, driven by family commitment and safe companionship only. No relationship growth, excitement of life, love or passion. But it works and may even last…….. for a long time.

Another woman mentioned that they even compensate by focussing heavily on your children to try fill the loveless void. Watching TV together, going out for dinner, seemingly a perfect couple but always being apart.


Sadly, the new normal is loveless


The absence of love and intimacy makes compromise and listening difficult. Sometimes loveless relationships are like tinderboxes set off by the slightest provocation, fraught with friction and poor communication.

Sometimes it is unclear what came first, lovelessness and lack of intimacy resulting in reactive disunity or a poor relationship causing a loveless relationship.

What might be happening and what you can do to help!

What is happening? Where is the “Joie de vivre” of intimacy and sex.

  • Sometimes life gets in the way and a new “normal” develops. This can be fixed for many:  Arrange to have regular sex and stick to it, until the spontaneity and intimacy returns and becomes second nature. Many patients have told me that despite hours of sex therapy, which certainly plays a role, just being involved and doing it often and regularly, is the key. Being active once and then letting things lapse is even more destructive to creating intimacy and love time. Sometimes: “Just do it” in a committed and regular way, can restore a good and intimate sex life.
  • One partner may have chronic low sex drive often with low self and sexual self-esteem. Female hyposexuality is common and usually treated well with cognition of the issues. Lack of confidence can be due to weight issues, surgery, post pregnancy stress, worry about what the labia or vagina look like and sexual confidence can play a role.
  • Female hypoactive sexual desire disorder (HSDD) is a more significant version of hypo sexuality and affects up to a third of women. There is a lack of desire for sex or fantasy that causes significant distress and interpersonal problems. Therapy can be multi-layered, but successful.
  • If hyposexuality from one partner is paired with lack of intimacy and affection, the relationship is in trouble and there may be an affair waiting to happen for the other partner.


If there is trust, good will and support from both partners to focus on timed intimacy, affection and sex while helping to build sexual confidence and freedom, baby steps can lead to better loving.

  • Couple therapy and sex therapy may be necessary.
  • Pain with insertion (Vestibulodynia) can destroy intimacy, passion and relationships. This can be treated resulting in improved sexual confidence and enjoyment. Sex therapy can also be helpful.
  • Stress, anxiety or depression. These can be managed with drug therapy, relationship therapy and sex therapy.
  • Absent or empty love. This unfortunately may not be solved and can lead to affairs and separation or chronic sacrifice for the family’s well-being.


Dr David Gerber, MD, MHSc, FRCS(C)

Dr David Gerber, MD, MHSc, FRCS(C), has been a gynecologist since 1997. He trained in Obstetrics and Gynecology at the University of British Columbia in Vancouver. He is an expert in minimally invasive clinic based surgery, procedures for fibroids, heavy vaginal bleeding, vulva disease and precancerous lesions of the vulva, vagina and cervix (abnormal pap tests), he has developed a successful micro-surgical technique for labia reduction surgery, and has become a resource for this condition.

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