The longer a couple goes without being intimate, the more ambivalence they will feel. It's like a vicious cycle, and this only increases the lack of trust, the awkwardness and the subsequent distancing.

Resistance to talking about the problems and to exploring ways to be intimate only puts greater stress on the relationship.

If your marriage is suffering from a lack of sex, consider these tips to help get the intimacy back into your relationship.

1. Rule out medical problems.

First, it's necessary to medically rule out physical causes such as side effects of chronic illness or medications as well as age-related issues. Sexual problems in marriage can also be related to incompatibility in sex drives. The contributing factors are not insurmountable.

2. Think about counseling.

A sexless marriage is usually a sign of more serious problems in the relationship—lack of trust, unresolved anger, deep resentment, one partner having an affair or with one foot emotionally out of the marriage. If efforts to discuss the problems are too uncomfortable, frustrating or going nowhere, seeing a couples’ therapist may very well shed some light on the problems.

3. Know each other's needs.

Compatibility of goals—both inside and outside the bedroom—is important, as well as the freedom to talk about what the partners both need and want. For some couples, control and withholding sex is one way to have the upper hand. If other problems in the relationship aren't attended to, the anger and hurt take away the desire to be close or even try to make it work.

4. Consider gender differences.

Another contributing factor can be the hard wiring differences that surface between men and women around a lot of issues—communication, support, problem solving and, yes, sex too. Men often view sex as the intimacy in a relationship and making love is when they feel closest to their partner. Women, on the other hand, need to feel the intimacy before opening themselves up emotionally. It takes some understanding of these dynamics and a willingness to work together so both partners can feel loved and satisfied.