The first thing to do is to try and determine the reason your spouse is refusing sex. This is difficult as there are a variety of sexual and non-sexual issues that can cause sexual refusal. It's also possible that previous sexual behavior was mostly or completely an act, meaning what appears to be a sudden problem may have alway existed, and was only hidden before. The problem can be a combination of things, and a person who tends towards negative feelings about sex may only need a very small "push" to stop wanting to have sex. It is also possible that the original trigger issue has ended, and the non-sexual behavior remains.

• Stress: Stress attacks both our desire for sex and the ability to become aroused and climax. Either sudden high levels of stress or lower but prolonged levels of stress can interfere with sex.
  
  
• Exhaustion/too busy: Being tired either physically or emotionally takes a toll on us. As with stress this can be a sudden surge, or a long term chronic condition. People who don't have enough time are forced to cut things out, and sex may be cut just because it was never really a high priority.
  
  
• Depression: Even mild depression can destroy sex drive and/or sexual function. Individuals with mild depression may be able to function with apparent normalcy in some aspects of sexuality, but be totally non-functional in other aspects.
  
  
• Relational: Good sex requires a good relationship. Unsettled issues, feeling unloved, feeling unimportant, and lack of respect can all cause a person to not want to be sexual.
  
  
• Intimacy: If non-sexual intimacy is lacking, sexual intimacy may feel awkward or even wrong. There can be a lag of many years between the loss of non-sexual intimacy and the refusal of sex.
  
  
• Over committed emotionally: We can become so closely tied to other people that we no longer have the ability to see our marriage relationship as more important than all the others. When a person starts to see their spouse as "just another friend", it's difficult to see them as sexual.
  
  
• Anger/Resentment: Often a person is knowingly or unknowingly refusing sex as a way of retaliating for real or imagined wrongs. This is passive/resistive behavior. Another version of this is the spouse who says yes to sex, but rarely or never allows themselves to enjoy it.
  
  
• Control: A spouse may use sex as a carrot to encourage wanted actions, or sexual refusal as a stick to punish unwanted actions. If the person who is supposed to be controlled "refuses to play," sex may stop all together.
  
  
• Habit: If not having sex, or having very little sex, goes on for a long time, it can become a bad habit. Being sexual no longer feels natural, and other things usurp the time and energy that should go into sex.
  
  
• Sexual Anorexia: This stems from the feeling that one has little or no control over one's life. As with the eating disorder, the sexual anorexic gains a sense of self control by denying them self something their body feels a need for. And as with the eating disorder, the sexual anorexic may so lose contact with their body that they no longer even feel the urges. A sexual anorexic could be highly aroused and in need of climax, but not feel a thing. Sexual anorexia is far more common in women then men, but some men exhibit signs of it. There also seems to be a sexual bulimia in which the person vacillates between not being able to get enough sex (and possibly seeking it outside of the marriage) and wanting absolutely nothing to do with sex in any way.
  
  

• Pain: Sex can become uncomfortable or painful for a variety of reasons. If a person has tried to ignore the pain,
  If you had any kind of sexual contact with your spouse before marriage, assume that this is a part of the problem.
  and it's gotten worse, he or she may not want to confess to how long the situation has gone on. Fear of what the pain could mean, or of what medial treatment might entail, can also result in wanting to hide the true reason for saying no to sex.
  
  
• Embarrassment: Physical problems such as impotence, premature ejaculation, difficulty getting aroused, and orgasm problems can be very embarrassing. Men in particular may choose saying no to sex, or masturbating privately, over revealing or discussing sexual difficulties.
  
  
• Guilt: Guilt, a big sexual destroyer, comes in several forms:
  
  
  • Sexual abuse: It is very common for sexually abused individuals to feel guilt, even if they were children when the abuse occurred. This guilt can be suppressed for a time, then come back with a vengeance.
    
    
  • Sexual behavior prior to being with spouse: This is particularly destructive if the sin has never been confessed, as hidden sin just keeps eating at us. We also tend to see things very differently as we become parents ourselves, so feelings of guilt may develop as our children reach the age we were when we entered into sexual sin.
    
    
  • Sexual behavior with spouse before marriage: This may be the most common cause of sexual problems in marriage today. Getting married does not retroactively sanctify what you did before marriage, and the anger, guilt and shame of your premarital sex may slowly eat away at your spouse. This is particularly problematic when one spouse feels bad about the sex, and the other sees it as "no big deal." If you had any kind of sexual contact before marriage (even if it was way short of intercourse) assume that this is a part of the problem.
    
    
  • Sinful behavior with your spouse since marriage: If you engaged in sinful behavior together after marriage (use of pornography, group sex, swinging), guilt may continue to build after the sin has stopped. This is particularly a problem if you stopped "for" your spouse, and have never agreed/confessed that your actions were wrong.
    
    
  • Adultery, porn, masturbation: Guilt over current or past hidden sexual behavior can cause a person to refuse sex. Even an "emotional affair" or lustful thoughts that were never acted on can cause this to happen.
    
    

In the final analysis a marriage being destroyed by sexual refusal is a difficult issue with no easy or sure fire answers. What works for one couple will not work for another. Some couples have gone so long that recovery would be a true miracle, and many couples never accomplish anything more than partial improvement. Change takes time, commitment, and a lot of prayer and energy. The one sure thing about sexual refusal, as with most problems, is that it only gets worse when it's ignored.