MANY people believe that marriage ruins sex between a couple. I've certainly heard my fair share of complaints about this from my patients who have been married for years.

There is some truth to this belief, although the reason for the problem lies not in the marriage itself, but in the routines and the complacency that come with a long-term relationship.

We all remember the excitement and passion of the marriage in the early days. How every look, whisper, and touch seemed to fan the flames of desire, mingled with nervousness about getting it right.

As you get increasingly comfortable with each other, though, the butterflies in the stomach ease and your sexual relationship becomes about closeness, familiarity and understanding.

Sounds like a good thing, right? The best part about being married to someone is that, over the years, your spouse knows you better than you know yourself.

However, comfort, while necessary in a relationship, can stifle sexual passion. You begin to follow fixed routines and motions, sticking to what you know and not allowing for any experimentation or novelty.

Eventually, comfort turns into blandness, and lovers become roommates.

Family life

Whether or not you have children yet, your marriage is about more than just about being a couple. You are building a family, which comes with greater responsibilities like maintaining a home, caring for someone else, having a successful career, and above all else, ensuring financial security.

There comes a point when you and your spouse reach the unspoken agreement that practical matters take priority above romance and intimacy. You tell each other "no sex tonight" because you have to get a good night's sleep for an early meeting the next day. You forgo spontaneity because of all the plans you've made with your children, relatives, friends or colleagues.

Do you even remember what intimacy is anymore? Do you still hold hands, look into each other's eyes, hug in bed or stop to really listen to your spouse?

A healthy sexual relationship is an important part of marriage. Problems in a couple's sexual relationship are often signs of other problems, and can serve as a warning sign for still bigger troubles ahead.

Physical problems

Studies have shown that people tend to have less sex as they age, regardless of whether they are in marriages or not. Married couples aged 70 and above have sex 16 times a year on average, compared to couples between ages 18 and 29, who have sex an average of nearly 112 times a year.

The ageing issue is most likely rooted in physical changes and conditions brought on by ageing, such as erectile dysfunction, heart problems, arthritis or rheumatism, that affects what goes on in the bedroom.

In addition to cardiovascular conditions, depression, anxiety and prostate disease can also be factors in sexual dysfunction or sexual problems. Unfortunately, many medications required by older people, especially men, negatively affect sexual functioning, creating a dichotomy between preventing medical crises and maintaining a healthy sex life.

Women also experience their fair share of problems from ageing, such as reduced vaginal lubrication and reduced blood flow to the sex organs. These can diminish desire for, and pleasure during, sex.

These problems will only get worse if you and your spouse are not open about it. Talking and sharing about these problems is the only way to discover solutions together - and there are certainly medical solutions to medical problems.

For many older men, it may be as simple as leading a healthy lifestyle - and not just in the 50s or 60s, but from a younger age. Be more active, don't smoke, maintain a healthy weight and lay off cholesterol-rich and fatty foods. These can help to reduce risk of cardiovascular diseases, which can help men to live longer, reduce dependency on medications and improve their sex lives.

Rediscovering sex in your marriage

The good news is that marriage doesn't have to be a killer in the bedroom, and research backs this up. A 1998 University of Chicago report that compiled the available sex research showed that married couples have 25% to 300% more sex than non-married couples, depending on their ages.

As for older couples, less sex does not mean bad sex. A survey by AARP (formerly known as the American Association for Retired Persons) showed that most mid-life and older couples were either extremely satisfied or somewhat satisfied with their sex life.

But this does not mean that you can take things for granted. Maintaining a healthy and exciting sexual relationship in your marriage takes hard work.

First of all, know that great sex is underscored by a committed, happy marriage. The University of Chicago report concluded that intercourse is more frequent among couples in happier marriages. The reason for this is simple: great sex requires intimacy, and that can only be attained through trust and security.

Be open with your spouse, don't be ashamed or embarrassed to discuss your sex life with him. If you can't be deeply sexual with your spouse - whom you have accepted as your partner for life - then you are not being true to the marriage.

Talk after intercourse, so that the memory of what you both did or said is still fresh in your minds. Discuss what you liked, why you liked it, and how you can recreate or improve it. Don't go negative, focus on what worked.

If you think that your spouse will not be comfortable talking about what you like or don't like, introduce the subject slowly and in a considerate manner. Remember that sharing goes both ways - you must also listen to what he likes or does not like, and try to please him.

When you both know what pleases each other, you have to make the extra effort to do these things consistently. Whether it's dressing in a certain way or doing something to make him feel special, it doesn't hurt to do something that he will appreciate - unless you find it humiliating or a violation of your rights (equality is important in a relationship, sexually and otherwise).

He also has a responsibility to please you, so make sure there is a mutual exchange of generous behaviour. For example, if you make the effort to dress up when you go out together, so should he.

This is, by no means, an exhaustive list of ways to spice up your married sex life. You have to discover together with your spouse what works for you as a couple.

But one last piece of advice I can give is this: enjoy yourself. Sex isn't like running a sprint, just to get to the end. It is meant to be a lifelong journey of intimacy, shared between you and your husband.

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