What to Do When You've Tried Everything and Nothing Works

You've read the articles. You've bought the books. You've scheduled date nights, tried new positions, had the communication workshops, maybe even gone to therapy. You've implemented the advice about non-sexual touch, quality time, and love languages. You've tried being more spontaneous and more scheduled. You've worked on yourself and worked on the relationship.

And nothing has changed. Your sex life is still unsatisfying, infrequent, or nonexistent. The intimacy you're craving still feels out of reach. The connection you're desperate for remains elusive.

You're exhausted from trying. You're starting to wonder if maybe this is just how it's going to be—or worse, if you're fundamentally incompatible and nothing will ever work. You're caught between giving up entirely and continuing to beat your head against a wall that won't move.

This is one of the loneliest, most frustrating places to be in a relationship. But before you resign yourself to a lifetime of sexual mediocrity or start planning your exit strategy, let's take a hard look at what "tried everything" actually means, why common solutions often fail, and what might actually be different.

Why "Everything" Often Isn't Everything

When people say they've tried everything, what they usually mean is they've tried everything they could think of, everything they read about, or everything that seemed reasonable to attempt. But often, there are significant categories of intervention they haven't actually tried. Let's examine what might be missing.

You haven't actually tried therapy—or you tried the wrong kind. Many couples say they "tried therapy" when what they mean is they went to three sessions with a generalist therapist who wasn't trained in sexual issues, didn't feel comfortable with the therapist, or gave up before the real work began. General couples therapy and sex therapy are different specialties. If you haven't specifically worked with a certified sex therapist (AASECT certified), you haven't actually tried therapy for your sexual issues. If you saw someone but it wasn't a good fit, that doesn't mean therapy doesn't work—it means you need to keep looking for the right practitioner.

You haven't addressed underlying medical issues. Have either of you had comprehensive hormonal testing—not just the basics, but thyroid, testosterone, estrogen, progesterone, cortisol? Have you explored whether medications (especially antidepressants, blood pressure meds, or birth control) might be affecting libido? Has anyone evaluated for chronic pain, sleep disorders, or other medical conditions that affect sexual function? Has the partner with a vulva been evaluated by a pelvic floor physical therapist for any pain or dysfunction? Medical factors kill sex lives all the time, and many people never investigate this systematically.

You haven't addressed mental health properly. If either of you is dealing with depression, anxiety, trauma, or other mental health conditions, those need to be actively treated—not just acknowledged and hoped they'll get better. Untreated mental health issues will sabotage every other intervention you try. And if past trauma is involved, that requires specialized trauma therapy, not just general counseling or trying to push through.

You've made surface changes but not addressed core patterns. Scheduling date nights is great, but if you spend those date nights arguing or stressed about getting home to the babysitter, the dates aren't solving anything. Trying new sexual positions doesn't help if the real issue is resentment about household labor. You can implement all the tips in the world, but if you haven't addressed the fundamental dynamics causing the problem, nothing will change.

You haven't had the really hard conversations. Have you talked explicitly about whether you're sexually compatible? About what each person actually needs versus what they can live without? About whether the relationship can survive if the sexual dynamic doesn't change? About whether there's been a fundamental shift in desire that might not be fixable? Most couples dance around these conversations because they're terrifying, but avoiding them keeps you stuck.

You've tried things, but not consistently or long enough. You scheduled intimacy twice, it felt awkward, and you stopped. You implemented date nights for a month, didn't see dramatic improvement, and let them fade away. Many interventions don't work immediately—they require sustained effort over months to create real change. If you've only tried things briefly or sporadically, you haven't really tried them.

You tried things that aren't actually evidence-based. There's a lot of advice floating around that sounds good but isn't actually effective. Generic "spice things up" suggestions, superficial communication exercises, or advice to "just make sex a priority" without addressing why it stopped being one—these rarely create lasting change because they're not targeting the actual mechanisms of desire, arousal, and connection.

One person is trying while the other isn't. You can't fix a two-person problem with one-person effort. If only one of you is reading books, suggesting solutions, and trying to implement changes while the other is passive or resistant, nothing will work. Both people have to be genuinely invested in creating change.

Diagnostic Questions: What's Really Going On

Before concluding that nothing works, you need accurate diagnosis. These questions help identify what you're actually dealing with.

Is this a desire discrepancy or is desire absent entirely for one person? If one person has lower desire but still experiences it sometimes, that's different from someone who never feels desire at all. The interventions are different. True loss of desire might be medical or might indicate that this relationship no longer generates desire for them.

Is the issue primarily physical (arousal, pain, dysfunction) or psychological (mental barriers, trauma, shame)? Physical issues require medical intervention. Psychological issues require therapy and often need to address things that happened long before this relationship.

Is there undiagnosed trauma affecting your sexual relationship? Sexual trauma doesn't always show up as obvious PTSD. Sometimes it manifests as avoidance, inability to stay present during sex, dissociation, or just complete shutdown of desire. If there's any history of sexual assault, coercion, or even just negative sexual experiences, this needs specialized attention.

Are you addressing the relationship or just the sex? If there's contempt, criticism, stonewalling, or defensiveness in your general interactions (what researcher John Gottman calls the Four Horsemen), fixing sex without fixing the relationship foundation won't work. You can't have great sex with someone you're in a toxic dynamic with.

Has one person fundamentally changed in ways that affect compatibility? People evolve. Sometimes someone discovers aspects of their sexuality (or lack thereof) that they didn't know before. Sometimes people realize they're asexual, gay, or have other aspects of their identity that make this partnership incompatible. This isn't failure—it's information.

Is the problem really about sex, or is sex the arena where other issues are playing out? Sometimes low sexual desire is actually about power, control, resentment, or other relationship dynamics. Sometimes the partner with lower desire is unconsciously withholding intimacy as their only source of power in an otherwise unbalanced relationship. Sometimes the higher-desire partner is using sex to avoid emotional intimacy. You have to look at what's underneath the presenting problem.

What to Try When Standard Advice Hasn't Worked

If you've genuinely tried common interventions and they haven't worked, here are less obvious paths forward.

Get comprehensive medical workups for both partners. Not just basic labs, but thorough hormonal panels, evaluation by specialists if needed. For men, this means testosterone, thyroid, and cardiovascular health. For women, this means hormones plus evaluation for conditions like endometriosis, PCOS, or pelvic floor dysfunction. For both, this means reviewing all medications with an eye toward sexual side effects.

Work with a specialized sex therapist, not a general couples therapist. Find someone certified by AASECT (American Association of Sexuality Educators, Counselors and Therapists) who specializes in desire issues. If the first therapist doesn't feel like a fit, try another. Therapy is too important to give up on because of one bad experience.

Consider intensive couples therapy or workshops. Instead of once-weekly 50-minute sessions that can drag on for months, some couples benefit from intensive formats—weekend workshops, week-long retreats, or multiple hours in one day. The concentrated focus can create breakthroughs that incremental therapy doesn't.

Explore whether medication might help. For some people, addressing the underlying anxiety or depression with appropriate medication actually improves sexual function rather than hurting it. For postmenopausal women, hormone replacement therapy can be life-changing for desire and arousal. Work with doctors who take sexual function seriously as a quality of life issue.

Try a complete reset. Some couples benefit from taking sex completely off the table for a defined period (say, 30 days) while focusing only on non-sexual intimacy and connection. This removes performance pressure and allows you to rebuild the foundation. But this only works if both people are genuinely committed to using that time to reconnect emotionally.

Use structured, guided experiences instead of trying to orchestrate everything yourselves. When you're stuck in patterns and every attempt feels forced, external guidance can break the cycle. Following audio guidance or a structured framework takes the pressure off both people and creates a different experience than what you've been doing. This is why guided intimacy works for couples who've been stuck—it provides a completely different pathway.

Address resentment through action, not just discussion. If the issue is resentment over unequal labor, talking about it helps—but actual rebalancing of responsibilities is what creates change. Hire help, redistribute tasks, make concrete changes that address the source of resentment rather than just acknowledging it exists.

Explore whether your sexual orientation or identity has shifted. This is difficult, but sometimes the reason nothing works is that someone's fundamental sexuality has changed or they're finally acknowledging something that was always true. If one person is questioning whether they're asexual, gay, or otherwise oriented away from this partnership, no amount of tips and techniques will fix it.

Consider whether ethical non-monogamy might address your needs. This is controversial and definitely not for everyone, but some couples with fundamental desire discrepancies have found that opening the relationship allows both people to have their needs met. This only works if both people genuinely want it, not as a last-ditch effort to avoid divorce.

Get individual therapy in addition to couples work. Sometimes the barriers to intimacy are about individual issues—shame, trauma, self-worth, anxiety—that need to be addressed separately before the couple can make progress together.

The Questions You're Avoiding

There are questions you probably haven't asked directly, either of yourself or your partner. These questions are scary because the answers might be painful, but avoiding them keeps you stuck.

"Do you actually want to fix this, or are you just going through the motions?" Both people need to answer this honestly. If one person is only trying because they feel obligated or they're afraid of divorce, but they don't actually want things to change, nothing will work. You can't fix something if one person doesn't genuinely want it fixed.

"Are you staying for the right reasons?" Are you staying because you want this relationship to work, or are you staying because you're afraid of being alone, worried about finances, concerned about the kids, or just comfortable with the status quo? If you're staying for fear-based reasons but don't actually want to be in this relationship, you're not going to be motivated to do the hard work required.

"Has one of us fundamentally checked out?" There's a difference between being discouraged and being done. If one person has emotionally left the relationship even though they're still physically present, no intervention will work until they decide whether they're actually still in or whether they're just delaying the inevitable.

"Are we sexually compatible, or have we been forcing something that was never quite right?" Sometimes the issue isn't that something broke—it's that you were never quite compatible sexually and you've been trying to make it work despite that. This is incredibly difficult to admit, but if it's true, acknowledging it allows you to make informed choices about what comes next.

"Is the relationship itself the problem?" Sometimes the sexual issues are symptoms of a relationship that's fundamentally unhealthy or unfulfilling. If you don't actually like or respect each other anymore, if there's too much damage and resentment, if the relationship is characterized by criticism and contempt—the sex isn't the problem. The relationship is.

When It Might Be Time to Accept Reality

This is the hardest section, but it's necessary. Sometimes "nothing works" because the situation genuinely isn't fixable. Here are signs that might be the case.

One person has completely checked out and isn't willing to do any work. You can't repair a relationship alone. If your partner is indifferent, resistant to all suggestions, unwilling to go to therapy, and shows no interest in improving things, there's nothing you can do to force change.

There's been fundamental incompatibility all along that's now undeniable. You have mismatched libidos, different ideas about what sex should look like, or needs that are genuinely incompatible. You've tried compromise but the gap is too wide. Nobody is wrong, but you're wrong for each other.

Damage has been too severe to recover from. Maybe there's been infidelity, major betrayals, or years of contempt and criticism. Sometimes relationships reach a point where the foundation is too damaged to rebuild, even with both people trying.

One person has changed in ways that make the relationship untenable. Sexual orientation shifts, realization of being asexual, or other fundamental identity changes that mean this partnership can't meet both people's needs anymore.

You're staying together for external reasons, not because you want the relationship. If you're only staying for kids, finances, fear of being alone, or social pressure—but neither of you actually wants to be in this relationship—all the therapy in the world won't make you desire someone you don't want to be with.

The cost of staying has become greater than the cost of leaving. When staying in the relationship is actively harming your mental health, self-worth, or wellbeing more than leaving would, that's important information.

What Acceptance Looks Like

If you've genuinely tried everything and nothing has worked, you have choices—none of them perfect, but all valid.

Accept the relationship as it is and stop fighting it. Some couples consciously choose to stay together despite sexual incompatibility because other aspects of the relationship are valuable enough. They accept a sexless or low-sex partnership, find ways to meet their needs individually, and stop beating themselves up about what's missing. This can work if both people are genuinely at peace with it—but it doesn't work if one person is just resigned and bitter.

Redefine the relationship parameters. Some couples move to a more open relationship, separate bedrooms, or other arrangements that honor the reality of their incompatibility while maintaining other aspects of partnership. This requires radical honesty and both people being truly comfortable with the new arrangement.

Separate or divorce with as much grace as possible. Sometimes the kindest thing is to acknowledge that you're not compatible and release each other to find partnerships that work better. This doesn't mean the relationship was a failure—it means you learned what you need and it wasn't this.

The Hard Truth

Here's what you need to hear: if you've genuinely tried everything—actual professional help, comprehensive medical evaluation, honest conversations about hard truths, sustained effort from both people—and nothing has improved, it's possible that nothing will.

That doesn't mean you're broken or that you did something wrong. It means that sometimes two good people are not good for each other, or that circumstances have changed in ways that make continuing impossible, or that the damage is too deep to repair.

The question isn't "why didn't anything work?" The question is "what do I do now with this information?"

You can stay and accept things as they are. You can try new approaches you haven't actually tried yet. Or you can choose to leave so both of you can find relationships that meet your needs.

All of these choices are valid. None of them is easy. But staying stuck in the limbo of "we've tried everything and nothing works" while neither accepting the situation nor leaving it—that's the worst option.

You deserve clarity. You deserve to make informed choices. And you deserve either a relationship that works for you or the freedom to find one that does.

Feeling stuck and out of options? Download the Coelle app for a completely different approach to intimacy. When conventional advice hasn't worked, structured guidance can break through stuck patterns and create new pathways for connection.

Want to understand why conventional approaches often fail? Read "Guided: Why We All Need a Guide in the Bedroom" to discover how external guidance addresses the underlying mechanisms that make change difficult—and why it might work when other approaches haven't.