Podcast Summary: “Sexless Marriage Truths: Why It Happens [And How to Fix It]”

Rena Malik, MD Podcast | Host: Dr. Rena Malik | Guest: Keeley Rankin | Dec 31, 2025
Honest answers to the questions you’re too embarrassed to ask.

Overview

This episode dives deep into the realities of sexless marriages, exploring why couples lose their sexual connection, how to talk about it (or what to do when your partner refuses to discuss it), and strategies for rekindling intimacy. Dr. Malik and sex therapist Keeley Rankin blend real-world examples with science-backed advice, providing actionable steps and empathy for listeners stuck in “touchless and eroticless” partnerships.

Key Discussion Points & Insights

1. When One Partner Refuses to Talk About Sex [00:00–02:50]

• The Scenario: Listener wonders what to do if their partner won’t discuss a sexless marriage.
  • Keeley Rankin: “How do we respect that person’s choice to say, like, I’m not interested in being sexual? Because that is a choice that every person gets to make.” [01:31]
• Possible Paths Forward:
  • Process grief & respect autonomy.
  • Consider solo sex, affairs, or “outsourcing” sexual needs—though not every couple is open to this.
  • Openness about the possibility of leaving: “I’m not sure that I want to stay in a relationship that is touchless and eroticless.” [02:28]
• The Challenge: This is rare and “heartbreaking,” as true deadlocks are difficult to resolve.

2. Life Stress, Hormones, and Why “No” Sometimes Means “Not Now” [02:50–05:47]

• Common Factors in Sexual Disconnection:
  • Hormonal changes
  • Overwhelm from work, childcare, aging parents (especially for women)
  • Loss of pleasure or desire, shame, and lack of sexual exploration
• Not Just a Women’s Issue: Men can lose desire too.
  • “It’s not just women who don’t want sex. There are plenty of men that decide, you know what, I’m just not interested…”
• Advice for Partners: Offer support (“Can I take stuff off your plate?”), stay curious, and don’t treat a “no” as permanent.
• Quote: Dr. Malik: “I hope this is true… when women say no… they’re just like, I can’t add this to my list of to dos right now.” [03:11]

3. Understanding Shifting Desire [05:47–06:37]

• Sexuality Is Fluid: Both hosts emphasize that the meaning and frequency of sex changes over the lifetime of a relationship.
  • Keeley: “These are ongoing, continual conversations… What [sex] meant the first year of your marriage is not going to mean the same thing 10 years in.”
• Encouragement: Approaching these conversations with non-defensiveness and patience is key.

4. Pornography, Sex Toys, and Insecurity [06:37–13:55]

A. Porn’s Double-Edged Sword [07:09–14:02]

• Porn vs Sex Toys: Not the same—porn is “curated to bring arousal… not real life.” [07:23]
• Unrealistic Expectations: Porn can set unattainable standards for sex and bodies.
• Potential Benefits: “I love porn because it can give people access to places and turn on things they might not know…” [08:09]
• Overuse and Dependency: If solo pleasure without porn isn’t possible, it’s time to step back and relearn arousal.
  • “You will feel limited in your sexuality because you found this crutch.” [13:05]
• Shame Leads to Secrecy: Shaming a partner causes them to hide behavior (“underground”), not stop. Citing Esther Perel’s “secret garden” concept.
  • “If you shame them, they will hide them from you, and they will still do them.” [09:45]
• Handle Jealousy Openly: Instead of bans, invite discussion and even shared experiences.
  • “It’s just really important to talk about. Sometimes… actually view porn… show me what you’re watching. Can we watch it together?” [11:45]

B. The Balanced Human Sexuality Model [12:49–14:02]

• Keeley’s Model: Sexuality has three parts—physical sensation, intimacy, and fantasy/creativity.
  • Porn fits into the fantasy/anticipation part of sexuality.
  • If someone can’t generate arousal through their own fantasy, their sexuality feels “constantly limited.”
• Quote: “Let’s give you back access to your creativity and your anticipation and your fantasy, because it’s only going to serve you…” [13:41]

5. AI, Technology, and the Future of Intimacy [14:02–19:52]

• AI and Desire: Dr. Malik wonders if AI (virtual porn, chat partners, dolls) will make people lose their ability to get turned on naturally.
  • Keeley: “Our limbic systems will be completely hijacked by AI… Some people are already having full relationships with AIs…” [14:41]
• Are AI Relationships ‘Real’?
  • For some, yes; emotional needs are met without real-world discomfort and “bumping up” against another person.
  • Keeley: “You can experience a level of closeness with an AI that doesn’t have the tension. And for some people, that’s really, really important.” [15:39]
• Loneliness Epidemic:
  • We're already in a “huge loneliness epidemic” among seniors and children.
  • Shaming people for using AI or porn for connection is counterproductive.
• Building Resilience:
  • Important to teach kids (and adults!) to handle relationship discomfort, not avoid it.
  • Keeley: “How do we teach children to bump up against each other… and not just say, you’re out?” [19:15]
  • “Be okay feeling discomfort and be okay not getting along and still feel like I can sit next to you.” [19:41]

Notable Quotes & Memorable Moments

• On Sexual Autonomy
  • Keeley Rankin [01:31]: “That is a choice that every person gets to make.”
• On the Fluidity of Sexual Desire
  • Keeley Rankin [06:13]: “We want to give people lots and lots of space to think about [sex]… Because it will change over the arc of a relationship.”
• On Porn and Jealousy
  • Keeley Rankin [09:45]: “If you shame them, they will hide them from you, and they will still do them…”
• On AI Relationships
  • Keeley Rankin [15:39]: “You can experience a level of closeness with an AI that doesn’t have the tension. And for some people, that’s really, really important.”
• On Building Resilience
  • Rena Malik [19:41]: “Be okay feeling discomfort and be okay not getting along and still feel like I can sit next to you.”

Important Timestamps

• 00:00–02:50: What to do when a partner refuses to talk about sex
• 02:50–05:47: Life stress, desire, and “no, not now” dynamics
• 06:37–13:55: Porn, sex toys, insecurity, and building healthy discussion
• 14:02–19:52: The impact of AI, technology, and the current loneliness epidemic

Tone & Language

• Candid, empathetic, evidence-based: The conversation stays grounded in real-life scenarios, balancing science with stories and normalizing difficult feelings around sex, shame, and jealousy.
• Practical and encouraging: Listeners are reassured that “end of sex” isn’t a death sentence for a relationship—but it does require ongoing, often uncomfortable growth.