The “Dear Sugars” podcast is an advice program hosted by Steve Almond and Cheryl Strayed. The audio contains more letters; submissions are welcome at dearsugars@nytimes.com. If you’re reading this on desktop, click the play button below to listen. Mobile readers can find “Dear Sugars” on the Podcasts app (iPhone and iPad) or Radio Public (Android and tablet).

Dear Sugars,

I am unable to feel sexual desire with any regularity due to chronic pain, mild depression and necessary use of medications. Other people struggle with desire for other reasons, such as a past experience of sexual trauma. Whatever the case, it’s excruciating to be unable — not unwilling, unable — to give one’s partner what he or she desires and needs. It’s also hard to have a relationship fall apart for that reason and difficult to re-enter the dating world with that cloud over your head.

In a previous column, you encouraged the high-libido member of a couple to ask his lower-libido partner to “just do it,” but I find it discouraging to be told that people like me should be “cured” of our lack of desire. I sometimes want to have sex, and I take advantage of those rare occasions to reconnect with my partner, but between those times I feel compelled to fake interest. I then begin to resent my partner, though it’s not his fault, and the downward spiral begins. How I should exist in relationships when I don’t possess erotic desire?

Not Feeling It

Cheryl Strayed: I feel for you. There’s a tremendous burden that goes along with feeling as if you’re always disappointing your partner and a different, but just as awful, kind of burden that comes with agreeing to do something more often than you want to. Both dynamics negatively impact your relationship, and they also deplete your happiness and sense of self-worth. The first step in making change in our lives is acknowledging that a change needs to be made. I hope your letter means that you’re ready to do that. My advice is that you talk to your partner, not about what you wish were true (that your libidos matched), but what is true: They don’t, and likely never will.

Steve Almond: I’m glad you decided to write us. We heard from others who struggle to feel desire — and who feel pressured by their partners, and themselves. It’s important to acknowledge the many reasons, both psychic and physical, that people don’t feel desire. You’re also right that sometimes those measures that might lead to a higher sex drive, such as dropping a medication, can pose other risks. You’re under no obligation to become more erotically enthusiastic for your partner. Your only obligation is to be honest with him, and to live with the consequences of that honesty. Your partner may not want to be romantically involved with someone who only rarely feels a genuine desire for sex, who has to feign interest the rest of the time, and resents doing so. To put that more affirmatively: You may want to find a partner whose desires are more predicated on nonsexual forms of intimacy.

CS: There are essentially four choices couples make when faced with the conundrum you present, Not Feeling It. They are:

1. Compromise by agreeing to do what they might not otherwise do except to please a partner (i.e. having sex more or less often than they’d prefer). This works best when the compromise feels more like a collaboration than a demand.

2. Change the rules of the relationship. A couple might choose to open a monogamous relationship, for example, so the partner with the higher libido can have his or her sexual needs met from others while maintaining a loving partnership with his or her primary, but less sexually active, partner.

3. End the relationship — or at least the romantic/sexual aspect of it — because No. 1 and No. 2 above are unappealing.

4. Do nothing and feel miserable and resentful about it.

SA: I realize this may sound bleak. That’s not our intention. We’re simply trying to get at the underlying truth here: that you’re sick of being pressured to feel more sexual desire. This pressure, by the way, doesn’t just come from a partner. It comes from the culture at large, which uses a hyped and fraudulent version of sexuality to peddle all manner of products. If you don’t want to “just do it” when it comes to sex, then don’t. But if you also love your partner and want to build a stronger relationship with him, you’re going to have to confront the incompatibility of your desires. The best way to do this is to start from a place of acceptance, then to figure out whether there are ways to compromise, to express your feelings and to meet each other’s needs without judgment or shame. That’s what true intimacy, of whatever form, is about.

CS: I think the most important thing for any of our readers and listeners to take away from this column and our podcast is that you get to make your life — and more than that, you’ll be happier if you do. But to do that you have to be willing to rewrite the stories you’ve been told about a wide range of things; you have to consider things that might scare you. Just as we told the previous letter writer that he had the right to ask for the sex he desired, you have the right to tell your partner that you don’t desire it, or at least not often. The truth has a powerful way of leading us to the light. So speak your truth and hear your partner’s truth. From that place of honesty, you’ll figure out where to go next in this relationship.

SA: One thing I can promise you, Not Feeling It, is that Cheryl and I are not in the business of dispensing cures. It would be dishonest and arrogant to even pretend we have such powers. What we try to do is help people confront their sorrows and disappointments. Sometimes those arise from an unmet yearning for sex. But as you rightly observe, they also arise from the misbegotten notion that the only true measure of romantic intimacy is carnal communion. Regardless of how our bodies operate, that’s not how the heart keeps score.