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Tune into any TV show, the radio, or your Twitter feed, and the message is clear: If you’re in a relationship, you should be having hot, mind-blowing, on-top-of-the-table sex … all the time.

Yet research shows that 10 to 20 percent of romantic relationships in the United States are “sexless,” according to Robert Epstein, PhD, a San Diego-based research psychologist and founder and director emeritus of the Cambridge Center for Behavioral Studies in Beverly, Mass. That accounts for about 40 million people in the United States.

And that may be an underestimate, because people are reluctant to ‘fess up about no-sex relationships. Because of society’s obsession with sex, some couples feel ashamed to admit that they're not experiencing a certain level of sexual frequency or satisfaction.

In fact, one survey found that 30 percent of male participants in their 40s and 34 percent in their 50s who were in a relationship hadn’t had sex the previous year. For women in their 40s and 50s, about 21 percent reported no sex with their partner in the previous year.

So what’s really going on in America’s bedrooms?

What ‘Sexless’ Really Means

Technically, a sexless relationship is defined as when a couple has sex less than once a month or less than 10 times a year, says Dr. Epstein.

What does that mean for your relationship? One thing is for sure — it doesn’t mean your relationship lacks love, says Jennifer Freed, PhD, marriage and family therapist in private practice in Santa Barbara, Calif. She estimates that about 5 to 7 percent of the couples she sees in her practice are perfectly happy in their sexless marriages.

If you’re in a sexless relationship, the main thing you should ask yourself is: Are you and your partner content about not having sex?

Are Sex-Free Marriages Always a Bad Thing?

Relationships lose the sex factor in a variety of ways. Both partners may have a very low sex drive and choose not to have sex very often. Sometimes, however, life gets in the way: A couple’s sexual satisfaction may be disrupted by pregnancy or a new baby, health problems, or aging in general.

Epstein remembers a psychology professor who said this: When sex is good, it’s 5 percent of the marriage, but when it’s bad, it’s 95 percent of the marriage. “The key is to understand what’s good and bad,” he says. Good means that each person’s sexual needs are being met. Bad means that at least one person’s needs are not being met.

If both members of the couple have a very low sex drive and their needs are being met, then they can have a perfectly happy, sexless marriage, he says.

When there’s a physical reason behind the lack of sex, such as a health problem, and both members of the couple have agreed that they’re okay with their rate of sexual activity as a result, they can also be happy. After all, couples can hug, cuddle, hold hands, give each other back rubs, spoon, and be intimate in other ways.

Problems occur when there’s an imbalance. This could happen if one partner has a low sex drive and the other has a high sex drive — even if they both started out with similar sex drives and then one’s sexual satisfaction needs changed, or if one partner develops a health issue, such as incontinence, that leads them to shy away from sex, and the other partner isn’t happy with the change.

Not very surprisingly, many people in sexless relationships aren’t happy. According to preliminary data that Epstein has collected from 3,000 people in the United States and Canada, 4.8 percent of men identify themselves as having a low sex drive, and more than twice as many — 10.8 percent — of women say they do.

“That’s a big difference,” Epstein says. “It suggests that females in general will be with males who have higher sex drives.”

What Should You Do About Your Sexless Relationship?

If you’re wondering where your relationship falls, take one of Epstein’s research tests online at arewegoodtogether.com or myloveskills.com.

Sexless relationships aren’t something for couples to aim for, Epstein says. Becoming sexually intimate is good for emotional bonding and great for your health and well-being. It burns calories, strengthens your immune system, has cardiovascular benefits, elevates your mood, and feels good.

But couples also shouldn't feel as if they have to measure up to the Hollywood standard of sexual satisfaction or performance, Freed says. “Successful relationships have to be something that you create uniquely,” she says.

If you’re concerned about the state of your sex life, get more information on therapy, treatments, and ways to spice things up in our Sexual Health Center. By Marie Suszynski