And the alternative is essentially choosing rape for her. Sorry, but you have a hand... Or work out a "hall pass" scenario or something.

As I've already noted, I am all for couples working this through so it doesn't come to that point, but for some, it just may be too damned bad. I have a friend whose family has a history of breast cancer - both her mother and sister have had it. Hormone replacement therapy is associated with increased risk of breast cancer, particularly when there's already a risk. So, without HRT, sex is painful for my friend - which has led them to decide that sex is off the table - for the rest of their lives. Should she put up with painful sex just because it otherwise "robs" her husband of access to her body? No, of course not!