The frequency of sex in long-term relationships worries many couples. It was therefore not surprising when Doris accompanied her husband, Johnson, to the Sexology Clinic in search of answers.

The couple had been arguing about how often they should be intimate. Johnson insisted that Doris was behaving abnormally and needed help. Doris, on the other hand, believed her husband was simply ignorant and needed some education.

The bone of contention was that the frequency of sex in their marriage had been progressively declining. They were now in their fourth year of marriage and were having sex only once or twice a week.

“When we got married, we would do it three or four times a day,” Johnson explained. “I do not understand why my wife now prefers to keep off and keeps giving excuses.”

“What do you mean, keeping off and giving excuses?” Doris interrupted, sounding offended. “Did I not explain that my desire has gone down since the baby came? Do you want me to fake pleasure?”

I asked the couple to calm down and began explaining aspects of sexual desire that commonly bring conflict into relationships. It is normal for the frequency of sex to be high in a new relationship. Over time, however, it settles into a more stable pattern. This stability often occurs after about two years, when rational thinking gradually replaces the intense hormonal drive that initially draws partners to each other.

Read: Why some people fail to satisfy their spouses sexually

In women, sexual desire also fluctuates throughout the month. There are days when desire is naturally higher and others when it is simply absent, largely because of hormonal changes. The arrival of a baby, coupled with breastfeeding demands and sleepless nights, often reduces the attention a woman can give to sex.

“Yes, please explain this to Johnson. It can never be the same,” Doris said enthusiastically.

Men also have their off days. When a man is under stress at work, he may lack the mood or energy for sex when he gets home.

“So exactly how often do normal people have sex, taking all these factors into account?” Johnson asked, looking uneasy with the discussion. One Canadian research study found that many couples had sex only once a week. Researchers then assessed the couples' happiness and relationship satisfaction to determine whether there was any difference between those who had sex once a week and those who did it more frequently. The study found no significant difference in happiness or satisfaction between the two groups. Couples who had sex less than once a week, however, were generally less happy. The researchers concluded that having sex at least once a week is important for marital well-being.

Read: How a woman in a sexless marriage feels

From a medical perspective, having sex two to three times a week is considered frequent enough for optimal biological functioning. Couples experiencing difficulty conceiving, for example, are often advised to have sex two to three times a week.

“We have been having sex at least three times a week. In fact, sometimes up to five times,” Doris chipped in. “My husband gets worked up when a day passes without it.”

“True, but even when we do it, it is just once a day. It used to be many times a day,” Johnson protested.

In sexology, having sex more than 15 times a year generally does not raise concern. Fifteen or fewer times annually is considered a sexless marriage and often warrants professional attention. In many cases, there is an underlying problem causing couples to avoid intimacy. These problems may range from relationship dysfunction and unhealthy beliefs about sex to medical conditions that interfere with sexual performance.

It is also important to recognise differences in sexual desire between partners. Your spouse may naturally desire sex more often than you do, and this mismatch can become a source of frustration. It helps to discuss the issue openly and find a balance that both partners can comfortably live with.

“What if you have a man who selfishly thinks you are sick simply because he has a higher sex drive than you do?” Doris asked.

“That is not being fair,” Johnson interjected. “I am not selfish, and I care. That is why I agreed to attend this clinic.”

Read: When belly fat gets in the way of intimacy

When couples find it difficult to agree, seeking professional help is always advisable. Conversations about sex can be uncomfortable, but sexual health professionals create a safe environment where difficult issues and hurt feelings can be discussed openly and constructively.

Another important point is that, as relationships mature, quality often becomes more important than quantity. Most couples eventually find greater satisfaction in one fulfilling sexual experience than in trying to recreate the marathon sessions of their early years, only to end up disappointed.

Doris and Johnson decided to focus on improving the quality of their sexual experiences. They realised that their frequency was healthy enough, although they still had some differences in sexual desire. They attended three months of sex coaching to address this mismatch and improve the quality of their intimacy.

As Johnson put it at the end of the three months, the coaching marked the beginning of "a fun-filled, fulfilling intimate relationship" that he truly cherished

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