Content warning: This article discusses sexual themes, including sexual trauma, that may be triggering to some readers. 

There’s no shortage of advice out there for improving the sex in your marriage or relationship.

And even though it may be well-intentioned, much of this advice is not all that helpful. It usually tends to focus on sexual positions, which ignores deeper-rooted issues, and is seldom given by experts.

In a committed relationship, a satisfying sex life is about more than just a physical connection. It results from a deep emotional connection in which both partners feel safe and secure. The good news is if you’ve lost this sense of connection, it can be rebuilt in most cases.

We sought out the expertise of Yvonne Cordoba, MSW, LICSW, a couples therapist here at Northampton Center for Couples Therapy who specializes in addressing sexuality-related concerns. She has a Sex Therapy Certificate from the California Institute of Integral Studies (CIIS), and her approach is trauma-informed, patient-centered, and leans on the wisdom of the physical body to navigate the work.

“There’s no one-size-fits-all approach to improving your sex life,” Cordoba explains. It depends on a variety of factors as each partner brings their unique perspectives and experiences to the relationship.

What are the most common sexual issues couples face?

If you feel like you’ve lost the passion in your relationship or are struggling to connect sexually with your partner, you’re not alone. We asked Cordoba about the most common sexual issues and concerns she sees in her work with couples.

Sexual trauma

According to the Rape, Abuse & Incest National Network (RAINN), the nation’s largest anti-sexual violence organization, one in six American women has been the victim of an attempted or completed rape in their lifetime. One in 10 rape victims is male. It goes without saying that sexual trauma can impact the experience of sex in a relationship. And if left untreated, it can make sex a triggering and even re-traumatizing experience.

Sexual desire discrepancy

A sexual desire discrepancy (SDD) is when one partner wants sex more than the other. According to a 2015 study conducted by Samantha Joel, the Director of the Relationships Decision Lab at Western University, 80% of couples experience a sexual desire discrepancy in their relationship. While it’s very normal to have a sexual desire discrepancy, it’s essential to manage it so that it doesn’t lead to resentment, hurt feelings, or going outside the relationship to meet sexual needs.

No sex

There are a lot of reasons why couples don’t have sex. One of the most common is they’re not talking about it. Research from Dr. John Gottman shows that only 9% of couples who can’t comfortably talk about sex with one another say that they’re satisfied sexually.

Difficulty reaching orgasm

Anorgasmia refers to difficulty or delay in reaching orgasm. This can cause distress and feelings of shame for the person experiencing it, and it can also cause their partner to feel insecure about their level of sexual attraction. In heterosexual relationships, women typically have fewer orgasms than men. Research from the Kinsey Institute at Indiana University found straight females only achieve orgasm during 63% of sexual encounters compared to 75% of lesbian women. And in a study conducted by the European Network for the Investigation of Gender Incongruence (ENIGI), one of the most frequent sexual dysfunctions experienced by trans women and trans men was difficulties achieving an orgasm (29% and 15%, respectively). 

Lack of sexual confidence

Lack of sexual confidence can lead to sexual insecurity and anxiety. Body image plays a big role here. According to one survey of 8,500 people conducted in 12 European countries, 94% of respondents believed it’s important for a man to be sexually confident for good sex.

Premature ejaculation

Premature ejaculation (PE) is defined as a persistent or recurrent pattern of ejaculation occurring during partnered sexual activity. There are four subtypes of PE (lifelong, acquired, natural, subjective), each with unique psychological concerns and issues.

Difficulty getting an erection

Erectile dysfunction (ED), which is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is the most common sexual problem in men. ED can be caused by physical factors like aging and alcohol use as well as psychological factors like performance anxiety. In some cases, medication may be required.

Low sex drive

Low sex drive can be caused by many different factors, including stress, anxiety, and depression. According to the Dual Control Model of Sexual Response popularized by sex educator and professor Dr. Emily Nagoski, we all have a “gas pedal” (accelerator) and “brake pedal” (decelerator) as it relates to sexual intimacy.


It’s natural for sexual desire to change over time as our bodies age, especially for women after menopause. With that said, many older couples report having better sex lives because they have fewer distractions and more time.

Recommended resources to improve your sex life

Depending on where you are in your sexual journey, you may want to be more in your body, you may want to be more in touch with your pleasure, you may want to know how to start conversations with your partner, or you may want to read and intellectualize sex and desire first. Here are some resources Cordoba recommends to her clients.

Calm app

The Calm app is more than just a meditation app. It has an intimacy section that can help build a practice of getting inside your body. Once you feel comfortable in your own body, then you can incorporate your partner.

Yes/no/maybe list

Make a yes/no/maybe list: “yes” for I always like these things, “no” for I will never like these things, and “maybe” I’m open to these things. Share your list with your partner and agree to try something new if you’re both open to it.

So Tell Me About The Last Time You Had Sex by Dr. Ian Kerner

Read So Tell Me About the Last Time You Had Sex by Dr. Ian Kerner. In the book, he introduces the idea of a “sex script,” which is the sequence of interactions (physical, emotional, psychological) that underlie the last time a couple had sex. By talking about the last time you had sex, you can understand and even rewrite your sex script.

Mindful masturbation

Mindful masturbation is the practice of sexually self-pleasuring while maintaining awareness of your body and feelings. Understanding your preferences allows you to communicate your desires to your partner better.


OMGYES is an interactive sexual education website helping women have better orgasms with science that’s been backed by Emma Watson. In an Indiana University School of Medicine study of 807 couples, comparing before & 1-month after using OMGYES, 95% experienced new kinds of pleasure, 89% experienced more pleasurable sex, and 81% discovered new ways to tell their partner what they like.

Sex with Emily Podcast

Listen to the Sex with Emily Podcast hosted by Dr. Emily Morse, an American sex therapist, author, and media personality. Sex With Emily is the longest-running sex and relationship podcast. Dr. Emily also has a popular MasterClass on sex.

Ethical porn

Watching ethical porn individually or with your partner can be a great way to experience sex differently. Lust Cinema has feature-length adult films and series. Audio porn is another option if you’d rather listen than watch. Dipsea has an entire collection of audio stories.

Come as You Are by Dr. Emily Nagoski

Read Come as You Are by Dr. Emily Nagoski. In the book, she explains that every woman has her own unique sexuality and that women vary more than men in their anatomy, sexual response mechanisms, and the way their bodies respond to the sexual world. She recently released a helpful companion workbook to the book.

Erotic love map

Build an erotic love map of your partner’s inner world, which is a concept developed by Drs. John and Julie Gottman. This map details your partner’s sexual preferences, needs, and desires. Keep it updated as they change over time.

Again, sexual intimacy is different in every relationship because each person brings their unique history and experiences to the table. What works for someone else may not work for you, and that’s okay. 

The important thing is to communicate openly and honestly with your partner about your needs and desires. And if you get stuck, don’t hesitate to ask a licensed professional for help. 

Want to improve your sex life? NCCT currently offers couples therapy online and in person in Northampton, Massachusetts. Click here to talk with an expert

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