You will not be surprised to hear that for many women, particularly from peri-menopause onwards, sex with a long-term partner is no longer a carefree tumble fuelled by hormones and novelty.
Here, sex and relationship therapist Natasha Silverman explains three of the most common problems couples bring to therapy, and how they can start to resolve them.
Our sex drives don't match
Desire discrepancy is the main problem I deal with in my practice.
In heterosexual couples, it is often the man who wants sex more often. But that does not mean his partner's libido is broken.
It could be because she does not feel desired. I've had women say 'the only time he notices me is when he wants sex'. I tell the higher desire partner, stop the pressure.
It's normal to feel hurt if a partner says no, but comments such as 'why don't you want sex any more?' or 'what's wrong with you?' act like a wet flannel on a flickering flame of desire.
But there's another reason women might not seem keen.
Men often want sex because they feel what we call 'spontaneous desire' - he wants sex because he just happens to feel like it.
But most women don't experience desire in that way, particularly after the first two years of a relationship.
Instead, many women experience responsive desire.
So they may not start out in the mood, but once a sexual cue - a sexy film, a kiss, a playful touch or even being in a hotel with clean sheets and no children - sparks something, their arousal begins to build.
Women tell me, 'I enjoy it when we do have sex, but I don't often feel in the mood', not realising this is completely normal.
Sometimes just being open to pleasure can mean having more sex.
'I've always faked it: I want a real orgasm'
Often faking orgasms begins right at the start of a relationship. A woman might be trying to appear sexually confident or protect her partner's ego.
She might think: 'He's trying so hard and I don’t want him to feel inadequate.'
Sex might even start to feel physically uncomfortable. So she fakes it to bring the experience to an end.
But every time you fake an orgasm you are training your partner to do the same thing next time, because it worked - or seemed to.
Often, the problem is a misunderstanding about how women's bodies work. More than 70 per cent of women need clitoral stimulation to have an orgasm, and often 15 to 30 minutes of it. Slowing down can certainly help.
Women have several ways to address the situation. The most honest approach is simply to tell your partner.
To do this tactfully, you could say, 'I thought there was something wrong with me. I was trying to protect your feelings.'
'Now I realise I didn’t understand my body well enough and I want us to explore what works for us.'
While the conversation may feel daunting, many feel relief afterwards. In my experience, most men say they’re glad their partner told them.
Often, they suspected something wasn't right and they welcome the chance to experiment in the bedroom.
If you really cannot face revealing the full truth, a softer starting point might be to say: 'My body has changed over time - perhaps after children or menopause - and my orgasms aren't as powerful or satisfying as they used to be.'
'I'd love to experiment more with what feels good for me, or even bring a small sex toy into the bedroom.'
While these discussions may make you feel vulnerable, you cannot build real intimacy without openness. When couples talk about sex honestly, they can achieve a much better sex life and relationship.
'Other couples have more sex than us'
It's common for people to think everyone else is at it like rabbits. But periods of low or no sex are completely normal. Childbirth, bereavement, stress or job changes can all affect desire.
Statistics back this up. Around a third of people had no sex at all in the past month and the UK average is less than once a week.
It's really not that common to be having sex three times a week in a long-term relationship. The quality matters more than quantity.
Sometimes what needs improving is what is going on outside the bedroom. This can include how couples speak to each other, how they show affection, whether they still nurture the relationship, such as a kiss when your partner leaves the house, compliments and kind words.
Even couples who have gone years without sex should not assume things are beyond repair. I've worked with couples who hadn't had sex for 20 or 30 years and still found their way back.
It's about rebuilding safety and small physical connections, not rushing straight into intercourse.