Q: I'm a 45 year old male and have been happily married to my wife for over 20 years.  One of our few points of contention is the fact that we only have sex once or twice a month. This is fine for her, but I have a higher sex drive, and this sometimes isn't enough for me.  Is our sex life normal?

A: Yes, your sex life is normal. It may be slightly below the national average (about once per week is the average sexual frequency for an American couple), but mismatched libidos are very common. In fact, desire discrepancy is the most frequent presenting complaint of couples seeking sex therapy.

Usually, the partner with the higher libido is the one who hopes that the therapy can somehow "fix" the less interested partner or motivate him or her to have sex more often. Unfortunately, there are no quick fixes when it comes to mismatched libidos but rather multi-factorial constitutional differences when it comes to our sexual desire--some of us just like to have sex more than others!

The first step would be to collect you and your wife's dating, sexual, and medical history. Was your wife's libido always lower than yours, or are there precipitating factors--such as childbearing, work stress, depression, medical conditions or menopause--that lowered her libido? Does she express satisfaction with your sex life? What are triggers for her arousal or pre-conditions for her desire (good nights' sleep, lack of distraction), and how often are they met?

Once these variables are known, a therapist can devise a treatment plan to boost your wife's libido. This plan may include lifestyle modifications, hormonal balancing, altering sexual scripts (changing when, where and how you make love and introducing novelty) and enhancing areas of intimacy and communication skills The key, of course, is for her to want more sexual interactions with you--otherwise, her motivation to go through with the treatment plan is likely to be low.

Dr. Victoria Zdrok is the author of Anatomy of Pleasure: The Head to Toe Guide for Better Sex and a sexuality expert for Liberator Bedroom Adventure Gear.  She earned her Ph.D.in Clinical Psychology from Drexel University in Philadelphia.