Elizabeth Bernstein

Lately, when I've been talking with readers about their marriages and long-term relationships, I hear the same question over and over. 'How do I say I'm not satisfied with our sex life?'

Some say they are unhappy because they have little or no sex in their marriage. Others wish they could find the nerve to tell a partner about sexual fantasies or what they really want to do in bed. Most worry their spouse doesn't notice there is a problem and that they feel unfulfilled.

You'd think it would be easier. Sex talk is omnipresent in our culture. We can read sex tips in popular magazines and listen to TV talk-show hosts joke about the latest political sex scandal.

But it's rare to see examples of someone discussing sex with the person he or she actually has sex with. 'Talking about sex as a personal, intimate experience with your partner is a totally different kind of talk,' says Barry McCarthy, a Washington, D.C., psychologist and sex therapist who has written books about nonsexual marriages and how to prevent them. 'You have to be open to talking about what you value and your vulnerability,' he says. No one teaches us how to do that.

How much sex is 'normal' in a long-term relationship? Almost 80% of married couples have sex a few times a month or more: 32% reported having sex two to three times per week; 47% reported having sex a few times per month, according to 'The Social Organization of Sexuality: Sexual Practices in the United States,' a 1994 University of Chicago study considered the most comprehensive in the field.

Married couples have more sex than either dating couples or co-habitating couples, other research has shown. When sex therapists talk about a nonsexual marriage, they mean a couple having sex fewer than 10 times a year, Dr. McCarthy says.

Sex is important but not necessarily at the core of what binds couples together. It energizes the relationship, making each person feel desired and desirable, and serves as a buffer against trials and difficulties, Dr. McCarthy says. When a couple avoids or is conflicted about sex, the disconnection can play an inordinately negative role, he says. Often, if you can repair the sexual bond, the relationship improves as well.

Love's initial romantic phase lasts anywhere from 18 months to three years, experts say. During this time, our hormones are out of control. We are intoxicated with our partner and find it easier to talk about sex.

But in a long-term committed relationship, talking about intimacy is more difficult. 'Earlier in a relationship, by contrast, 'we don't feel like we're springing new or buried parts of ourselves on them,' says Bat Sheva Marcus, licensed master social worker and clinical director of the Medical Center for Female Sexuality in Purchase, N.Y., and Manhattan.

Sexual problems can crop up for emotional and/or physiological reasons, whether it is stress from work and child-rearing, lack of time, medical issues, past sexual trauma or aging. Many couples get stuck in a rut where sex is all or nothing.

Pamela and Kai Madsen, of Riverdale, N.Y., have been married 30 years. They fell in love when she was a high school senior and he was a midshipman at the U.S. Merchant Marine Academy. 'Think 'Officer and a Gentleman' -- a man in a white dress uniform showing up at my graduation with three dozen red roses,' says Ms. Madsen, 50 and an author and blogger about topics including female sexuality.

They had trouble having children. Ms. Madsen underwent fertility treatments during which she gained weight and ended up feeling damaged and unsexy. They worked hard -- Ms. Madsen as the founder of an advocacy organization for fertility issues, Mr. Madsen in information technology -- and eventually raised two sons. They considered their marriage strong and warm.

About 10 years ago, Ms. Madsen started to feel unhappy and unfulfilled. The couple rarely had sex -- and when they did, it was 'efficient,' Ms. Madsen says. Her husband, 54, says, 'We knew exactly what was going to happen every time we had sex.'

Ms. Madsen went to bed around 8:30, woke up at 5 and liked to have sex at night. Mr. Madsen went to bed at midnight, woke up at 7 and liked it in the morning. When his wife asked him to come to bed earlier, he explained that he was still working. 'I acknowledged that we needed to schedule time to have sex more often, but realistically, not much changed,' he says.

Some of Ms. Madsen's friends were having extramarital affairs and encouraged her to do the same. 'I wanted to feel sexually alive again, too,' she says. Instead, she decided to try sex therapy, and several therapists helped her explore her desires. She read erotic books. She discovered that sexual fantasies and role-playing about bondage turned her on -- and she has since written a book, published last year, about exploring her sexuality within a monogamous marriage titled, 'Shameless: How I Ditched The Diet, Got Naked, Found True Pleasure and Somehow Got Home in Time to Cook Dinner.'

It took six months, though, for Ms. Madsen to get up the nerve to talk to her husband about her realization. She blurted it out one night in the kitchen over a pot of chili. 'I love you but there is something I need to tell you,' she said.

Mr. Madsen says he was stunned and hurt. 'My first reaction was, 'Why? What am I not giving her?'' His wife said her dissatisfaction wasn't a reflection on him and invited him to accompany her to a therapy session. They talked about her fantasies and his feelings about them. They learned what turns her on doesn't do the same for him -- and that is OK. They feel sure the frank discussion of sex made their marriage stronger, in and out of bed.

Some couples are so estranged that not only don't they have sex, but they also don't sleep in the same bed or even touch each other. Experts say such couples may need professional help. Not all marital therapists have experience with sexual issues, though. Two groups that can help are the American Association of Sexuality Educators, Counselors and Therapists or the Society for Sex Therapy and Research.

To jump-start their sex life, couples need to start by sleeping in the same bed, experts say -- no kids, no pets. Spontaneity is great, but 80% of married couples schedule time to have sex, says Dr. McCarthy -- preferably when not dead tired.

Try showing more physical affection. 'A lot of couples don't have any touch if they aren't going to have intercourse,' says Dr. McCarthy. 'But touch has value in and of itself and can be a bridge for desire.'

Still too embarrassed to talk? Get a how-to book. Put sticky notes on pertinent pages. Add a message: 'This embarrasses me to talk about, so I thought I'd show you.' With a smiley face.

Breaking the Ice

Having trouble discussing problems in your sex life with your spouse? Here are some ways to make it easier.

-- Be gentle. Need an opening line? 'I love you, and I'd like to feel more connected to you.'

-- Never discuss sex right after having sex (unless you have only good things to say). Sex therapists say the best place to discuss sex is out of the bedroom -- in the kitchen while making dinner, on a walk, taking a drive.

-- Realize that the discussion may take more than one conversation. You don't have to knock it out all in one sitting.

-- Don't ascribe blame. Don't psychoanalyze. Just describe what you feel is the problem. 'You seem much less interested in sex than you used to be.' Ask if your partner has noticed this as well.

-- Tell your partner five to 15 things you really like about him or her. Never say, 'If you loved me, you would . . .'

(In nearly a decade at The Wall Street Journal, Bonds columnist Elizabeth Bernstein has covered education, philanthropy, psychology and religion - all areas in which personal relationships loom large. Now, Elizabeth is using her acquired insights and expertise to explore the manifold aspects of human interactions, whether at home, at work or among friends.)