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By "Today" contributor
TODAY
updated 1/27/2005 12:32:38 PM ET 2005-01-27T17:32:38

“Sheila” has just picked up a floor strewn with toys, cleaned up puddles of water from three over-enthusiastic baths, begged her children to eat dinner, and then pleaded with them to go to sleep.

Now, Sheila just wants to collapse onto her own bed, zone in front of some mindless television and go to sleep.

“Tom,” on the other hand, has come home from a long and frustrating day at the office and is looking forward to making love with Sheila once the kids are tucked in.

When Sheila rebuffs him he feels hurt and angry. He feels that she never wants to have sex, and when they do have it, it's only once a week, and even then it seems as though she isn't interested.

Tom feels unloved and ignored. Sheila feels like Tom always wants sex, regardless of how tired she is. She feels guilty that she has lost her desire for lovemaking and tries at least once a week to do it for him although it really isn't pleasurable for her.

A wedge of frustration and hurt is growing between them and they feel unable to find a way out.

This is an extremely common scenario. Sometimes the man wants sex more often, or sometimes the woman does. Or maybe he wants to leave the lights on during lovemaking and she wants them off. In another instance, she may want more foreplay, and he wants less foreplay. There is also the issue of different positions, different practices, fantasies, styles and levels of desire.

Partners often come to the table with different sexual needs, or they develop them along the way. It doesn't take long for these differences to erode at the intimacy in the relationship and create real turmoil. 

Because both men and women are often uncomfortable talking about sex, they may just let their anger and hurt fester, with no hope for working on the problem. When a sexual relationship fails, the marriage is often not far behind.

Some women say: "Sex isn't that important, as long as we get along." That's true if you want a roommate, but it really doesn't work for a marriage. A good sexual relationship is a crucial ingredient, and communication is the key.

If you and your spouse bring different appetites to the table, what can you do to make it work? Here are some strategies:

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1. Choose to be open minded
As best-selling author John Gray has written in "Men are from Mars and women are from Venus,"  you should expect some differences in desires between the sexes.

In addition, no one is your clone, so there are bound to be differing tastes. You can stay stuck in the belief that the way you like things is the "right way", and that what he wants is "abnormal," or "gross". If you want to make it work, try to keep an open mind and see that your partner is offering you the chance to try some new dishes from the menu. If you can listen to what they want, and give it a tryout, then you may find you like it.

2. Create alone adult time
I can't really emphasize this one enough! If you cannot create child-free, work-free time to have pure adult fun, then it is not fair to expect either of you to be in the right frame of mind to get back to enjoying sex.

I know, I know -- you are much too busy.  Well, who isn't? It's all a matter of priorities -- and this should be at the top of the list.

If you’re worried about taking time away from the children, consider this: If you and your spouse are miserable, then chances are your kids will know it.

Get a sitter if you can once a week. Every once in a while, ask your mom (or another relative or close friend) to babysit for the weekend -- and go away with your partner. If that is financially unfeasible, swap with a girlfriend so each of you will get a romantic night with your husbands. Worst-case scenario, tell the kids they are going to bed a little early (because you are very tired) and plan a romantic evening in your room, with the door locked. You need time to talk, have fun and feel relaxed together so that you can discuss how to make matters better in bed.

3. The road to compromise
Making things better takes discussion, honesty and effort. Communication, of course, is the key here. You need to tell your partner what you like and why. Then you need to really listen to what they want and try to understand. Do not judge or be critical of what your partner thinks is sexy and ask that he do the same.  Your partner's sexual desires may run the gamut, but as long as no one gets hurt, two consenting adults are entitled to explore their sexual appetites.

Being willing to give something a try, goes a long way towards making them feel you really care. If you try something once and you really don't like it, then it's perfectly fine to say you don't like it. You have to know that you will not be pressured into doing something you don't like.

If you approach it as something you want to try, rather than have to do, you may find that expanding your sexual horizons is exciting.

4. Rule out a medical problem
Sometimes the cause of your lack of sexual interest may be a medical one. A drop in testosterone level, onset of menopause, various medical illnesses or a new medication can all result in a change in libido. If the problem is a real change from your previous sexual situation, see your gynecologist or urologist to rule out a medical problem.

5. Seek therapy
There’s a chance it could be medical, but most sexual problems are psychological, due either to difficulty both within the relationship or within your own view of your sexuality (or both). Sometimes the hurdle is too hard to jump on your own. A therapist can help by dealing specifically with the sexual problem or differences between you.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to “Today.” For more information, you can visit her Web site, www.drgailsaltz.com.

© 2013 MSNBC Interactive.  Reprints

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