Several years ago, a colleague referred a couple to me for treatment of a sexual problem. When I asked what the problem was, he said he didn't want to bias my judgment and suggested I hear about it directly from them.
The couple was very attractive. Both were successful 40-somethings; each had been married previously. When I asked what the problem was, the husband volunteered, "My wife doesn't have enough orgasms." He then informed me he had to go to work and left my office. In his mind, the problem belonged exclusively to his wife.
The woman then explained that her husband's success in business allowed them very flexible schedules. Her husband felt that romance should be part of every day, with candlelight, soft music, and sex. Although she liked this scenario, she had problems with her husband's insistence that in addition to having sex every day, she also experience an orgasm during each sexual encounter.
The husband viewed sex as a contest: he won if his wife had an orgasm but lost if she didn't. It was critical to him that she experience as many orgasms as possible, not to enhance her pleasure and satisfaction with their sex life, but rather to sustain and support his self-image as a great lover.
This is an example of a couple who had an excellent sex life in the context of a great married life who, nonetheless, did not enjoy their sexual intimacy. The husband had made their sex life into a win-or-lose contest for both of them. They were winners if she had an orgasm, thus fulfilling his image of himself as a consummate lover. They both lost if she didn't have an orgasm because it meant that he'd failed to achieve his ego ideal, and she'd been made to feel inadequate and responsible (along with him) for that failure.
Human sexuality is a natural source of great personal pleasure and satisfaction. When encumbered by competition, scoring, and rules, it's almost certain to become a great deal less so.