Heiman et al. (2011) reported that in a large sample of midlife and older couples in five countries, frequency of sexual activity in the past 4 weeks was associated with greater sexual satisfaction but unrelated to relationship happiness in both sexes, which led them to state that ‘‘[T]he degree of independence/dependence of sexuality and relationship satisfaction is a point of disagreement in the literature with evidence in both directionsbutoftensupportingamore independent factor structure’’ (p. 751). The determinants of sexual and relationship satisfaction are certainly an important topic to be examined cross-culturally. However, the summary measure of sexual activity that they employed is misleading, as it suggests that all partnered sexual activities could contribute equally well to sexual satisfaction, and that relationship happiness is largely independent from the sexual activity of the couple. In fact, when sexual activities are differentiated, a different picture emerges. In large nationally representative Swedish and Czech samples, univariate analyses showed that sexual and relationship satisfaction were associated with greater frequency of penile– vaginal intercourse (PVI) (Brody & Costa, 2009; Brody & Weiss, 2011; Weiss & Brody, 2011). Sometimes, in univariate analyses, greater frequency of partnered noncoital activities is associated with sexual and relationship satisfaction (Brody & Costa, 2009), but univariate analyses might be misleading because many people have noncoital sex as a preliminary to PVI. Indeed, multivariate analyses controlling for frequency of specific sexual behaviors (and age) reveal that sexual and relationship satisfaction are positively associated with PVI frequency, but unrelated or even inversely related to frequency ofpartnered noncoital sexualactivities (BrodyC Philippsohn & Hartmann, 2009; Tao & Brody, 2010). In a Portuguese study, greater PVI frequency was associated with several components of relationship quality (satisfaction, love, trust, intimacy, and passion). Noncoital partnered sex frequency was unrelated to all components of relationship quality, and masturbation was inversely associated with love (Costa & Brody, 2007). Interestingly, other sexual factors that contribute to sexual and relationship satisfaction beyond PVI frequency are other aspects of PVI, such as satisfaction from PVI (Philippsohn & Hartmann, 2009), erectile function (Weiss & Brody, 2011), simultaneous PVI orgasm (Brody & Weiss, 2011), and capacity to attain vaginal orgasm (triggered by penile–vaginal stimulation without simultaneous clitoral masturbation) (Brody, 2007; Brody & Weiss, 2011; Costa & Brody, 2007). In the cited Czech study, for both sexes, simultaneous PVI orgasm was associated with sexual and relationship satisfaction, independently of the significant contribution of PVI frequency (Brody & Weiss, 2011), and scores on the International Index of Erectile Function-5 (IIEF-5) generated by both men or female partners were equally associated with sexual and relationship satisfaction, independently of the significant contributions of PVI frequency and, in the case of women, also of the capacity to attain vaginal orgasm (Weiss & Brody, 2011). In a study of German women, multivariate analyses revealed that sexual satisfaction was predicted by PVI frequency and satisfaction from PVI, but not by frequency nor satisfaction from R. M. Costa (&) S. Brody School of Social Sciences, University of the West of Scotland, Paisley PA1 2BE, UK e-mail: rmscosta@gmail.com