The purpose of the article is to discuss reciprocity in sexual interaction within a couple relationship in which heterosexual orientation is assumed and satisfaction considered. Reciprocity is modelled as an exchange of services which at its best functions as an unwritten contract, a mutual understanding regarding fairness of returned services, and a desire to comply with this principle together with a loved one/lover. An equal treatment of and balanced attitudes towards one another are present together with a just distribution of benefits and concessions or compromises. Reciprocity involves a relative term although healthy reciprocity can be defined for discussion and assessed as a degree of mutual satisfaction. Sexual interaction issues, skills to obtain satisfaction, and sexual and emotional compatibility are important elements in reciprocity. Understandable communication is an essential contributor in the implementation of reciprocity. Conflict-making dialogue should generally be avoided and connotive meanings of words taken into account. Erotophilia–erotophobia dimensions influence both the learning about and attitudes towards sexuality and contribute to personal and professional abilities to assess sexual problems and to attend to them. Erotic touch is a minimum requirement of love making. Sexual orientation, sexual desire, and intimacy influence sexual compatibility. Equity and exchange models are discussed, and a reciprocity model is proposed.