Introduction <p>In the context of couples, the focus has traditionally been on partnered sex, relegating solitary masturbation to second place, although it is also part of the sexual repertoire of this context and its importance for sexual health. We aimed to investigate the patterns of frequency of solitary masturbation and partnered sex, sexual functioning, and sexual and relationship satisfaction in men and women in a different-gender relationship.</p> Methods <p>A total of 1028 Spanish adults with a history of relationships exclusively with different-gender partners aged 18–75&#xa0;years (<i>M</i> = 37.08; <i>SD</i> = 11.95) were evaluated. Cluster analysis divided the sample into three groups with different patterns: a group with high frequency of partnered sex and solitary masturbation, a group with high frequency of partnered sex but low in masturbation, and a group with high frequency of solitary masturbation but low in partnered sex.</p> Results <p>Overall, the results show that, especially in women, the combined practice of partnered sex and solitary masturbation is associated with positive indicators of sexual health. In addition, men and women who masturbate more frequently but have less partnered sex present indicators of poorer sexual health.</p> Conclusions <p>The results show that solitary masturbation is important for assessing sexual health in the context of the couple.</p> Policy Implications <p>Given that the combination of partnered sexual activity and solitary masturbation is linked to better sexual health indicators, particularly in women, sexual health education programs should include discussions on the benefits of diverse sexual practices.</p>