I almost always need to come first. I have a difficult time with orgasm, since peri-menopause graced me with her ill-fated presence, much too early a few years ago. I used to be able to orgasm so easily, I would make My Man stop and do different things as I would otherwise come so early in out sex episode that I would lose interest before he was able to come.
As I have gotten a bit older, not only have I gained the ability to have multiple orgasms, but I remain aroused after a number of orgasms. I no longer lose interest after my first orgasm. But, as it is sometimes difficult for me to have my first orgasm, we usually try to get me to come first and then he gets his. I also tend to relax quite a bit after my first orgasm and can actually enjoy the rest of the sex session without worrying "Am I going to come?" and thus more orgasms seem to come more easily.
In the evening, My Man sometimes gets sleepy, even if he hasn't had an orgasm yet. I don't like him falling asleep while I am trying to get there, so we usually try to get my first one done first.
As for what he'll do? Just about anything to help me come. Sometimes he's so exhausted after I finally get what I need that he'll manfully engage in some PIV or anal just to please me, and put off his own orgasm until morning. He doesn't seem to mind, as he's asleep in about 30 seconds after telling me "Sweetheart, I'm done. We'll finish in the morning." and then I have a nice quickie session to look forward to the next morning as I fall asleep.
Honestly, I do prefer it when we both get to come during each session. I've been known to beg him to let me play with him, suck him, do anything he wants, because I feel SO good after coming, I want him to feel the same way at the same time. When we're lucky (about 3/4 of the time) we both get what we need in the same evening session. I usually don't come during weekday morning sessions, he has to get to work and there just isn't time for the 30 to 45 minutes I need to orgasm. But, I'm always happy for a quickie in the morning, knowing there will be more that night.