My ability to orgasm from penetrative sex seems to come and go. With some partners, I never climaxed; with others, I was able to climax at the beginning of the relationship and then became unable to; and then there are those with whom I had no issues climaxing. Now, I have suddenly become unable to orgasm from penetration with a partner that I previously had no problem climaxing with. I know people chalk it up to being a mental thing, or stress, but the relationship was great, the sex was great and out of nowhere I just became unable to feel anything during penetrative sex. We have been trying to solve this for 11 months.

Is achieving orgasm through penetrative sex really so important to you? Many people see this as an ideal and even (erroneously) consider that there is something wrong with a woman who cannot climax during vaginal intercourse. For most women, though, the main physiological pleasure centre is the clitoris, which is located outside the vagina. So, in order for a woman to have an orgasm during penetration, areas related to the clitoris have to be stimulated; very often, direct clitoral stimulation has to be employed. So, in worrying about the elusiveness of one type of orgasm, you are expecting a great deal of yourself and of your physical sexual response.

It is normal to have times when orgasm does not occur for one reason or another. Sometimes, a change in position will help the connection with clitoral nerve endings, or with an area sometimes referred to as the G-spot. Experiment, but avoid being goal-oriented during lovemaking, as that will set unrealistic expectations, increase anxiety and reduce the likelihood of reaching orgasm. Instead, try to simply focus on giving and receiving pleasure.

Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.