I have lost sensation in my penis - and long to orgasm with a partner

I’m 64 and have had many lovers, but I can now only climax through masturbation, and frequently find myself faking it in bed

I am a 64-year-old single man and have had more than 30 sexual partners in the 15 years since my divorce. However, I haven’t achieved orgasm by any means other than masturbation in years. It doesn’t matter what my partners try, I can’t climax, and I frequently fake orgasms because they get frustrated and I get tired. I was diagnosed with multifocal motor neuropathy several years ago, and my penile sensation is definitely diminished. Using a condom makes it worse, but I comply with a partner’s wishes for our protection. Even with masturbation and visual stimulation via pornography, it may take me more than 30 minutes to have an orgasm. I know there is a lot to unpack here, but what do you suggest?

There is way more to sex than a race to orgasm. You are smart and self-aware sexually, but you are failing to truly experience pleasure because you are now (understandably) goal-oriented and fearful. Many people subscribe to the idea there should be one particular pattern to lovemaking – usually the one that starts with a bit of “foreplay” and proceeds to the “main event” of orgasm. Stop thinking like this. Instead, focus on pure pleasure rather than on achieving a climax. Consider the possibility that foreplay is overall a more erotic and pleasurable main event and that orgasmic ecstasy is a very brief, not altogether necessary, exclamation mark at the end. An enormous amount of prolonged pleasure awaits you and your partner if you can approach sexual encounters in this way and be honest about what works for you and what doesn’t.

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

If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.