I used to have wonderful vaginal orgasms. Why did they stop – and how can I get them back?

My husband and I still have sex – but something’s missing. Is stress the culprit?

I’m a woman in my 50s and have been with my husband for decades. We have always had a wonderful sex life and I used to be able to climax vaginally very easily, often without clitoral stimulation. During an eventful time for the family a couple of years ago, my libido and ability to climax disappeared, though they did eventually return. A few months ago, I had a health crisis, which has slightly impaired my coordination on one side. Although I have recovered very well, I am again experiencing a loss of libido and sexual sensation.

We continue to have sex regularly and I enjoy the intimacy. I can climax with clitoral stimulation but it takes a long time and can be almost physically painful. I really miss vaginal orgasms and the release they brought. Although I am of perimenopausal age, I have no obvious symptoms and a hormone test came back normal.

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.