I am five months pregnant and my husband has not had sex with me since conception. This is the longest we have gone without intercourse. We do still kiss and cuddle, but nothing further is initiated. While I have put on weight, it has been limited to my abdomen, and I don't feel as though I'm giving off signals of a lack of self-confidence. I tried to broach the subject once, and he said he was tired. Does he find me unattractive? Or is it simply that I'm pregnant?

Some men find it difficult to reconcile the notion of their partner as both mother and sexual being. Keeping this possibility in the back of your mind, talk to your husband about your own sexual desire. Let him know you miss intimacy with him (use the word "intimacy" rather than "sex" – he may find it more palatable) and say "please help me to understand your feelings about that". If he indicates he is struggling to feel sexually connected to you, consider seeking some counselling together. If he expresses concern about your well-being during pregnancy, it may be worth asking your family doctor to reassure him that intercourse during pregnancy is usually safe.

Many pregnant women continue to experience sexual desire, and clearly you too would like to continue making love. Be brave enough to ask him to give you oral or manual orgasms if you reach a point where intercourse is no longer comfortable. He cannot read your mind, so gently give him the information he needs in order to please you.

• Pamela Stephenson Connolly is a US-based psychotherapist specialising in sexual disorders

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