I am an 86-year old man who has enjoyed a good sex life. But last week I suddenly found I could not achieve an orgasm, no matter how much my wife tried to help or how many porn videos I watched. Am I just going through a temporary orgasm stoppage or have I lost my ability to ejaculate for ever? Is it possible my body will not enjoy another orgasmic moment? Can you help me? I’m desperate.

Age itself is not a cause of anorgasmia or an inability to become aroused or ejaculate. So it is important that you try to reduce your understandable anxiety about this and do some detective work to figure out what has changed since you were last able to climax. Have you changed medications? Have you been taking new over-the-counter medications? Has your stress increased? Have you suffered a bereavement or loss? Have you recently become more anxious or depressed?

Any of these factors can influence your ability to climax. If you think it might be a medication issue, ask your doctor to find an alternative. It’s just a matter of discovering the root cause. I know all of us are going through a very difficult time, so it would help to find some at-home methods of relaxation and stress-reduction. Try to exercise in moderation if your doctor allows it. You might also seek a general medical checkup and perhaps request some hormonal supplements. Consider seeking online therapeutic help if you think you would benefit. Age itself is not the problem. You deserve to be able to continue to have pleasure.

• 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 and in print. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions: see gu.com/letters-terms.

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