I am a 40-year-old woman who has always enjoyed a good sex life. However I have been unable to orgasm during intercourse and experience little sensation when penetrated, although it feels good! I have always been able to reach orgasm through clitoral stimulation and wonder whether I have "desensitized" myself on the inside by directing my energy on the outside - I began masturbating at a young age.

There is nothing wrong with you. Although it is highly pleasurable, intercourse alone does not provide sufficient stimulation to bring many (probably most) women to orgasm. The nerve endings in a woman's genital region are concentrated on the clitoris, so it makes sense that that centre - as well as the area in the upper wall of the vagina known as the G-spot - triggers orgasm.

There has been much misunderstanding about this, and women have been made to feel anxious about what is normal (this is where "faking it" comes in). But that's how women are designed: the clitoris is the only human organ of which the sole function is pleasure. Men who feel inadequate because they are unable to bring their partners to orgasm through intercourse alone should be reminded that they have tongues and fingers.

Also, "clitoral" orgasm extends to the entire genital region. To experience orgasm during thrusting, ask your partner for additional clitoral stimulation and experiment with different positions to stimulate your G-spot.

· Pamela Stephenson Connolly is a clinical psychologist and psychotherapist who specialises in treating sexual disorders.

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