I am a 73-year-old woman who has had no trouble having orgasms with a vibrator – until recently. Now I get close, but it just doesn’t happen. Do you think something is wrong with me?

As with most sexual problems, in order to find a solution, you have to be something of a detective. Puff on your Sherlock pipe and consider the following: what else has changed in your life recently? Have you been more anxious than usual lately? Anxiety and other mood changes can affect sexuality, so perhaps you need to exercise more, or calm yourself with meditation or another kind of self-soothing activity.

Have you perhaps been ill lately? Some illnesses can also affect the sexual response. Have you started taking different medication, either prescribed or over-the-counter, or has your dosage of an existing medicine changed? If so, research side-effects of each, to see if there is a possible connection. If you suspect a link, ask your doctor to change it (and do expect him or her to take your request seriously – this affects your quality of life and you deserve to be helped).

You could also have your hormone levels checked. Testosterone, for example, is an important hormone that assists the orgasmic response in men and women; some doctors can provide supplemental cream or patches.

And if anyone says it is down to your age, refuse to listen.

• Pamela Stephenson Connolly is a psychotherapist who specialises in treating sexual disorders.

• If you would like advice from Pamela Stephenson Connolly on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments).