I’m a 70-year-old man who enjoys sex and intimacy, but my wife, who is 65, feels she is too old for this. We sleep in the same bed but keep the pooch and pillows between us. Talking is useless and always becomes a blame thing. She has occasionally said “Well, go ahead,” as if that will work. At my age I require foreplay – which I enjoy giving as well as getting.

It’s been years since we’ve been intimate. For a while we would couple up on birthdays or new years, but then that stopped, too. We have both lost a lot of weight and things are sagging and wrinkly. I think part of the problem was, during intimacy, she would notice me finding a bump or wrinkle that she felt self-conscious about.

The insight you expressed in your last sentence may be the key, so you might do well to start there. Poor body image and self-loathing are often responsible for lowered sexual interest. And one of the most powerful predictors of our level of desire is who we feel ourselves to be in the context of our partner. Clearly, you still perceive yourself to be a lover – albeit a lover who is sadly imbued with longing and unrequited passion – but who do you think your wife perceives herself to be? Help her to feel special, attractive and loved. Find ways to caress and soothe her without expecting sex until she shows interest. Listen to her preferences, and avoid any kind of pressuring or blame.

READ RELATED: Kushitha Kallapu Height, Weight, Age, Body Statistics

• 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 [email protected] (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: see gu.com/letters-terms.

• Comments on this piece are premoderated to ensure discussion remains on topics raised by the writer. Please be aware there may be a short delay in comments appearing on the site.