My partner is loving, kind and wonderful. But he avoids being intimate with me because he cannot maintain an erection. I am trying hard not to take this personally. I want to support him, but he doesn’t want to talk about it. He feels pressured to perform but he doesn’t need to for me – I would just like some level of intimacy. I have gently raised the subject of Viagra, but he puts off the conversation. I have suggested we go to the pharmacy together or he goes alone, and though he has agreed, he never does. I tell him it is very normal, especially after 40. Maybe I should just accept things as they are as I definitely don’t want to pressure him.

Many men avoid sex because they are afraid they will be unable to achieve an erection. It’s easier to say to a partner: “I’m not in the mood” than face what they would consider a failure to perform. No matter how often you insist it wouldn’t matter, your husband will not believe you. An approach that is more likely to succeed is for you to mention truthfully that you have learned erectile difficulties are not necessarily age-related and need to be investigated. Let him know that, in fact, they can be symptoms of an underlying medical condition (diabetes for example) and send him to your primary care doctor. A physician may be able to calm his fears and educate and assess him – and perhaps prescribe something to counteract erectile dysfunction. At the moment, I imagine he is scared, and will feel threatened by any discussion you may initiate, so seek the kind of help that will hopefully be more palatable for him.

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

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