I am 37 and a single disabled mum to 13-year-old twins. I have not had sex in more than 11 years because I urinate when I orgasm. I also don’t feel attractive because of my scars and limitations. Now I’ve started dating a man who is nine years my junior and, while he is a great guy, I’m scared to have sex with him. How can I talk with him about my concerns so we can embark on the next stage of our relationship? Talk to a doctor about your incontinence. There are solutions, and finding one will greatly improve your confidence. I recommend that you approach the subject of your sexual concerns playfully, even seductively. Try to use humour, and keep in mind that when there is strong mutual sexual desire, most limitations can be accommodated. You are the one who knows what your sexual needs are and exactly how to achieve them, and it is important to share that with him once you feel that acting on your attraction for each other is likely or inevitable. Do not expect him to read your mind. He will probably need very specific guidance and, if he is a caring person, he will be grateful for the information and eager to comply. Don’t forget to reciprocate by inquiring about his specific sexual needs and doing your best to meet them. 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. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions. 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.