I am a 74-year-old woman and have been with my 73-year-old partner for 30 or so years. Many years ago he had bladder cancer, which is now under control, and before that he had arthritis, which meant he was only comfortable having sex in one position (with no foreplay). I began to dread sex. I thought he was mentally too fragile for it and, as a result, we had hardly any sex for a while. Then our relationship got difficult and he told me he didn’t fancy me any more, that we were old and wrinkled. I don’t know if there is any way back from that. I am sorry you are facing such difficult and painful challenges. “We’re too old” and “I don’t fancy you any more” are often code phrases for “I have no libido generally”, so try not to take it personally. My guess is that if your partner can be persuaded to seek medical help to restore his sexual interest – which may involve having evaluation for hormone treatment – you may find your erotic connection will improve. There could even be a psychological issue. Depression, for example, is known to lower sexual desire in many people. Then again, there may be a need for sex therapy to help find a way for both of you to be more comfortable and less pressured during sex. I understand that you will admire him more if he takes this situation seriously and respects your needs; do try to engage him in finding help and answers … for both your sakes. 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.