I am a 63-year-old woman married to a man I love and find very attractive. I enjoy vaginal penetration, but struggle to engage in foreplay. I feel anxious and not especially aroused by having my breasts touched. Clitoral stimulation is almost unbearable and while penetration with fingers had been off the menu for a long time, with a lot of patience and talking I am now beginning to enjoy it once again. I have had a lot of therapy to get over some very unpleasant sexual experiences and when I was younger my libido was powerful and less inhibited. It’s as if now, post-menopause, I have a less hormonally driven sex drive and old ghosts and inhibitions are revealed once more. How can I enjoy a wider range of sexual activity than penile penetration? Understandably, you miss the way you felt when you were younger. You may imagine that the quality of your sexuality has diminished, but, on the contrary, it might be that you are only now beginning to experience genuine pleasure that is authentic and on your own terms. Although sex does not seem as powerful now, it is undoubtedly less the product of those traumatic experiences, and that makes it enduringly precious. Lower your expectations for increasing your repertoire of sexual expression and focus on simply giving and receiving pleasure in the here and now. Practise being fully aware of your partner, and be clear with him about what genuinely feels good to you and what doesn’t. Be careful to prioritise your own pleasure rather than trying to please him, and help him to understand that this is vitally important for you. Sex is not something you have to “be good at” or achieve milestones with. Listen to and act on the desires of your true self. Never endure something you dislike, and remember it is always OK to say, “Stop!” 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.