My husband and I both work full-time and have four kids under 10. When we do get intimate, half the time we are interrupted by a kid banging on the door. I can usually get back into the zone but my husband struggles and can’t orgasm. I asked if he would consider taking an erectile dysfunction drug, but he said no because he doesn’t think he has an erectile problem. Should I pursue this?

Your problem is distraction, not penis-action. In order to focus on pleasure and achieve orgasm, many people need a particular type of environment. You may be able to switch on and off with ease, but your husband cannot. I doubt that an erectile dysfunction drug would help him, and it sounds as if he is correct when he says he doesn’t have a problem that would warrant one.

Could you escape the household now and then, or get a babysitter? A “date night” once a week would provide a much-needed break for both of you, especially if it included an erotic stopover at an understanding friend’s place. It is challenging to transition from frequent lovemaking as singles to “stolen moments” as harried parents, but aiming for quality rather than quantity – and valuing it – will help. Returning to the environments of your courtship – movies, clubs, or perhaps the back seat of a car – should further enhance your erotic connection and allow you to re-experience the exciting relationship that bonded you in the first place.

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

• If you would like advice from Pamela Stephenson Connolly on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments).