I am a 24-year-old virgin. The only means of masturbation I have employed since my teens has been clitoral stimulation and have never had a “real” orgasm (I read online about mini-orgasms you can have with clitorial stimulation and it seems a close fit to what I experience). Even though there is no lack of desire between me and my boyfriend, and even though I enjoy everything he does, I never become fully aroused. This compounds the issue of my boyfriend being unable to penetrate me during sex. I can comfortably pass one finger in at best. I tried to use a menstrual cup, but could barely get a tenth of it in. In light of this discovery I feel anxious every time we try to have sex because I know penetration is impossible and I end up losing my drive. Is this normal given my sexual inactivity or is there reason to consult a gynaecologist?

Your hymen is probably still more or less intact. Some people have thicker hymens that can be more difficult to break. Check your status with a gynaecologist. There are clinical options for solving such a problem, and in your case that might be better than continuing to experience such fear and discomfort while trying to have intercourse. You have already been suffering from negative psychological effects of what is likely a simple and normal physiological issue to do with first-time penetration – and it’s time for you to start having sex without so much anxiety. You clearly have high levels of desire and arousal, but it is not easy to have great orgasms when even the thought of penetration makes you anxious and actual attempts produce pain and disappointment. Most importantly, teach your partner how to pleasure you clitorally; this may be your best route to orgasm – now and in the future.

• Pamela Stephenson Connolly is a US-based 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). Submissions are subject to our terms and conditions: see gu.com/letters-terms.