I’m a 36-year-old man. I have been in a relationship for a year, and love my girlfriend. But she is a virgin, and says she is not sure she ever wants to have sex. She is not comfortable with physical contact. I don’t want to lose what we have. I don’t want to make her uncomfortable by asking her to do things that she isn’t happy with. Is there a way of being physically satisfied in a sexless relationship?

It is not unusual for someone who has never made love with another person to feel unsure, anxious or even afraid of sex. Patience is vital. But if you feel sexual expression within a relationship is really important then you will have to explain that to her and address this together. An ideal starting point would be to help her to feel safe enough to try to explain exactly why she lacks sexual interest. Some reasons could be a fear of pregnancy, lack of education about sexual behaviour, previous relationship problems or lack of attraction.

More complex causes could be: a medical issue such as a hormonal imbalance, a phobia such as fear of body fluids, anxiety, depression or another psychological issue, a history of sexual abuse, true sexual aversion (perhaps based on a traumatic incident) or conflicted feelings regarding sexual orientation. With your girlfriend’s agreement, you may need to involve mental health or medical professionals. Even if a person has strong erotic desire for someone it can take time to feel ready to act. Support her erotic exploration and developing sexuality without making demands. Instead, engage in sensual, nongenital contact, and gently help her to feel safer, at her own pace.

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

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