I was previously in a sexually abusive relationship. Now I am with a loving and caring partner, but we are having issues with our sex life. I can no longer seem to orgasm. I’m not sure if this is a side-effect of my antidepressants or the trauma that I went through. This means that I usually tell my partner to focus on himself during sex, which often leads to me feeling used and brings back memories of sexual abuse. I want to recover my healthy attitude towards sex, to be intimate with my partner and not end up in tears or having a panic attack. Feeling like this during sex makes it seem as if my ex-partner still has control over me, which is upsetting. We are a young couple; I love my partner very much and want to be intimate with him, but my brain seems to switch off from my body.

Certain medications – including antidepressants – can significantly affect a person’s sexual responses, at either their desire, arousal or orgasmic phases, so it would not surprise me if the culprit here was indeed the particular antidepressant you are taking. This is especially likely if your inability to orgasm began fairly suddenly, soon after you started taking the antidepressant. Your first step is to return to the doctor who prescribed it and ask them to try something different; there are usually other options without these sexual side-effects. But trauma can also affect a person’s sexual functioning. For example, sometimes intrusive negative thoughts or images related to the trauma can interrupt one’s erotic flow, or perhaps a residual feeling of being unsafe during eroticism can cause sexual difficulties. Whether antidepressants are negatively affecting your sexuality or not, it is important that you help your partner to understand that, until you heal from your trauma, you need to have a high level of lovemaking control.

• 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.