Due to an old injury, testicular cancer and blood pressure problems, Im pretty well useless at straightforward sex, but would do anything to pleasure her. How can I raise this subject?

I am 67, married twice and now getting friendly with a lady of similar age. She has hinted at missing out on a sex life since her husband was ill (dementia) and eventually passed away. My problem is that, due to a complex mixture of an old injury, testicular cancer and taking blood pressure tablets, I am pretty well useless at straightforward sex. I would, however, do anything to help her find satisfaction. I want to get this subject out in to the open, but dont want to appear presumptive.

Dont dwell on your problems; your willingness to give pleasure to a partner will outweigh them. Believe that you can collaborate in finding a style of intimacy that suits both of you, because that is always possible, no matter what the obstacles. Most importantly, banish your performance anxiety, as it will inhibit you and get in the way of your sexual creativity. You have begun a warm and promising alliance, but dont second-guess yourself, and dont rush into anything. Tenderness, soothing touches, hugs and kisses may be the right way to establish a physical connection with this person, and I would only go further when and if you feel confident and receive the right guidance from her. At that point, you can demonstrate your dedication to giving her pleasure without having to explain your own difficulties too early. If you allow things to take their natural course, you may be surprised by theease of it all.

Pamela Stephenson Connolly is a US-based psychotherapist specialising in 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 dont send attachments). Each week, Pamela chooses one problem to answer, which will be published online and in print. She regrets that she cannot enter into personal correspondence.

Read more: https://www.theguardian.com/lifeandstyle/2017/jan/16/67-seeing-woman-same-age-worried-cant-satisfy-her