My husband and I haven’t had sex for 10 years. Can we start again?

I am 60, and my husband is 62. We have not had sex for nearly 10 years and my husband states that he can’t see us ever having a sex life again. Is it possible for a man who has completely lost his sex drive to rediscover it? If so, how can I help him? I have asked him to see the doctor, or for us to get help, but he says no. I think it would hurt his ego. I love him immensely, but would love to solve this.

You have omitted to explain why now – after 10 years – you suddenly want to return to having sex. The reason is highly relevant, and could perhaps be the basis of a renewed effort to change things. It doesn’t sound as if you have been imbued with longing all this time, but maybe you have. Whatever the reasons or circumstances, you have a right to have the conversation now and to seek help. Why or how you stopped making love in the first place is an important factor.

For example, sometimes men stop wanting to have sex because they are experiencing a problem that scares or embarrasses them – such as erectile dysfunction, which is something that can be addressed. Many of the reasons for a loss of sexual interest are caused by solvable issues – depression, stress, anxiety or another treatable psychological issue. Sometimes, attitudes or beliefs towards sex in middle age or later years get in the way. A number of relationship or family factors can be at the root of this loss, too. Most importantly, there could be an undiagnosed medical condition that requires diagnosis and treatment. I urge you to seek the underlying reason. Nothing will change unless you gently insist. A concern about possible medical causes will often be a palatable excuse to seek help without ego hurt.

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

• If you would like advice from Pamela 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.