How to Do It is Slate’s sex advice column. Have a question? Send it to Jessica and Rich here. It’s anonymous!

Dear How to Do It,

My husband (30s) and I (30s F) have been married for four years. Sex at the beginning of our relationship was great. He and I are great friends, and enjoy each other’s company platonically, but have stopped sexual contact pretty much entirely.

Last summer, my husband would fall asleep and grope me in his sleep. It would wake me up and disturb me greatly. He would wake up without any recollection of it happening but would be deeply upset over his unconscious actions. After having this happen around half a dozen times in a month, he talked to a specialist and changed his sleep routine to prevent it from happening again. It worked and there hasn’t been an instance since then.

The problem is, despite knowing he didn’t intentionally do this, and that it hasn’t happened again, I still don’t feel comfortable with him touching me sexually. If we do have sex, I have to be very dominant, which can be fun for me but difficult for him to stay fully aroused. He is an incredible partner in every other way and I know he works on making me comfortable after all this has happened. We’ve gone to therapy, I understand and accept that it wasn’t intentional but I become repulsed or go cold if he tries to physically initiate sex. Is there a way to get over my physical discomfort or are we doomed to this marriage of roommates?

—Sexless and Sleepless

Dear Sexless and Sleepless,

Have any of your therapists suggested sensate focus? It’s a technique that was developed by Dr. William H. Masters and Virginia E. Johnson in the 1960s (two early luminaries in the field of sexuality) as a way of helping couples sexually reconnect. Essentially, you take every kind of sexual contact off the list, and slowly add options back while giving desire a chance to grow before moving to the next stage. Many therapists, counselors, and coaches are able to walk you through the process, but there are a couple of books I can recommend, too. Barbara Carrellas’ Urban Tantra and Annie Sprinkle’s The Explorer’s Guide to Planet Orgasm both contain fairly detailed discussions of both the mechanism and steps of this practice.

You might go through the process once with you acting as the initiator but without being “very dominant,” and then consider a second round where your husband is also occasionally initiating.

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Dear How to Do It,

I think birth control is an amazing invention that’s made life better. But I’m in the small percentage of the population that can’t seem to tolerate it. At 30, I’ve tried multiple proportions and types of the pill, I’ve tried both copper and hormonal IUDs, I’ve tried the ring, the shot, the arm implant, everything. I’ve had side effects including: frequent fainting, a year of constant heavy bleeding with subsequent dangerous anemia to splitting migraines, debilitating depression combined with weight gain, zero sex drive, and a dangerous blood clot in my leg. Please trust me when I say I want it to work for me but I have had more ambulance trips in my life from birth control complications than any other thing in my life combined. So I track my cycle, avoid high-risk days with casual partners, and always use a condom. I have a well-thought-out and funded emergency plan in case of condom failures.

I want to have a family but I’m single right now. I’m starting to date seriously after the end of a three-year relationship, and I don’t know how to talk about my birth control situation. In one past relationship, we started out using condoms and then I got huge pushback a year in when I wasn’t able to switch to condomless sex. Pretty much every ex has complained, even if they weren’t pushy. A one-night stand found out I was only using condoms and acted like I’d tried to intentionally get pregnant. Until male birth control exists, or I’ve made a family and am able to get surgery, I’m going to be stuck with this. How do I talk to partners about it? And am I supposed to be doing it earlier than I have been? I also feel like everyone thinks that birth control is a mildly unpleasant thing women need to tolerate as a price for getting more choices, but I can’t find a mildly unpleasant option and I’m so touchy about it. How do I handle this? I’m so tired of dealing with medical failures but I like sex, want to date, and want a family someday.

—Avoiding Pregnancy or More Blood Transfusions

Dear Avoiding Pregnancy,

I believe you. I myself have issues tolerating hormonal interventions, and know many other women who’ve had similar difficulties.

When it comes to gynecology, medicine simply fails some of us. Here’s one unsolicited suggestion just in case you haven’t tried it: A lower dose IUD like the Skyla or the ultra-low dose pill Lo Loestrin Fe might be worth a trial period. I’ve heard from women over the years who’ve had difficulties with hormonal contraceptives and then fared better on a lower dose. I know, it’s another version of the same thing that has caused you hell for three to six months to “see if it settles,” but you’re beyond all the options that work best for most people and running short on other methods to try. (The diaphragm, for example, has around a 17 percent failure rate with typical use give or take, and requires spermicide and a significant amount of timing and preparation.) We’ve been hearing that male birth control options are just around the corner for ages, and so far none have made it to market. You’re doing everything you reasonably can to control the risk of pregnancy.

Mostly, you’re right—people, even other women who haven’t had these problems—think of birth control as an easy little pill that allows condoms to be thrown out the window before a cream pie party. Doctors will sometimes act as though women are being unreasonable, hysterical, or hypochondriacal when we report issues. And dudes often expect to “earn” raw sex without any of the real risks. It sucks, I don’t have any real solutions, and I wish the situation was less awful.

The guy who overreacted to the news that your birth control method is condoms is hopefully an outlier, but, just in case, I’d broach the subject before taking someone home. No need to go into details unless they and you both want to do that, but let them know up front that the only birth control method that works for you is condoms, so they’ll need to use them. You can use this as an opportunity to see how they react, which lessens your chances of being yelled at or stealthed in the future.

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Dear How to Do It,

Do you have any suggestions for a really sensitive clit? My clit is and has always been really, really particular, which is annoying because I can’t orgasm without it. Pinpointed, direct stimulation is a HARD NO, and is in fact really painful. I rarely directly touch it myself. The idea of wearing underwear during sex feels utterly ridiculous to me. A light touch does absolutely nothing. The vibrators I’ve tried thus far are usually a miss. I can make it happen by myself with my hands, but whenever I try and explain how I manage it, it never seems to work when someone else tries to touch it. Oral is nice, but doesn’t get me there. I don’t have any dryness issues. Help?

—Hair Trigger Clit

Dear Hair Trigger Clit,

First, you might try demonstrating instead of explaining. Our vocabulary around sex isn’t very specific, compared to, say, food (half a cup here, 2 grams there), and the different words we use—such as a “light” touch—are highly subjective. Letting your partners watch you get yourself off, and then getting yourself off while using their hands, is a great way to teach.

Meanwhile, if you aren’t familiar with the concept of crotchless panties, they might work for you. It’s a long shot—everyone’s anatomy is different, as are the patterns for each pair of panties, so you might have alignment issues. But you might find a pair that allows vaginal access while insulating your clitoris. Building on that theme, Lorals (a recently FDA-approved single-use underwear meant to protect against STIs during oral sex) might be less bulky to pull to the side and could certainly have a custom-placed slit cut into them. Just, cut while they’re off your body, please.

Dear How to Do It,

My (straight male) girlfriend can no longer have penetrative sex, but that’s what I crave most in a sexual encounter. She’s indicated that she’s open to me having occasional one-night stands to “relieve the pressure,” but here’s the problem: I tend to “catch feelings” for whoever I have sex with. I can’t seem to get past it, and it’s gotten me in plenty of trouble in the past. Obviously, my falling for someone else would hurt my girlfriend in ways I don’t want to even imagine. This doesn’t seem normal (I can’t find a term for it; “demisexual” is the closest, but that’s not quite it). What can I do?

—Horny But Halted

Dear Horny But Halted,

It’s really not that odd to need an emotional connection to enjoy sex, or to develop an emotional connection during enjoyable sex. I know we’ve got this “demisexual” label and all, but emotionless hookups are merely one way to handle sexual interactions not the rule. It seems like your concern is romantic feelings, but it’s also worth keeping in mind that friends with benefits arrangements also tend to involve feelings of, at the very least, regard and affection.

How easily do you fall out of love? As in, can you connect with someone deeply, feel strong emotions, feel butterflies, engage in sex, and then leave that as a beautiful moment? Not everyone can, but if you’re one of those sorts of people that might be an option. You still may want to clue your girlfriend in on the emotional rollercoasters you’d be going on, and you might find yourself emotionally exhausted more often than you’d like, but it is a possible approach.

—Jessica

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Here’s a problem I’ve not had before. After a long, tense marriage, my wife and I are splitting up. That’s going OK, I think, and I am making moves to move on. Right now, that includes a dating app that has put me in contact with a lot of women. Sometimes, we exchange smiles, sometimes, brief conversations. I’m not especially bummed out when these fizzle, or when (occasionally) I get blocked by someone the program tagged as a match. But there are quite a few—a half-dozen or dozen, depending on who’s counting—who’ve lasted longer than that.