I’ve had a few dreams where I orgasm in my sleep while fantasizing about gay men having sex. Even more disconcerting is that in one of those dreams I was a “bottom” gay man who had female parts. I’ve also had deviant dreams and fantasies where I orgasm and they also do not involve straight men. I don’t fantasize about females either because it doesn’t do anything for me.

I am very confused. Am I normal?

– Confused Woman

All right, Confused Woman, we have two concerns here: Your lack of orgasms during sex with your boyfriend and your fantasies about being a bottom gay man with a vagina. First, to the issue of climax, just consider the feverish search for “lady Viagra” and other magic fixes to increase desire and orgasms. When Big Pharma goes after something it’s because there’s big money, and there’s big money because lots of women struggle with this issue.

Elisabeth A. Lloyd, author of “The Case of the Female Orgasm,” surveyed research on orgasmic frequency and found that, when it comes to penetrative intercourse without clitoral stimulation, only a quarter of female respondents regularly climaxed during sex; and five to 10 percent never orgasmed. (Including manual stimulation, Alfred Kinsey reported that 39 to 47 percent of women orgasmed regularly during sex.) We also know that women report having more orgasms as they get into their 30s and 40s. As sex researcher Debby Herbenick puts it in her recent book, “Sex Made Easy,” “learning to experience orgasm takes practice.”

It’s probably easier to orgasm alone because there is less pressure, self-consciousness and concern about your partner’s experience. (I could go on and on about how women are socialized to put men’s desires first, to prize our partner’s pleasure over our own — but I’ll leave it at that.)

Now, to the issue of your “troubling” gender-bending fantasies: Girlfriend, there is no cause for concern. Russell Stambaugh, a clinical psychologist and board member of the American Association of Sexuality Educators, Counselors and Therapists, explains, “Fantasies have many different tasks to perform, so it is very common to report ones that seem strange.” (And, honestly, yours isn’t even that strange.) Stambaugh says that one of those tasks is “to compensate for things we can’t get in reality” — others are “to let off steam,” “to reassure us” or to “provide novelty, which often intensifies excitement.”

Fantasies are by definition fantastical. It’s incredibly common for people to get off on either impossible or entirely unrealistic scenarios. “Just look at genre fiction: historical romances, science fantasy and police procedurals, for example,” says Stambaugh. “Many recreational readers are consuming well-crafted, bizarre and elaborate fantasies they could never actually experience in reality. Some fantasies are much more fun in the imagination than they would be in reality.” You seem to have zero desire to make your fantasy come true, which is lucky because it would be hard to do so, short of gender reassignment.

Plenty of straight women fantasize about gay men. When another reader asked me about her taste for gay male porn, I wrote that the genre “is an erotic vacation of sorts for hetero women where the usual gender baggage is left behind. Guy-on-guy scenes don’t automatically call to mind real-world power dynamics between the sexes or the social and political history of male-female roles.” That’s not to mention that gay porn luxuriates in, and lingers on, the male form in a way that straight porn does not. These same explanations might apply to the personalized porn film playing in your head.

The only real problem in your letter is your concern itself. “As long as you accept that [your fantasies] don’t mean that there is anything wrong with you,” says Stambaugh, “you needn’t feel confused, and enjoy them for what they are.”

I want to be supportive and I get immense pleasure from guiding and giving someone an amazing sexual experience. My goal is to provide a safe environment so they can open up and ask any question or do any thing and not risk feeling ashamed or embarrassed about it. But that is often not enough. On the other hand, I want that to be reciprocated and if there is hesitation and anxiety about my, um, “needs,” then I lose the ability to enjoy it on the level I want to.

In my marriage, we have an ebb and flow in a pretty consistent fashion. Inside I begin to build up a large amount of sexual tension that is craving to be released in a manner that is not easily obtainable. I begin to push for something that will amount to that release and when it doesn’t happen it’s like sticking a cork in a volcano. I will spend a few days getting edgier and edgier until finally there is some blown-out-of-proportion conversation that ends up with everyone feeling inadequate and generally bad. We will then promise to work on it and things will go well for a few months until life gets in the way and the cycle starts again.

I want to break this cycle and we are currently doing an immense amount of work to try to bridge the gap. But until that happens, I’m still left with the need to reset my libido and I have few, if any, options available. I do not want to go outside of the marriage but if that is my only option I will.

Besides our sexual gap we have a fantastic relationship, but I am getting to the point where, after five years, I feel like I’m never going to achieve what I need. Any thoughts?

So this is funny: You’ve written such a smart, interesting and lengthy email, but I have no idea what you actually want. I see only amorphous sexual wanting. You don’t list a particular desire, like wanting to have more sex or to explore a specific kink. Instead, I’m left trying to read in between the lines in search of what’s missing from your sex life.

I wonder if your wife feels the same way. I wonder if you feel the same way.

There are a handful of words and phrases that stand out to me from your letter. The positive ones, the ones that seem to represent what you want, are “exploring,” “safe,” “open” and “do any thing.” The negative ones: “ashamed,” “embarrassed” and “anxiety.” You seem to believe that your wife is repressed — and that may very well be true, because, who isn’t? — but freedom from sexual shame can look very different on different people. For some, open exploration means joining a local swinger’s club; for others, it’s losing themselves in the pleasures of monogamous sex. There are as many personal definitions of sexual freedom as there are people. How does your wife’s definition compare to yours?

If you use the same abstract language when talking to her about what you feel is missing, it’s very possible that she is picturing a different goal than you are. Your strap-on fantasy might be her dream of bubble bath cuddles — or vice versa. There’s a tendency to expect our partners to know what we want, to intuit what we mean when we say, “Let’s explore” or “Let’s get kinky!” In part, that’s because the idea of our partner wanting exactly what we want is a compelling fantasy, right? But it’s also just damn hard to talk about these things. You gotta do it, though.

This is my personal take — and I’m just an unmarried, childless 28-year-old with a sex column. Marty Klein, a sex therapist and author of “Sexual Intelligence: What We Really Want From Sex, And How to Get It,” took a look at your email and determined that therapy — preferably with your partner — is the way to go. “Without that, or something like a near-death experience, this couple will split up (or he’ll have an affair),” Klein, who has over three decades of experience counseling couples, wrote in an email. The man tells it like it is.

I went to sex therapist Ian Kerner with the question of how one can tell the difference between a relationship that is hopelessly sexually mismatched and one that can become sexually compatible and satisfying with work. He said that there are two types of people: “thrill-seekers and comfort creatures.” This is a broad generalization, sure, but it can be useful to spark discussion around a tricky topic, he says. “Thrill seekers often crave a high degree of novelty and tend to get bored rather quickly, while comfort creatures believe that less is more and enjoy the familiarity of a sexual routine,” Kerner explains. “Part of the problem is that in the early stage of a relationship, the infatuation of falling in love provides a level of excitement that often masks real differences in our sexual types.”

Are these differences insurmountable? “Not at all,” he says. “But dealing with the issue is going to require creativity and communication.”

Aw, buddy. This is the second week in a row where I have to come straight out and say it: There’s nothing wrong with you. Nothing. Not a thing. (OK, so there might be something wrong with you, seeing as you’re human, but this isn’t it.)

Porn represents a popular fantasy norm, but it doesn’t necessarily reflect what people want to do, or are actually doing, in real life. Researcher Debby Herbenick, a sexual health educator at the Kinsey Institute, tells me, “There are probably many, many things that are shown in porn in our culture or other cultures that he or his partner don’t have any interest in doing and that’s OK,” she says. “Having some sense of self-awareness about your sexual likes/dislikes is a far better place to be than being clueless as to your own boundaries. So, good for him for having some sense of this.”

I recently wrote an article on why the money shot is such a fixture of porn and spent some time talking about “facials,” as they are so politely called. Lisa Jean Moore, author of “Sperm Counts: Overcome by Man’s Most Precious Fluid,” speculated that in the era of HIV, semen has come to represent disease and danger; and thus, “a fantasy develops about somebody actually wanting [semen], and they want it so badly that they want to drink it and they want to slather it all over their bodies and they want you to wipe it all over their faces,” as she said.

None of the experts I spoke with for that piece pinned the phenomenon to a real world, as opposed to porn world, rise in the practice. Herbenick says, “We have no numbers [on the practice] but it’s definitely not ‘the norm’ as in ‘most people are doing it.’” In fact, your very concern seems more common than the act itself: She sees your question come up often in group discussions, from college classrooms to talks she gives to middle-aged crowds. “While some people are into it, particularly on an infrequent basis, most people seem not as into it,” she says.

That isn’t to say that there’s something wrong with people who are into it. In terms of sexual practices, numbers and averages mean very little. They tell us nothing about whether we’re having authentic, fulfilling sex. The truth is that being in the majority actually means being unsatisfied with your sex life. How’s “normal” looking now?

But pleasurable sex is possible for you.

The most important thing is “making a connection between the present day sexual problems and the abuse of the past,” says Maltz, author of “The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse” (which is being reissued this summer). So you’ve already taken the first step, and it’s one that many people never get to on their own. The next crucial step — and maybe you’ve taken this one too, you overachiever — is talking to a therapist who can help you sort through what you’ve experienced and how it’s affected you, and not just in the bedroom.

The biggest challenge ahead of you, in terms of experiencing sexual pleasure, is redefining sex and your own sexuality. (No small task, I know.) Maltz says that ongoing abuse reinforces sex “as what you experienced in the abuse.” She explains, “Survivors often feel that they’re bad or an object or damaged goods, and you kinda have to shed that and separate yourself from what was done to you to see that your sexuality was there before the abuse.” As a result, oftentimes survivors approach “sex from a place of not feeling as empowered as their partner or desirous of what is happening,” and then continue to reinforce a dynamic reminiscent of the original abuse. “Developing a new meaning for sex and developing a new sexual self-concept” is key, Maltz says.

One way to do this is to “relearn touch” by experiencing physical sensations that you want and that feel within your control. Of course, the touch that you’re most in control of is your own, and that’s a great place to start. Maltz’s book details a range of exercises, some of which can be adapted for solo use, that focus on basic pleasurable sensations — like hugging and massage — which are sensual but not explicitly sexual.

Sex therapist and author Ian Kerner suggests that if you’re in a “loving relationship, with a caring partner” — or if you enter into one in the future — you can try “sensate focus” exercises, ideally with the help of a sexuality counselor. “In traditional sensate focus, sex is taken off the table, and then gradually reintroduced, one aspect at a time, which would help this woman take baby-steps back into the world of sex without feeling emotionally hijacked,” he says. “Sensate focus takes couples through a process of touching, connection, and awareness, during which each partner takes turns as giver and receiver.” By taking away the goal of actual intercourse, it lets the couple focus on “sensual experiences and the careful processing of emotion,” Kerner says. He describes this as “small loving interactions.”

As I said last week in my response to a woman seeking to revive her sex life after her husband’s stroke, this is great advice for anyone.

The key ingredient for partnered pleasure, though, is a trustworthy, caring and committed partner whom you can tell about your experience. “The partner needs to be clued in with what’s happening and what she’s experiencing so that the partner can kind of get on board and become a partner in healing,” says Maltz. Yes, it might sound sucky having to introduce this into a new relationship, but the right person won’t care — or rather will care enough about you to go through this with you. Plus, Maltz says, “A lot of the couples I see who have gone through this process, they reach a level of mutual intimate understanding and enjoyment that couples that haven’t had to deal with something this heavy often don’t get to.”

This is hard work, but it might help to think of it in terms of reclaiming your sexuality. “This is taking back what you were robbed of,” says Maltz. “Sexual abuse is abuse of someone’s sexuality.” By finding sexual pleasure for yourself, she says, you’re “going to the heart of the wound and healing.”

In addition, since he still has little feeling and some mobility problems on his right side, sex seems more like therapy than, well, just sex (that is, I sometimes come away with bruises since he doesn’t realize he’s elbowed me in the ribs or whatever).

In short, in the past nine months I’ve had one orgasm.

What can I do to move away from the more parental role and back into the role of wife and sex partner? And how can I manage this while minimizing his overwhelming feelings of guilt (for “ruining” everything about our lives, including our sex life)?

Thanks for any advice on the matter.

Oh honey, I’m so sorry. What a thing you’ve gone through, and are continuing to go through. Most couples struggle with keeping passion alive in their relationship — and many women’s sex lives are cooled by caretaker feelings — but you’re facing these issues very early and in especially unfortunate circumstances.

What’s remarkable to me, standing here on the outside at a far remove, is that you not only have a sense of humor about what’s happened, but you’re also taking action to make sure that things improve. My guess is that, hard as it was, you did pretty damn well as the Sole Adult in Charge of Everything. I can picture you cringing at these words, but: It’s impressive. Pat yourself on the back, woman.

Luckily, I come bearing good news. There is a tremendous amount of resources out there that can help you, and I’ve rounded up a couple of experts to weigh in on your particular case.

William Finger, a clinical psychologist and president of the American Association of Sexuality Educators, Counselors and Therapists, says communication about sex is the most important issue here. Of course, your husband’s speech problems complicate what is already a challenge for most couples — but communication is essential to everything from preventing him from accidentally bruising you during sex to understanding the particular challenges, fears and insecurities each other are experiencing.

Donald D. Kautz, a registered nurse and professor of nursing who has written extensively on the topic of post-stroke sex, asks whether your husband is working or has somewhere to go during the day. “The more independent he can become, including activities on his own, often helps the ‘caregiving’ partner feel less like a caregiver and both feel more like lovers,” he says. “Many couples report that getting involved in outside activities makes them feel better about themselves, which transfers over into the bedroom.” (And, might I add, that’s often true, regardless of whether a stroke is involved.)

You might want to try scheduling sex, setting aside a time removed from your caretaking routine. I know, I know, the idea of scheduling nookie is routinely viewed as sad and unsexy, but Finger says, “Nobody has spontaneous sex, except many when they first meet.”

As for the nitty-gritty of your bedroom happenings, there are several positions that should be more comfortable and hopefully prevent bruising. Sex with you on top — cowgirl, reverse cowgirl, him in a chair, whatever you please — is the most obvious option. (Again, something that’s awesome, stroke or not.) Kautz sent me a guide to positions that are ideal for those dealing with a chronic illness or disability; while they might not apply directly to you, I wish I could link to it, because the illustrations were an inspiring testament to the way sex can remain fun through injury and old age. They show an elderly couple in various convenient coital arrangements, and it seems a reflection — a NSFW reflection, sure — of lasting love. You can find another, less tear-jerky guide here.

To the issue of his lack of sensation on the right side of his body: You’ll want to focus more attention on his left side — but, duh, you probably already figured that. Optimistically speaking, this does force you guys to slow down and discover anew which sensations feel best — and not just for him. The issue of your own pleasure is crucial here too. Kautz recommends asking for “more direct genital stimulation, through touch, cunnilingus, or a vibrator.” (Again, advice worthy of all women.) He adds, “Making sure that she has an orgasm first may make sex seem less like therapy — and much closer to what intimacy was like before he had the stroke.” (At least we can hope that’s what it was like!)

Finally, I know this is annoying advice, but you should check out both online and local resources for stroke survivors. Kautz points out that you might not have much in common with those who show up to a nearby “stroke club” meeting, seeing as most could be your grandparents, but the medical professionals who run the thing should be a great connection. There are countless respectable online resources about sex after a stroke — try this comprehensive guide, for starters — that cover far more ground than I can in this column.

Good luck to you both, and have fun.