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Poor health or chronic health conditions, such as heart disease or arthritis, make sex and intimacy more challenging.

Certain surgeries and many medications, such as blood pressure medications, antihistamines, antidepressants and acid-blocking drugs, can affect sexual function. You and your partner can experiment with ways to adapt to your limitations.

Now, please don't feel bad if you'd never really realised this before, because you're not alone.

In my consulting room, I've seen many successful women – including lawyers, bankers and TV presenters – who were quite unaware of what it takes for most women to climax and who, as a result, had spent ages blaming themselves and feeling inadequate.

Lucia in the West Indies, to conduct field research and compile vacation-sex best practices for you, dear reader.

(I know, my job is hard, but someone's got to do it.)On the menu: a weekend in a beachfront cottage; late-night dancing at a nearby street party; a couple's massage; a candlelit dinner on the beach; far too much champagne (this all-inclusive thing is dangerous); and, yes, some much-needed time and space to reconnect physically, because after a long week of battling New York City, my partner and I are much more likely to be eating takeout in his bed than scattering it with roses.

It deserves its reputation as particularly delicious.

So here are four sex positions that might help you to enjoy intercourse more and to have fulfilling orgasms at the same time.You may feel some anxiety about these changes, but remember they don't have to end your enjoyment of sex.Adapting to your changing body can help you maintain a healthy and satisfying sex life.Stay positive and focus on ways of being sexual and intimate that work for you and your partner.Whether you're planning a trip with your partner or merely fantasising about one, vacation sex likely plays a starring role in your vision.

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