I'm shy in the sack. How do I tell my partner what I want during sex?

Q. I'm a woman who has a hard time asserting myself in the bedroom. How do I learn to be open about my sexual needs and wants?

A. A lot is written about the elements of healthy relationship and good communication always makes this list. Recognising how the power dynamics within your relationships affect your ability to openly discuss your desires is also key.

It is also important to know and understand your own body and what makes you feel good. Self-play and masturbation is a good way of finding this out and will give you the confidence to articulate your desires.

It is a good idea to give feedback to your partner during foreplay, oral sex and penetrative sex in a way that feels comfortable to you. A little moan or whispered word will let your partner know they are on the right track.

Over time you may become more comfortable and be able to give instructions regarding the type or depth of strokes, the pace and positions you enjoy most.

You should not feel apologetic about giving directions or worry that you are being demanding.

When this feedback is given and you and your partner's affirmative consent respected, you are on your way to a fulfilling and thriving sex life.

Although the communicating skills and details about your own pleasure depends on you, it is important to have a partner who is receptive and willing to listen and be guided by you. Openness, honesty and clarity will help you get what you want. It will also help you say no to things you don't want.

There may be relationship issues, personal experiences, defensive reactions, communication issues and triggers that you may need assistance with. Sex therapy for individuals and couples can be beneficial.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, DISA Clinic, 011-886-2286, visit safersex.co.za.

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