My personal situation sounds nearly identical to yours. Including the BDSM fetish, and I also went to the limp noodle state upon penetration. My therapist was unable to address my issues, and admitted her sex therapy training was limited. As Bill3 described above, I began seeing an aaesect trained sex therapist. We have explored my emotional, physical, and performance issues. With the help of Cialis and sex therapist things have improved. While I haven't orgasmed during intercourse, I have from hand or oral stimulation. I was even able to give my girlfriend an orgasm during intercourse. I am optimistic my intercourse orgasm is going to occur soon. Without the sex therapist this may never have happened. Thank goodness for the Cialis, but thank god for the sex therapist.