That elusive O!

Doctor, I am on my third marriage and it has been very happy. We have been together now for 15 years.

But there is one problem. In the last few years, I have noticed that it is often difficult for me to reach an orgasm, even though I get a fairly good erection. There are times when I can try for 30 or 40 minutes and still I don't get there. At the end of that period, I can sometimes lose my erection and then can't get it back.

My wife is quite the reverse, doc. When we first got married, she could hardly climax at all. But these days, she regularly has multiple orgasms. While I am 'working away' at her and trying to climax, she does it again and again.

Is there something wrong with me?

You don't say how old you are. But what you are describing is a change that happens to many men as the years go by.

American sex researchers Masters and Johnson studied the sexuality of men over the age of 50. What they found was this:

As men get older, they tend to take a little more time to achieve an erection;

The erection is often maintained for a long period;

But sometimes it takes them quite a while to ejaculate;

If they lose their erection, they may find it difficult to get it back.

Sounds like that is approximately what is happening to you. So my guess is that your symptoms are just part of the normal process of ageing.

As it relates to your wife, it is often the case that women who feel comfortable about their bodies get in the habit of having multiple orgasms as they grow older. That is particularly true when their partner is a good lover. And I expect the term 'good lover' applies to you.

In fact, it is quite possible that your spouse is very grateful to you for giving her multiple orgasms.

I would say that what is happening to you is part of the normal ageing process. You should talk it over with your wife and reassure yourself that she is happy.

Should you have any medical treatment? Well, it is possible that a small dose of Viagra, Levitra or Cialis would help you, because they would ensure that you do not have the problem of erection loss, which you have sometimes noticed. I wish you both well.

I have very painful and heavy menses and I have been advised to take an operation called endometrial resection. But I do not know what that is. Is it like a hysterectomy, Doc?

No. A hysterectomy is a complete removal of the womb. Endometrial resection is a rather milder operation. It just involves stripping out the entire lining of the womb.

The gynaecologist does this operation from below, working through the vagina.

After it has been done, you will probably have no period at all, and any periods that you do have will be very light.

All operations can have their risks. But endometrial resection has provided a good answer for many women who have heavy menses.

After four years of marriage, my wife has suddenly become very passionate about sex. She says she 'adores' my lovemaking, and wants me to do it a lot.

Doc, is this a sign that she is cheating on me?

Certainly not. I would take it as an indication that your wife loves you a lot and that, over the last few years, she has grown to really appreciate your efforts in bed. So stop worrying.

I am a 36-year-old female and I have been on the Pill for 10 years, Doc.

Should I take a break, as I have heard?

These days, it is not considered necessary to take a break from the Pill.

Doctors used to say that women should have a temporary pause every few years, but that is no longer the advice of medical experts.

However, please bear in mind that you are now over 35 and that the slight risks which are associated with the oral contraceptive do tend to increase after that age.

You can reduce these risks by:

Avoiding smoking;

Keeping optimal weight and

Getting a lot of exercise.

I am a 27-year-old married man. All my adult life, I have been unable to last more than five minutes during sex with women.

Does this mean I have premature ejaculation, doc?

Well, there is no exact definition of premature ejaculation (PE). This is because of the fact that a period of time which is insufficient for one couple might be quite adequate for another.

Studies have shown that some men who can last only two minutes do not consider themselves being premature ejaculators. Other men who can keep going for 12 or 14 minutes think that they have PE !

What it boils down to is this. If you and your partner are happy with the length of time you achieve, then that's fine. But if either of you is not happy, then you should seek treatment.

I must stress that there are a lot of women who are definitely most dissatisfied about how quickly their partners discharge. In such cases, it is a good idea for the couple to get advice from a therapist or a doctor.

There was a very good article about PE in The Sunday Gleaner, August 12, by Dr Heather Little-White. It is still available on the Internet, and I would recommend that you have a look at it.

I note that I am bleeding from the bottom whenever I 'go out'. Does this matter, Doc?

Yes it does. It may be just piles. But as people get older, there is an increasing chance that rectal bleeding may be the result of bowel cancer.

Whatever age you are, you should see a doc this week and have a rectal examination.

At age 25, I have noticed that at the moment of orgasm, my seminal fluid does not 'travel' as far as it used to.

Is that normal, doctor?

Yes, it is. Scientists have shown that the fluid travels the greatest distance in adolescence, and that it gradually 'shoots' a shorter distance after the age of 20. So there is no need for you to be concerned.

Doctor, is it true that all blood pressure pills interfere with a man's nature?

No. Some do, and some don't. Unfortunately, it is not easy to forecast these effects.

If a particular medication does seem to be giving you erectile dysfunction, then you should ask your doctor for a change of tablet. Fortunately, there are plenty of alternatives.