Doctor's Advice - My wife wants separate beds

Q.  Doctor, can a woman's sexuality change? I am concerned about my wife. When I married her, she was a very sexy woman. She would have an orgasm five times in one night without any problems. Today, 10 years later, things have changed. I find it hard to persuade her to get into bed with me. In fact, she wants to have 'separate beds' these days! She hardly ever orgasms and, when it happens, it is only one for the evening. I wondered if there was something medically wrong with her, so I made her go to the doctor with me. He checked her out, but said he could find 'nothing amiss'. Should I insist that she has some hormone tests? Do women kind of lose the ability to climax as they get older?

A. No, they do not. In fact, quite a lot of women become more orgasmic when they get into their 30s or 40s, as they learn to relax and enjoy sex with someone they love. I would say that your wife's story suggests that she is unhappy about something. She could even be depressed. But it is unlikely that there is anything physically wrong with her. After all, the doc who you consulted could find no physical problem.

I do not think that there is much point in your suggesting that she takes a hormone test. I don't recall ever seeing a woman with hormone problems which have caused her to lose the ability to have orgasms.

To be honest, I am not pleased with some of the phrases you used in your letter. You say that you 'made' her go to the doctor. And you talk about 'insisting' that she has blood tests. Frankly, that suggests a very 'bossy' attitude towards your wife. I feel that the origin of these marriage problems may lie in the state of the relationship. Have you considered the possibility that she may have fallen out of love with you? Her request to sleep in a separate bed does suggest this.

Probably, your best course of action is to ask your spouse to go with you to see a marriage counsellor. The counsellor may be able to work out what is wrong with the marital relationship and your sex life.

Q. My doctor says that I have 'chronic cervicitis'. Can you please explain this?

A. Well, the word 'chronic' means 'long-term'. As for 'cervicitis', that means 'inflammation of the cervix'. It is very common.  As I am sure you know, the cervix is the lower end of the womb. It projects downwards into the vagina, and you can easily feel it with your fingertip. It is rather soft, like the tip of somebody's nose. It is also the part that generally comes into contact with the tip of a man's penis, during sex. That makes it vulnerable to damage and infections.

Sometimes, cervicitis is caused from infection by chlamydia or gonorrhoea. But often no germ can be found and the condition just seems to be due to minor trauma or irritation, or possibly an allergy. Some cases are provoked by childbirth. If chronic cervicitis is a major problem, it should be treated by a gynaecologist using a laser or a special gynaecological 'cold probe'.

Symptoms of cervicitis include:

• Vaginal discharge, often thin and white or grey;
• Slight vaginal bleeding;
• Deep pain during intercourse.

Q. If I go on the Pill, can I continue smoking?

A. Ideally, you should stop. The Pill carries a very small risk of causing heart attack and stroke, particularly in women in their 30s. But the risk is much greater in women who smoke.  So anyone who goes on the Pill should really stop smoking. If you cannot give it up, then at least cut down on how much you do.

Q. I have met the most beautiful woman and want to marry her. She is also fantastic 'in the sack', Doctor. But one thing concerns me. When she discharges, she often shoots out a jet of fluid, which drenches the sheets. I have never before encountered a female who does this. Is she sick? And should I try and get her some treatment from a doctor?

A. No, she isn't sick. What you have witnessed is the phenomenon of 'female ejaculation'. That means that fluid is suddenly secreted from an area near the urinary pipe.

This response occurs in a small but substantial minority of women. Some experts have estimated that 10 per cent of women do it. These women have no control over it, and it is important to realise that it is normal.  There is no point in taking her to see a doctor as there is no medical treatment for what is just a variant of normality.

Q. Doctor, I have led a vigorous sex life with quite a few men, and have been married three times. Doc, I don't know if my sexual history has anything to do with my problem. For the last eight months, I have noticed a sore, raw place on the outside of my 'privates'. I have put ointment on it, but no improvement. What should I do?

A. I hope that all female readers will read and remember this. A sore place on the outside of the genitals which won't clear up can sometimes be due to a serious malignancy, namely cancer of the vulva.  This is rare before the age of 30, but becomes increasingly frequent after that. It can be cured if treated early.  So right away you must see a doctor, preferably a gynaecologist. Do not delay.

Q. I have heard that there is some injection that can help a man who has lost his nature. Do you just have the injection once, and then you are ok from then on?

A. No, I am afraid not. The erection-inducing drug is called 'alprostadil'. You have to inject it into the penis yourself. A few minutes later, you should get a good erection.  But you have to do it whenever you want to have sex. These days, many men who do not want to stick a needle in their penis prefer to take Viagra or one of the related oral pills.

Q. I am usually very slow to orgasm. My husband has got the idea from a US website that he should put the tip of his organ against my clitoris. But would this work?

A. Yes, it is a recognised technique that sometimes helps.