Q Doc, I would really like to satisfy my wife, but it seems like I am not doing so. I love her a lot.

She has been married twice before, and although she has a 'hostile relationship' with her two ex-husbands, she does say that they both had the ability to make her have an orgasm during intercourse.

Doc, I'm not able to do that and it makes me feel bad.

I can actually make her climax when we are fooling around BEFORE intercourse, and even after. But I really would like to make her climax while we are having sexual intercourse. I have read on the Net that this is possible if the husband uses his hands. But I do not understand how.

A I am sorry to hear that you are feeling inadequate compared to your wife's previous husbands. But, I don't think you should feel too bad. It sounds like you have a loving relationship with your wife, and you can clearly make her have an orgasm.

The trick is to be able to do it during intercourse. This can be done with the skilful use of your hands!

From what you say, I think you already know all about how gentle pressure with the fingertips on the clitoris will make women climax.

Now, we have to get you doing the same thing for her during intercourse.

One simple way of achieving this is to make love to your wife from BEHIND her. For instance, you could do this with both of you lying on your left sides. This gives you ample room to 'reach around' with your right hand and stimulate her clitoris with your fingertips. In that way, you can help her to climax while you are inside her.

There are a lot of books on 'sex positions' which actually tell you which ones gives you better access to the clitoris. You can also find some positions on the Net.

Unfortunately, the standard face-to-face position does NOT give the greatest access to the clitoral area. However, if you take care to position your hand so that the PALM of it is facing your wife, and with your fingers pointing downwards, you will find that it is quite possible to use it during intercourse to stimulate her clitoris whenever she wants you to.

Some couples like to employ that technique so that the woman have multiple orgasms during intercourse. Others are perfectly happy to use it so that they orgasm simultaneously.

Finally, there are women who choose to use their own fingers to achieve an orgasm during sexual intercourse. But that particular manoeuvre is not acceptable to everyone. Nevertheless, it works very well since the woman can precisely time her climax.

Q I am a woman a little over 40. In the last year or two, I have been completely single with no sex.

To my surprise, I find that I don't miss sexual intercourse at all. Am I abnormal?

A Not in the least. Sometimes it is possible to get the impression from books, magazines and films that ALL 'mature' women should be wild sex-hotties!

This is not true. In fact, a lot of women over 40 do enjoy sexual relations, but others are bored by the idea of sex. And a few do not like it.

This summer, a European researcher did a major survey of hundreds of women over 45. She found that about a quarter were still very keen on sex. Another quarter liked it, and another quarter were not interested at all.

However, a substantial minority of women said that they WOULD become interested in it if a interesting guy came along!

Q Doctor, unfortunately I have to go on Viagra soon. This is because I have temporarily lost my 'nature', due to diabetes.

My doctor is offering me the choice of Viagra tablets or Cialis. Which is best?

A Sorry to hear that you have 'lost your nature'. I hope everything improves soon. There are now several drugs for erectile dysfunction, of which Viagra and Cialis are the best known.

Frankly, I do NOT think there is a lot to choose between them. However, an advantage of Cialis is the fact that it LASTS a lot longer than Viagra.

You see, as a rule, Viagra will only work for about four hours. With luck, Cialis may continue to work all day, or longer, if you are lucky.

These two drugs cause the same side-effects, except that Cialis is more likely to give you muscle pains or backache.

Q Doc, we are a newly married couple in our 40s. Do we still have a chance of conceiving a child?

A Yes. A woman's fertility does decline rapidly after 40, but you still have a good chance of conceiving, particularly if your periods are still regular.

Because 'the clock is ticking', my advice to you is to start trying now if you want to have a child.

Your best plan is to make love on the day you think you might be ovulating (that is, releasing an egg). If your husband can manage it more than once that day, then that would be a good idea.

If you have NOT succeeded in conceiving after about four months, please contact me again.

Q Would vitamins help my sex life, Doc?

A To be honest, I do not see any way in which vitamins could help a person's sex life UNLESS they were suffering from some definite vitamin deficiency.

Q Does smoking hurt a guy's ability to have erections?

A Most definitely! The nicotine in tobacco has the unfortunate effect of NARROWING the tubes that carry blood to the penis.

As the years go by, that makes it more difficult to get a good erection.

Therefore, I would recommend all men who smoke to try and give up now!

Q Doc, ever since I reached menopause last year, I find that I get a severe jab of pain in my belly whenever I have an orgasm. Why?

AThis is very common for women in their 40s. The pain can be very distressing. It is thought to be due to the drop in female hormones which usually occurs around the age of 40.

Some doctors treat it with hormone replacement therapy, and I feel you should give that a try. So, see a doc, have an examination and get her opinion.

I hope it will cheer you up if I tell you that all the women I have seen who have this condition did eventually get better, and were able to have an orgasm without any pain. In the meantime, it is OK to continue having sex with your partner.