Q I am a 31-year-old woman and I have a problem which may be psychological. When I was young, I lived with an uncle - who sexually molested me.

This uncle is a well respected man who pops up in the media from time to time. Every time I see his name I get really distraught. I keep on thinking about what he did to me.

How do I deal with this issue?

A The answer is 'Not on your own.' You really must get some professional help to deal with the bad memories of what happened to you when you were young.

Many people do not realise how distressing it is for a young girl when she is molested by a relative. Sadly, it can cause psychological problems that last a lifetime.

I urge you to go and see a therapist or counsellor now. You may need many sessions. But you should make 2009 the year in which you deal with this ghastly 'hangover' from your youth. Good luck.

Q I am a 44-year-old male and I am wondering if I am suffering from 'male menopause' doc?

The reason I am asking is this: during 2008, I grew increasingly tired. I am a businessman in Kingston, and I have found it hard to get all my work done. On weekends I am exhausted.

I wake up tired in the mornings. I used to like sports, but these days I just don't have the energy.

As for my sex life, I have not lost my 'nature', but I have a feeling that that might happen soon!

There are times when I feel almost too tired to have sex and I am not sure that my erection is quite as hard as it used to be. Also, when I checked my diary, I found that in recent months I have only been making love to my wife around three times for the week.

A Well, three times for the week is pretty good for a guy of 44. It really does not sound to me as though you are becoming deficient in the sex department.

Now, you asked me whether you might be suffering from 'male menopause.' I have to tell you that although people talk a lot about this alleged phenomenon, in fact there is no such thing.

The word 'menopause' means 'ceasing of periods.' And as you have probably noticed, guys do not have these!

However, I must acknowledge that in the United States and England there are some doctors who claim that men do experience the equivalent of female menopause. They state that, in many men, the levels of sex hormone 'falls off' quite dramatically in the 40s and 50s.

They also maintain that this is rather like the big fall in female sex hormones which occurs in most women at the time of menopause.

Personally, I disagree with that viewpoint. In contrast, I agree with American scientists who say that in most men, levels of male sex hormone (testosterone) decline only very gradually - from about the age of 20 to around the age of 80. If you look at the graph of testosterone production over the years, it is a slow and gentle curve downwards. In most males, it does not reach a really low level until far into old age.

However, it is clear that you are not feeling too well and are tired all the time. Why is this? There are many possible causes, including:

Stress

Depression

Overwork

Anaemia (weak blood)

Excessive alcohol intake

Excessive smoking

I think that what you should do is to go see a doctor who can listen to your story and give you a thorough check-up. He will almost certainly want to do blood tests. There is no reason why these tests should not include an estimation of male sex hormones, just in case you really do have any testosterone deficiency.

I feel pretty sure that the doc will be able to find a reason for your constant fatigue, and give you the correct treatment for it.

VAGINISMUS

QI am 35-year-old female, and I kept my virginity for marriage. In fact, I finally got married around 10 months ago.

But to my surprise, doc, my husband and I have not yet succeeded in having sex.

I don't know why. I think it is something to do with the fact that I kind of 'tense up' whenever he tries to enter my body.

A You may well be right. 'Virgin marriages' are more common than most people imagine.

In most cases, the problem is that the wife has a condition called 'vaginismus.' This is a kind of 'muscle contract' which affects the muscles around the vagina, and also the muscles of the thighs.

The result is that the woman tenses up whenever anyone approaches her genitals. Usually, she has never been able to have a vaginal examination by a doctor. And, as a rule, she has never been able to insert tampons.

The cause of all this is stress and nervousness. Often, the unfortunate woman has been brought up with false ideas about sex being a very painful thing. And she may wrongly believe that her vagina is real small and narrow. Therefore, she dreads getting hurt.

Fortunately, this problem of 'non-consummation' can generally be put right - once the woman has been taught how to relax her body, and let her vaginal muscles decontract.

If there is a medical clinic near you where they deal with family planning and related matters, I think you should see the doctor there, and talk to him/her about the problem. It would be a great help if your husband went along with you.

I am sure that she will examine you carefully, and help the two of you to overcome this difficulty. I wish you well.

PULMONARY EMBOLISM

QMy mother has just died, doc - of something called a 'pulmonary embolism.'

But I do not understand what that is. Is it like a heart attack? And was it caused from the fact that she was a smoker?

A I am sorry to hear that your mother has passed away. A 'pulmonary embolism' is a common condition. What generally happens is this. A clot forms in a vein in the person's leg. That clot breaks off and travels up the vein, and then through the right side of the heart.

Finally, it jams in the lung, where its effects can sometimes be fatal.

Yes, smoking does make a person more liable to develop such clots.

QDoc, I have noticed that if I drink too much I cannot get an erection. Is this serious?

A Well, it is a warning. Alcohol is notorious for causing men to lose their nature, and it tends to get worse as time passes.

So you should cut down on your drinking right away.