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Dear Doc | Should we be doing it more often?

Published:Sunday | November 6, 2016 | 12:00 AM

Q Doctor, how often should a couple have sex? My wife and I cannot agree on that! I must tell you that we are both 47 years old, born on the same day!

We have been married for 19 years, and our 20th anniversary is coming up. We use to have a lot of sex when we were in our 20s, but I must admit that it is less often now. Still, by my estimate, we 'do it' around twice a week, and sometimes more.

Now my wife says that I am not giving her enough! She thinks that at our age we should be doing it more. She has it in her head that most couples in their 40s have sex around four times a week. I think that she read this in an American women's magazine.

Doc, please tell me which one of us is right.

A The first thing I must say is that you two must get this dispute sorted out as soon as possible. At the moment, it may just seem like a friendly disagreement, but in a year or two, it could easily develop into something more unpleasant, and the final result could even be divorce. So please, get this matter fixed as soon as you can.

Now, who is right? Well, the short answer is that you are. Despite what your spouse has read, most couples in their 40s do not have intercourse four times for the week. Some do, but most don't.

Let's look at the best available figures from the famous Dr Alfred Kinsey. Here is a table which shows how often husbands have sex at various times of life:

So you can see that a man at your age (47), cannot really be expected to have intercourse four times for the week, unless he is unusually virile!

The average would be around one and three-quarters per week. Please inform your wife of this.

But it is not enough to prove her wrong. You must do something about your wife's apparent frustration. My advice is that you should try to spend a lot more time on foreplay each week. It would be a good idea to make certain that she gets as many orgasms as she wants.

If she agrees, it might be a good idea to buy her a nice little vibrator with which you can satisfy her, even when you are too tired. Let her pick one out on the Internet.

If possible, the two of you should also get some advice/counselling from an experienced doctor, nurse or therapist. Please don't ignore what your spouse has said. She is clearly not too happy, so you have to take action. I'm sure you do not want to lose your wife.

Q My doctor wants me to use the medicated coil. But I do not see the point of it!

I know that a lot of women have coils, but what is the purpose of a 'medicated' one?

A Well, as you say, a lot of women do use ordinary coils (IUDs) to protect against unwanted pregnancy.

But coils do have a small failure rate, so a few pregnancies occur. Therefore, years ago, experts decided that they could improve the success rate of the coil by adding a female-type hormone to it. That is what the phrase 'medicated coil' means.

The medicated coil is often known as the 'intra-uterine system', or 'IUS.' The good thing about it is that the hormone which is contained in it will usually reduce menstrual flow. This means that the periods are often much easier to cope with.

Quite a lot of women who have had very heavy menses have been able to avoid having a hysterectomy (womb removal) because they have opted for medicated coils, such as the well-known Mirena. I hope you get on well with the IUS.

Q Doc, I am frantic with worry. I think my wife has cheated on me?

You see, several years ago while I was working in England, I went and got a vasectomy. I understood that this would totally protect me against having children!

But now the terrible thing is that my wife is pregnant. Does this mean she has had sex with another man?

A No, not necessarily. You seem to have been slightly misinformed about how effective a vasectomy is.

In fact, there is a failure rate of about one in 2,000. So it is just possible that your vasectomy has failed, and that when you had sex with your wife, some sperms are getting through.

If you can, I think you should ask a doctor to arrange a sperm test for you. And if this shows that you have a lot of sperms in your seminal fluid, then it will be certain that your vasectomy has failed and the obvious conclusion would be that you are the baby's father.

Even if the sperm test does not show any sperms in the fluid, it is possible that some managed to get through on the night your spouse became pregnant.

So please do not condemn your poor wife. It may well be that she is totally innocent.

Q How safe is it to use condoms for sex, Doc? I have heard that they can fail, and that as a result the woman can get pregnant.

A Condoms do sometimes break, particularly if they are used roughly. And, occasionally, they get torn on people's jewellery, or even on the woman's teeth.

But, in general, they are a very good method of contraception. The success rate is generally around 98 per cent if used properly. This means that if 100 couples employ the condom for a year, adhering strictly to the instructions, around two of the women will get pregnant.

The most important thing to remember is that you must put the condom on the penis before intercourse begins. Don't make the common mistake of putting it on when you are halfway through!

Q Doc, my husband is thinking of taking Viagra. But does it have any side effects?

A Yes, but they are mostly very mild. They include headaches, blocked nose, gas, discomfort in the abdomen, and feeling dizzy, especially if the man gets out of bed too fast after sex!

However, any man who is thinking of taking Viagra should first get a check-up from a doctor.

Q Dear Doc, up to what age can a woman take the Pill?

A Well, I have known a few fit, healthy, non-smoking women who have stayed on it until they were 48 years old. But the fact is that the Pill carries a small risk of thrombosis (that is, clotting), and this risk does tend to increase around the age of 35.

So my view is that at 35, women should be looking for some other method like the mini-Pill.