Questions about human sexuality begin as soon as we can talk and continue until very old age.

If you have unanswered or private questions about sexual issues, please talk to your doctor about them. Women may also refer to the section about "Women's Health" for questions that are not addressed here.

However, sex can also result in serious problems such as unwanted babies, sexual diseases, bad relationships, and bad feelings about yourself.

A weak relationship gets worse when fights or major concerns about sex become part of it. Your doctor hears from patients who worry about whether they have enough sex or too little or reach climax enough or too little. There is no correct answer. Impotence and failure to reach climax are very common concerns for couples who are having personal difficulties. Doctors and marriage counselors can help couples talk about and resolve these issues.

A health care professional will consider many other possible causes of impotence. First on every doctor's list are some medications for blood pressure, depression, and emotional problems. Drug and alcohol abusers often have difficulty with sexual function. A change in medications and drug or alcohol habits usually corrects the impotence.

A second cause is (sugar) diabetes. Third is a poor blood supply to the legs which also supplies the penis.

In impotence with no obvious cause, the man must decide when treatment makes sense to him. A man whose partner "does not care" may decide on no treatment. Some couples find that snuggling and other forms of intimacy meet their needs.

Pills taken by mouth or tablets inserted into the penis are helpful for many men but about 1-3 in 10 men will be bothered by these medications. Men who use nitroglycerine should generally not use these pills because of the risk of heart stoppage. Yohimbine also helps some men and only about 2 in 10 men have minor problems cause by the drug. Zinc is often pushed for impotence but there is not much evidence that it works.

More women than men have sexual concerns. Pain during sex is a very common problem.The causes for painful sex depend on whether the pain occurs most noticeably during insertion or during deep penetration. Insertion pain can be due to inadequate lubrication or other problems in the vagina such as an infection. If no discharge or bleeding and dryness seems to be the cause, a trial of a water-based lubricant (like gel products) is a reasonable first approach.

Deep penetration pain may be caused by problems in the uterus or lower abdomen. A pelvic examination should usually be performed.

Women can have satisfying relationships and sexual feelings without frequent orgasms. On the other hand, if you feel that your lack of orgasm is a problem, please bring it to your doctor's attention.

In another third of couples with infertility, the woman has a problem which leads to infertility. First, the doctor will usually ask the woman to track her temperature early in the morning. This will identify her most fertile period. If pregnancy still does not occur, the doctor will recommend additional tests.

The frequent female cause is found in the ovary (20-40%) or tubes from the ovary to the uterus (20%). A problem in the tube most often follows infection with sexually transmitted diseases or abdominal surgery.

Relationship problems between the partners is another important cause of infertility.

Many persons do not have intercourse and explore their sexual feelings in other ways. You need to decide what you want. It helps to decide ahead of time about which sexual activities feel right for you. Communicating your wishes to your partner is very important.

The simplest and safest birth control method is a condom or "rubber" (a balloon-like device worn over the penis). The most important thing to remember about condoms is that it has to be used every time. Overall success of condoms for preventing pregnancy is 90% and condoms are the only way to reduce the risk for sexual diseases.

Never use baby oil, petroleum jelly, or cold cream with a condom because these will weaken it. Water-based lubricants can be used.

A diaphragm (worn inside of the woman) and vaginal sponges are usually less effective than a condom. The success rate of these methods ranges from 65-85%. Condoms and diaphragms may be made more effective by using a spermicide with them. (A spermicide is a jelly that kills sperm). Using a condom with a diaphragm increases protection from unwanted pregnancies.

Natural family planning or the "rhythm" method if very difficult because you have to time your sexual activity with the least productive time of your monthly cycle. About 2 of 10 women who use this method will become pregnant in a year (in comparison to 8 of 10 who use no method of birth control). Birth control pills reduce the chance of getting pregnant about ten times better than natural family planning. In young women the chances of getting pregnant using a condom are about four times better than natural family planning.

Birth control pills are easy to take but do require a prescription from a doctor. They do have some problems as well. Pills are quite safe, especially for women who don't smoke. The success rate is over 95%.

Other forms of birth control include placing match stick-sized "pills" under the skin of the upper, inner arm. The implants can be removed any time and last up to five years. Birth control shots are available. These shots can protect for several months. Intrauterine devices are best used by women who have had children.

Emergency contraception after intercourse will be over 80% effective for the prevention of pregnancy if standard contraceptives are used within 72 hours.

Permanent birth control, tubal ligation for women, or vasectomy for men are appropriate options for some couples. Both forms requires some surgery.

There are other virus diseases that spread in the same way as AIDS. Herpes causes sores on your mouth, penis, or vagina. One in five persons in the United States now has herpes and the percentage has increased by 30% since 1970! A large number of sexual partners greatly increases your risk. An anti-virus medicine can help but will not cure herpes.

Warts that grow on the skin of your penis or vagina are growths caused by viruses. They can be treated but the treatments often don't cure the problem.

A lot of sexual diseases are caused by bacteria. Syphilis, gonorrhea, and chlamydia are the three most common ones. All usually cause sores, pain or dripping. Early treatment is important. Gonorrhea and chlamydia can cause problems for women who want to have babies later in their life.

You can lower your chances of getting a sexual disease by using a condom. The chances may be made even lower if you use a spermicide with the condom.

Young women who are sexually active should have pap tests and a test for chlamydia.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.