Q I was interested in your recent article about hormone replacement therapy. I am 47 and I am getting hot sweating attacks and a rather dry vagina - which is making sex slightly difficult. But I am not good at taking tablets, doc. Is there any other way of having HRT?

AYes, there certainly is. You can take it vaginally, or as a skin patch, or via a coil. There are also other ways, as explained below.

Vaginally - There are female hormone creams and 'pessaries' (that is, vaginal tablets) which give you a modest dose of HRT. They are very good for vaginal dryness or soreness during intercourse. However, the hormones don't just work on the vagina. Some of them are absorbed into the body, and might have untoward effects on the womb or the breasts in the long run. Therefore, these vaginal hormone preparations should only be used under a doctor's supervision.

Via a skin patch - This works very well in treating menopause symptoms, but you have to remember to change your patches - usually every week. In some cases, you have to take tablets as well as use the patch.

Nose sprays - Nose sprays containing hormones are not as popular as other methods.

Vaginal rings - These rings are impregnated with female hormone. You 'wear' one continuously in your vagina. Surprisingly, this does not usually interfere with sex. You have to remember to have the ring changed every three months.

Coils - Hormone-loaded coils work very well, and are an increasingly common choice.

Skin gels -These also contain female hormone, and you just apply them to your thigh each day - alternating between the right and the left thigh. Some women need to take tablets as well.

Implants - Under-the-skin implants gradually release hormone over several months.

There are many different ways of taking HRT. They all have their advantages and disadvantages, and your doctor can tell you about these.

QI am a guy in my 'middle years', and my doctor has just told me that I have 'a mildly enlarged prostate'.

Will this affect my sex life, doc?

AProbably not. Generally, the prostate gland affects the flow of urine - because a guy's urinary pipe goes through it.

But unless the gland swells very large and becomes uncomfortable, it does not usually affect the man's ability to have sex.

QI am a woman who has been battling with my sexuality. I have dated guys, because of the expectations of society, but, to be honest, I definitely prefer women, and have loved them from my teenage years.

I cannot express my feelings to my family, because I do not want them to be disappointed or upset. But I want to be true to myself. What should I do?

A Well, there are people who would tell you that you need to 'get your head sorted out' by seeing a psychiatrist. Personally, I do not think that would do any good. To date, I have never seen a lesbian-inclined lady who had her orientation changed by consulting a psychiatrist.

However, I do think that you would benefit from some sympathetic counselling - particularly regarding the difficult question of letting your family know about your feelings. Do not be in too much of a rush to tell them. Some parents (and siblings) can be very upset by hearing that their daughter or sister is a lesbian.

QI am a guy who is not very successful with women. Recently someone told me that I have bad breath!

This is quite a big shock for me. Is it due to some kind of belly complaint?

ANot usually. In most cases, it is caused from a problem with the teeth. Unfortunately, tiny pieces of food can easily get trapped in crevices of a tooth. They then rot and cause a bad smell.

So, your first move should be to consult a dentist and get some advice about your oral hygiene.

QDoctor, I have met a guy who is good and kind. He says he loves me. I would like to marry him and have children.

But there is one big problem. When we have sex, he is completely unable to discharge. He goes on for hours, but does not 'come'. He says he has been like this all his life. In fact, he has never climaxed inside a woman. Naturally, this means he has no children.

Apparently, he can have an orgasm when he is on his own. So what is wrong with him? And will he ever be able to give me children?

AThis guy has a condition which until very recently, was known as 'ejaculatory incompetence'. You can find out a lot more about it on the Net, by googling its newer name - 'delayed ejaculation'.

It is quite a common male disorder, and its characteristic feature is that the guy is unable to discharge inside the vagina.

No one really knows the cause, but frequently these patients are 'strong and silent' men who are very self-controlled and who find it difficult to let their emotions show. They also find it difficult to climax when other people are around.

When they are young, such males are often very popular with the ladies - because they can 'go on and on' having sex for hours without having an orgasm. But as you have discovered, they are not very useful for fathering children!

So, if you marry this guy, I do not think that he is likely to get you pregnant, unless you used 'artificial insemination'. That is the process whereby a man's sperms are artificially introduced into the woman, usually with a syringe.

However, it is possible to get treatment for 'delayed ejaculation'. The treatment is by means of special counselling. Usually the counsellor or sex therapist makes use of the fact that the man can ejaculate on his own. The guy is encouraged to climax in a room adjoining the one where his wife is. Over a period of months, he is encouraged to move closer and closer to her - until he can do it in the same room as her.

Usually, after about three months, he is able to climax in the marriage bed. Then the therapist teaches the couple certain simple manoeuvres which gradually accustom the man to the idea of climaxing near the vagina - and then inside it.

As you can see, this psychological treatment is not easy, and it is very time consuming.

However, it does offer your best hope of having a satisfactory sex life with your man - and having children.