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Q. My husband and I have been married 16 years and we have a good marriage. But since my husband turned 40, his lovemaking has really slowed down. Is this common?

A. A sexual slowdown is common in males. It may come sooner or later and may express itself in different ways. Guys just run out of steam about midlife.

One way is that his physiological response may not remain as rapid and intense. When men become aroused, it's usually fast and leads to a firm erection. But with age, stress, and fatigue, this may change. It may take longer for him to become erect, he may not be as firm, and it may delay ejaculation. These expressions of "slowdown" can be physical—related to the neuro-vascular response to stimuli—or psychological—because of relationship or self-confidence issues.

When this slowdown occurs, it may cause him to lose an interest in sex because he may become fearful of "failing" again and lose his self-confidence. So he just avoids sex.

Fortunately, the most common causes that can be successfully changed are: fatigue, stress, medication, physical illness, relational conflict, and alcohol use. So the first step is to do an evaluation of what's going on in his life. He may want to talk to his pastor or a buddy to help identify the contributing factors. He may also need a thorough physical evaluation to rule out such things as thyroid disorder or diabetes.

If nothing much is found except the changes accompanying his mid-life transition, counseling may be helpful. You can be a great support by expressing your loving encouragement.

Whatever the situation, it can usually be helped and intimacy restored.

She's Overweight

Q. My wife has gained 25 pounds since we've been married. I don't get as excited just looking at her as before, and find myself not making advances. I also compare her to other, thinner women. My wife's aware of my feelings, and is trying to lose weight, but she has fibromyalgia, which makes it difficult for her to exercise. I know I don't have a perfect body, and that physical attraction isn't everything. What can I/we do to improve our sex life?

A. You're another victim of our cultural revolution! Turn off the TV, don't go to movies, and avoid many magazines. Hollywood and the media constantly present thin (actually underweight) women as the sexual ideal. Of course they also present those Bowflex guys as the desired male image. You mentioned you don't have a "perfect body" either. Has your wife lost her attraction to you?

Sex, love, and marriage go a lot deeper than dress size and abs of steel. It's important for you to focus on the things about your marriage and your sweetheart that attracted you in the first place. You have the power to turn off the negative thoughts and reinforce the positive ones. It's your choice and responsibility to approach your wife sexually. Serving is what love is all about.

It sounds as though your wife's been feeling a lot of stress. We suggest the two of you seek counseling now rather than let the destructive patterns become solidified. Her fibromyalgia and weight gain might be stress-related and will continue to be affected negatively by the added stress she's feeling from you. You can help most by finding out what her needs are and meeting those needs. When she's feeling your love and affirmation more than your criticism and disappointment, she'll be much more motivated to change. And maybe you could exercise and change together.

I Had an Affair

Q.It happened more than two years ago. It was a one-night thing and I confessed everything to my husband. I know I hurt his self-worth and sexuality. But he's still unable to forgive me. To be honest I'm not sure why I allowed the affair to happen—which is the worst thing about it. We're both afraid I'll allow an affair to happen again. What should we do?

A. It sounds as though you truly regret the incident and obviously you care enough to try to make things right with your husband. While you say it was a "one-night thing" and you're not sure how you "allowed it to happen," we're not surprised you're not sure you won't "allow it to happen again."

We're also not surprised your husband hasn't forgiven you. In our experience working with couples, we've found the be-

trayed spouse often has a hard time forgiving adultery—especially when, as you claim, you're not sure why you did it. But there are keys to healing the wounds caused by your infidelity.

The first key is to have genuine remorse about committing adultery. As we hear from adulterers in counseling, we find that many try to minimize the significance of betraying their vows. Our secular culture reinforces the notion that just a "one night stand" isn't such a big deal. But that thinking is a dangerous deception. All adultery creates hurt and a huge barrier to ever trusting again. Not only was your marriage jeopardized, but any kind of casual attitude about the sinful choice also jeopardizes relationships with your family and God. While there can be repentance, grace, and forgiveness, they have a price.

The second key is a genuine confession (and yours may have been) without any attempt to justify or minimize the sin. That helps rebuild the relationship and makes you aware of your vulnerability. You have a will and the power to make your choices. As a Christian, you also have the Holy Spirit to help you avoid giving in to the temptation. First Corinthians 10:13 says: "No temptation has seized you except what is common to man. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can stand up under it."

A third key is developing self understanding. You said you don't know why you had an affair. But if you honestly seek the truth and explore the underlying causes of your adulterous relationship, you'll find answers. Often they lie in self doubts about being attractive or desired. At other times it may be a need for excitement and risk taking. There may be an impulsivity left over from adolescence. While there are many reasons that can contribute to adulterous behavior, they're explanations, not excuses.

Fourth is spiritual forgiveness before God. We can understand Psalm 51 in which King David expressed his broken heart to God about his adultery with Bathsheba. He realized his sin was ultimately an affront to God: "Against you, you only, have I sinned and done what is evil in your sight" (vs. 4). Realizing the destructive spiritual consequences of adultery is essential to total restoration. David went on to plead, "Create in me a pure heart, O God" (vs. 10). And he does! Every time.

Fifth, you need to establish firmly identified boundaries on your behavior. Don't allow yourself to go into relationships and situations where you might be in danger. I (Louis) know when a woman is coming on to me in a seductive way—most men do! And I know I'm titillated by the flirtatious attention. I also know that's a temptation I don't need. I can flirt with that woman and expose myself to the excitement of her sensuality (and the risk of indulging in inappropriate touch or talk), or I can make sure I steer clear of her. Choose to set boundaries that will keep you from falling.

My Husband Is Disabled

Q. My husband was disabled in a bad accident and now he's in constant pain. So we haven't had sex in a long time. I love my husband and want to turn him on. I've exhausted every option: dressing up, taking a vacation, marriage counseling, sexual toys. Nothing helps. I really miss his touch. And being without it is killing my self-esteem. Any ideas?

A. Chronic pain is often too difficult to ignore in order to respond sexually. Have you and your husband pursued every avenue to achieve pain control? If not, go to a pain management clinic for treatment and emotional rehabilitation.

Your best approach for physical affection and sexual release is to tell your husband just what you told us. You expressed your love and concern for your husband; you indicated your willingness and attempts to make things happen. You stated clearly your desire for his affection—and what has happened to your self-esteem as a result of not having sex. Your husband needs to hear those things. As a person in pain, he should be able to identify with your pain.

If he hasn't read the letter you sent us, write those words in a love note to him. Let him know he doesn't have to become some super lover, but that you want to feel his touch again. Maybe you can remind him of the warmth you once shared. Then discuss some ways you can both work to have a satisfying sexual relationship. While you tried marriage counseling before, you may also want to consider revisiting that option as well.

Melissa and Louis McBurney, M.D., are marriage therapists and co-founders of Marble Retreat in Marble, Colorado, where they counsel clergy couples.

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