You and your partner need to begin talking (not screaming) about how to solve this problem. Fatigue or depression may be factors. You should be asking yourselves how much time you devote to your relationship. Is it enough? You should be able to find out whether there is a hormonal problem by asking your GP to refer you to an endocrinologist, who is interested in hormonal problems around the time of the menopause. Some drugs, particularly the newer anti-depressants, can suppress sexual desire and pleasure. I would suggest that you and your partner see a specialist therapist who is accredited by the British Association for Sexual and Marital Therapy. You can contact them at PO Box 13686, London SW20 9ZH; or visit their website at http://www.basmt.org.uk
I SUFFER from a dry throat and mouth at night. What can I do, apart from sip water?
If the problem occurs just at night, it is likely to be caused by either breathing through your mouth when you are asleep, or some environmental factor in your bedroom. If you breathe through the mouth, it may be because your nose is blocked or even obstructed, perhaps by a deformity of the septum that separates the nostrils. Try an anti-inflammatory nasal spray such as Beconase for a month or two. Have plenty to drink throughout the day. This will prevent you from becoming dehydrated overnight. If you are taking any regular medications, look at the side-effects. Many drugs cause dryness of the mouth. Make sure the air in your bedroom is well- humidified. Containers of water on the radiators will help.
I HAVE noticed that if I sleep in a certain position (with lots of pillows, on my side, with arms curled in front of me), as I am drifting off to sleep I can feel my breathing get shallower and shallower until I wake suddenly, gasping. Is this sleep apnoea, and should I worry?
Sleep apnoea causes many episodes through the night in which breathing becomes shallow and then stops for 10 seconds or more. Most people with sleep apnoea snore. Ask your partner to watch you when you are asleep. If the same thing occurs while you are sleeping, it may be sleep apnoea, which can have serious effects if untreated. The way to find out is to be referred to a sleep laboratory.
Send questions to A Question of Health, 'The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; e-mail health@independent. co.uk. Dr Kavalier cannot respond personally to questions