Does my sperm problem make me less of a man? And why do my ears turn red?

SEEDS OF DOUBT

SEEDS OF DOUBT

Q. I'm a bit shy about this one. I'm in my seventies and have needed Viagra for several years. But I have - for me - a wholly satisfying sex life with my younger wife. But over the last year or two, she has become aware that, although I still have proper climaxes, I'm not producing much semen. I had no idea that this mattered to a woman, or even that she would be particularly aware of it. But several times she has made remarks that suggest that she is a bit disappointed, or that she is afraid that I am (I'm not). Is there anything that can be done to improve my output?

A. If you are asking for my advice about how to discuss this with your wife, I'm sure that openness and honesty will be much more successful that bluffing and double bluffing. The amount of semen that a man produces does decrease with age. The volume of semen decreases by about 20 per cent between the ages of 30 and 50. After that, I'm afraid, the slope of the curve continues downwards. But don't despair. The last time I wrote on this subject, a reader commented that the volume of semen can be affected by the amount of time a couple engage in foreplay. I don't know if it's true, but it's worth trying.

RED ALERT

Q. For about six months, I have been suffering from red ears. The symptom occurs almost always in the late evening, usually persists through the night and clears up when I get up in the morning. I rarely experience this before the middle of the evening, unless I take strenuous exercise, and then it might be triggered. The first sign is a pulsing in the ear, and then an increasing warmth. My ears can then become uncomfortably hot, and almost port wine in shade. I have a history of allergic reactions, and wonder if this might be the cause, but, to my knowledge, I have not in any way changed my eating or other habits recently.

A. Most people who get red ears also find that they blush easily. For them, the blushing is usually caused by fear or anxiety, such as when they find themselves in difficult or uncomfortable social situations. The blushing is a true psychosomatic reaction - the tiny blood vessels in the ears open up and allow excessive blood flow in response to anxiety. The ears are not the most common site for blushing - the neck and upper chest are where blushing is visible in most people. Your symptom doesn't sound like blushing, because it seems to come in response to either exercise or at a certain time of day. An allergic reaction is a possible cause, but it is going to be difficult to be sure if you can't identify anything in your diet or environment that sets the redness off. Another possibility is simply that your body's vascular system has become somewhat over-reactive. Alcohol causes opening up of the small blood vessels in the skin, and I wonder if a drink with dinner might be the source of your problem.

Have your say: Readers write

AB from Cambridge thinks I was too relaxed in my advice about wasp stings:

Having been stung a few times with only mild local reactions, a few years ago, a wasp sting caused anaphylactic shock. Thanks to prompt intervention, I'm still here. My GP said that you can get sensitised to repeated stings until one can become fatal. Now, I always carry adrenalin. Contact the Anaphylaxis Campaign, a charity for allergy sufferers, for info: www.anaphylaxis.org.uk

Send your questions and suggestions to A Question of Health, 'The Independent' 191 Marsh Wall, London E14 9RS; fax 020 - 7005 21 82; or e-mail health@independent.co.uk Dr Kavalier regrets that he is unable to respond personally to questions

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