FORMER US president Bill Clinton did all men a favour by getting involved with Monica Lewinsky, says John Conaglen, Waikato endocrinologist and associate professor.

In the past, he says, people never discussed sex or sexual problems.

"HIV's brought us the ability to talk about condoms and to talk about different forms of sex.

"Bill Clinton's given us the ability to talk about oral sex. You might laugh but it's very important.

"And Viagra's changed things too.

"It's all right to talk about sexual difficulties and bring them to your doctor," says Prof Conaglen.

Men's sexual difficulties might include:

* Not getting and sustaining erections;

* Premature ejaculation;

* Differences in sexual desire between themselves and their partner;

* Worry about size.

Prof Conaglen says the first step is to see a health professional to rule out physical causes. Problems with erections can be caused by a blood vessel disorder such as blocked arteries, diabetes, prostate or abdominal surgery or a neurological disorder. Other factors in sexual performance include medications, marijuana, smoking and alcohol (brewers' droop).

Psychologist Helen Conaglen (married to Prof Conaglen), says there is a proven connection between erectile dysfunction and mild depression.

"People who experience depression feel less inclined to behave sexually and that can be indicative of an underlying medical problem. And erectile dysfunction can cause depression."

The good news is that much sexual dysfunction is curable, often without unpleasant tests or treatment.

Dr Conaglen's advice: "When having a check-up, cover all the territory, rather than just the obvious. If you do have sexual problems, then raise them with the doctor so you can start the process of working things through."

If you've got the all-clear from your GP, says Robert Jenkinson, manager and counsellor at Relationship Services, counselling might help.

"All men experience erection problems and premature ejaculation at some time in their life but we just don't talk about it.

"Sometimes it can be because men are just too stressed. They have a month of long hours or alcohol or whatever and as they relax they recover.

"But if it does persist it can be helped."

Mr Jenkinson takes men -- and later their partners too -- through a programme of exercises designed to enhance their sexual experience.

"For premature ejaculation the common response used to be to put on a condom to decrease sensation.

"Well, that doesn't work. What the man has to do is get to the point of losing it but then pull back. We get the man to recognise his growing excitement and slow it down."

Mr Jenkinson says sessions often touch on other areas of life.

Sexual unhappiness can be caused by trauma, inhibition, performance anxiety, sexual preference, sexual abuse, fear of pregnancy or disease, or relationship difficulties.

"Men also need to realise that as they get older there tends to be a slowdown of their sexual response. Again, it's quite normal," Mr Jenkinson says.

He is reassuring about those receiving counselling: "They don't get their gear off but they're afraid they might have to. That's not what counselling is about."

Reference Source 110