Q: Am I over the hill at 24?  I’m 24, so I know I’m already past my sexual prime. Are there exercises I can do to help me keep my sex life going as long as possible?                   –Curious

Dr. Linda: Past your sexual prime? Give me a break. A man’s sexual peak being at 18 is the ultimate myth. Think about it. Do you really think  you were a better lover at 18 than you are now? Doubtful, unless you’re using trigger speed as your measure–hardly a result that would inspire girls to line up for their turn.

Great sex involves acquiring and expanding a set of sexual skills. That takes time. So does increasing your knowledge of how to connect intimately with a woman in non-sexual, “vertical” ways. Developing comfort and insight with those forms of connection has a direct bearing on the quality of your “horizontal” intimacy. That’s why, generally speaking, mature lovers, not teenagers, make the best lovers.

The best exercises for keeping your sex life robust?. Any exercise that promotes endurance (aerobic), strength (weight training) and flexibility (stretching) promotes sexual fitness. It’s being inactive, along with other harmful lifestyle choices (poor diet, smoking, drugs, excess alcohol), that can hamper your sex life.

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Q: A bit of stinging while doing the deed.      My husband and I have been married a little over a year, and in the beginning, our sex life was normal. For the past several months, however, I’ve been feeling some anxiety when he starts to penetrate. It stings, and I often have to make him stop.  Instead of having intercourse, we do other things. I honestly enjoy oral sex and variety, but I really miss having intercourse, yet I’m becoming more and more fearful of it. Is there any medicine that can get rid of my fears and the pain? — Serena

Dr. Linda: First things first. You need to see a doctor if you haven’t already done so. Maybe you have a minor infection or some other problem that could trigger pain. If a doctor gives you a clean bill of health, you have a couple of other options to explore.

Don’t always take one doctor’s verdict as the gospel truth. A referral to a specialist, in this case a gynecologist, if often a good bet. In the past, many women complaining of pain have been dismissed as simply having “hang-ups” when a true physical problem existed.

One common cause of  burning sensations on penetration is a problem called vulvar vestibulitis. For more info on the physical front, check out Chapter 9 of Dr. Christiane Northrup’s recent Women’s Bodies, Women’s Wisdom.

On the other hand, don’t overlook the psychological side. Start thinking about what else was going on in your lives or your relationship when your problem began–a new job, a failure, weight gain, your bad haircut–whatever. Maybe he started cutting corners with foreplay and got a bit too eager–a common complaint. Are there any other issues in your background that have never been resolved? If you can’t readily figure this out on your own, try seeing a licensed therapist in your area.

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Q: Can the Clap Cause Impotence?     I’m only 25 but I’m having trouble keeping my erections. The problem started last year after I was treated for chlamydia. I was treated and it cleared up, but is there any chance it causes permanent damage such as impotence?        –Unhappily soft

Dr. Linda: Chlamydia can cause permanent damage, but not to your cherished member. It can cause infertility by scarring your tubes. You didn’t clarify how you got the chlamydia. From a cheating girlfriend? From being a player who doesn’t use condoms?

If a wandering girlfriend hurt you, it’s common to have leftover anxiety and resentment toward women in general. Whatever the source, your out-of-commission penis probably reflects ambivalence about resuming sexual activity. This “wisdom of the penis” kicks in when you’re not consciously aware of your mixed feelings. Even though your inability to perform is distressing, it is also protecting you from further emotional and physical harm.

It’s time for a little reflection on how to make your sex life hot, happy and responsible. You’ll find lots of helpful tips in Bernie Zilbergeld’s book The new male sexuality, Rev. ed. If that doesn’t do the trick, contact the American Association of Sex Educators Counselors and Therapists (www.aasect.org; 319-895-8407) for a list of certified sex therapists in your area.

Look at the bright side. This is a great opportunity to boost your confidence and become a gifted lover.

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Q: Keeping it Up.  Early this summer my sexual abilities were relatively normal. But I started seeing someone new, and two things happened at once. Twice, by the time I had the condom on, I had lost my erection and couldn’t regain it. I also achieved orgasm unusually quickly a few times. This especially upset me because I stopped dating one girl I had no problems with to start dating the girl I had these problems with. I’m only 24, but my complaints make me sound 50. I’m scared of getting in bed with another woman feeling as ineffectual as I do. Is my problem physical or psychological? Help!                          —-Ignacio

Dr. Linda: At your age, when the “equipment” lets you down so abruptly, the odds favor a psychological source. Your description actually sounds like a classic case of performance anxiety. You gave up familiar territory when you stopped seeing the first woman and were undoubtedly very eager to please the new woman in your life. Maybe a little guilt entered into the picture, too.

To get back on track, you’re going to have to take things more slowly. You have to replace your negative self-talk with positive confidence building. Get to really know a new woman before getting physical.

Do whatever you need to do to feel comfortable. Take small physical steps on successive occasions when you get together. Talk openly with her about preferences—both yours and hers.

Consider telling her about your recent problem and assuring her it’s not a long-standing one. Avoid alcohol or drugs. Do some reading, such as Bernie Zilbergeld’s The New Male Sexuality. Cheer up. This crisis is a great opportunity to become more sophisticated about your sexuality and become a really great lover.

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Q: Brush Up Course in Dating.   I hate to admit it, but I’m 25 and still a virgin. I’m a geek who never dated in high school, and by the time I got to college I felt even more intimidated about asking a girl out. When I graduated last year, I lost whatever chance I had to get over my fears. I tense up whenever I think about approaching a woman. I really don’t know what to say or do. How can I get over this and get on with my life?              –Mickey

Dr. Linda: Your best bet is to enlist the help of a qualified sex therapist. Since anyone can call him or herself a sex therapist, “qualified” means she or he holds a bona fide state-issued psychotherapy license of some sort (e.g., licensed psychologist, board certified psychiatrist, licensed clinical social worker, or licensed marriage and family therapist).

A national organization, AASECT, also certifies licensed psychologists and other mental health professionals as sex therapists after they meet additional specialized   educational and supervised training requirements.

Men such as you who are shy and typically have limited social skills often do well with a specialized form of sex therapy known as surrogate partner therapy. Although it is controversial, you might want to consider it. There’s a lot of confusion about what this really entails, thanks to distorted media images.

A reputable surrogate always works collaboratively with a therapist trained in this approach. Typically you see both the therapist and the surrogate once a week, at separate times. Much of your time with the surrogate is devoted to talking, developing social skills, communication skills, and connecting. Relaxation exercises and anxiety management are also emphasized.

The physical contact that occurs happens very gradually, over a number of sessions. Its exact nature varies based on the nature of the problem, the surrogate and the therapist. Obviously, there are practical considerations. A course of surrogate partner therapy is expensive, and surrogates tend to be located primarily in the largest cities.

Stick with traditional sex therapy if surrogate work if unavailable or holds no appeal.

Good luck.