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In the good old days before we lost our innocence, sex was a simple fun thing to do. When someone noticed the cause and effect of producing babies, relationships became a series of choices. Curiously, modern couples are choosing not to have children. In many developed countries, the birth rate is falling below the level necessary to maintain the population. The reasons are complicated but mainly flow from the change in gender roles. Instead of men marrying women to stay home and raise children, women are making careers for themselves and delaying marriage until later in life. They are happy as DINKS – Dual Income, No Kids. Add to this to stress of modern life which puts pressure on relationships and, suddenly later in life, some men find their erections failing when they are expected to fire the bullets to produce pregnancy. What seemed a natural and uncomplicated process of young people producing children has now been converted into a race against time when the couple finally decide to stop the contraceptive measures.

Before the arrival of oral medication, the quite common failure of erections in ageing men was a real problem that could only be “cured” either by quite painful injections or the use of embarrassing pieces of vacuum equipment better suited to the laboratory than the bedroom. Wives were therefore left with the task of manually trying to encourage a sufficient hardness to achieve penetration. In future the same massage may have a rather better chance of success thanks to developments at Yeshiva University. In this instance, the linkage of Albert Einstein’s name to a College of Medicine seems to have produced a great scientific step forward. Dr Kelvin Davies has been leading a team to develop a topical cream that can be rubbed into the penis and produce an erection. This is the first time that so-called nanoparticles have been used to treat erectile dysfunction. The idea is that these tiny particles will pass through the skin and be directly absorbed into the penis. Up to now, the team has been trying out the product on rats and all involved have found satisfactory results. Now the team are planning to move on to human testing.

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For some reason, anxiety has become one of the most common problems of our age. It seems to have overtaken depression. One explanation is that people are less judgmental if you admit anxiety. There is considerable prejudice and some discrimination against people suffering with a depressive disorder. It’s considered only one step away from madness and insanity which justifies locking up those affected in a hospital or institution – the public safety argument is that these people are a danger to themselves and others. The reaction of family, friends and employers is the unsympathetic view that depression is a sign of weakness, that with a little effort, people can snap out of their despair and turn their lives around. But we have all experienced some anxiety at some point in our lives and so are more accepting. It’s may seem strange that a change of label can make such a big difference. In many cases, there is nothing to choose between anxiety and depression, i.e. the depressed are often anxious and the anxious get depressed.

The results of a clinical trial in the north of England have just been published. It involved almost 4,000 patients with anxiety and depression. They were referred to a stepped program of psychological counseling. The majority received low level cognitive behavioral therapy (CBT) delivered over the telephone. Their progress was carefully monitored and those who did not respond well were referred to higher levels of CBT on a face-to-face basis. Over a twelve month period, the participants each received counseling lasting an average of 2 hours 45 minutes. The results show that 75% were either in remission or recovery. This is yet another piece of scientific research confirming psychological therapy to be the most effective way to treat anxiety disorders and depression. What is particularly interesting about this latest English study is that about two-thirds of those who improved only received therapy by telephone. Even a disembodied voice offering comfort and advice delivers effective treatment. As a result of this latest research, many patients have now been enrolled in a national program of telephone therapy. The initial results are promising.

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