ANDROPAUSE, sometimes called MALE MENOPAUSE   Though the potency crisis that hits many men in middle age has some obvious causes – age, alcohol, stress – the decline is hormonal and psychological as well. Men often won’t discuss it with their doctors, their wives, or their lovers.   Dr. Stephanie Buehler (www.LearnSexTherapy.com), heading up The Buehler Institute, joined the program once again. When men and women face the same passages with different needs and directions, how does the partnership survive? Dr. Stephanie and Dr. Diana talked about it all!  Women go through the process of menopause in different ways, but it’s almost a universal experience. Men are all different.   Often there are existential issues. For example: Does my life have meaning? What parts of myself have been neglected that I am now free to live out? Do I matter? The denial of aging can show up in a man’s embracing symbols of success and vitality. It may also contribute to men avoiding seeking help when they experience sexual issues as they age.   Women are often concerned about their partners. One of Dr. Diana’s clients said, “I have some menopausal symptoms – but the main problem is that my husband has more! He’s 52, withdrawn, moody, and angry that he’s aging and losing his hair. Also, he just doesn’t get aroused anymore. And I got tired of things not happening when I tried to get sex started. I always thought it was me. I stopped trying because I thought it was embarrassing to him.” These are not uncommon complaints from female partners.   The two sex therapists discussed typical psychological problems such as lethargy, depression, increased irritability, mood swings, and an overall lessening of a sense of well-being. As men move into their 50s and 60s, they may have intermittent problems in gaining and sustaining erections. They may also feel some slackening of sexual desire. And unless a man is in a good relationship with a supportive partner, the shock of all these changes can bring on a powerful psychological crisis, which can actually frighten a man into erectile dysfunction (E.D.). Still, they don’t talk about it. Men may have integrated this idea: “Your job as a male is to be strong.”   It’s important to underscore that there is a robust population of older men who survive this potential crisis with their egos and erectile abilities intact. In one large study, forty percent of these healthy males remained completely potent at age 70. A man’s general physical health picture is significant. Organic factors contribute to E.D. in up to 80 percent of men. Of all the causes for erectile dysfunction, the most common is impairment of the blood supply to the penis. This results in many males who won’t even try to have sex!     Dr. Stephanie points out that some female partners are not helpful, heaving insults like, “What’s wrong with you?”   Once again, USE IT or LOSE IT comes into play. And it requires a trusted partner, and some self-discipline around drinking, eating, exercise, and preventive health measures. Many men have emotional connection problems. They didn’t get training in this; rather, they got performance training. Dr. Stephanie recalls Dr. Steve Braverman asking, “Does a man have to have a hard penis in order for sex to take place?”  As a man gets older, and feels less secure sexually, intimacy and trust with his partner become critical.   The two sex therapists also talked about alcohol, diet, and stress. The chronic use of alcohol can murder potency. Urologists report that when looking at the tissue from patients with chronic alcoholism, the nerve is killed inside the penis. Tom Lue, an internationally known expert on the treatment of male sexual dysfunction, notes “It’s almost impossible to revive. Usually, it takes 10 or 15 years of chronic heavy alcohol use to kill the nerve.”   In 1995 Dr. Diana spoke about aging and sexuality at a Washington, D.C. confere