There are many reasons for fatigue, yet anyone can interfere with satisfactory sexual expression. Anemia, liver damage, a lack of B vitamins, nervous tension brought on by deficiencies of calcium or magnesium, the strain of holding in negative emotions, and adrenal depletion are all common causes. Millions of people endure daily fatigue due to low blood sugar, which often results from nothing more serious than having missed breakfast. A few months ago a pale and lethargic young woman told me she hated preparing breakfasts, and therefore ate none.

The symptoms of low blood sugar run the gamut of lassitude, fatigue, apathy, tension, nervousness, aimlessness, weakness, trembling, sweating, headaches, and a loathing of daily monotony; if little has been eaten the night before, these symptoms are usually present on waking and often remain throughout the day. Taking potassium chloride, which brings almost immediate relief, is preferable to pep pills, but it is not needed if small meals low in carbohydrate are eaten frequently and the diet meets the needs of stress. Foods rich in the B vitamins and protein, such as yeast, liver, and wheat germ, often give a marked pickup within a single day. A persistent low blood sugar, however, is typical of adrenal exhaustion, and calls for an increase in salt instead of potassium.

Because sex is a form of expressing love, it can continue as long as life itself, provided physical and emotional health permit. The late Dr. Flanders Dunbar, a noted authority on sex, collected data from 20 per cent of all individuals 100 years old and older in the United States. When asked at what age each had lost interest in sex, these delightfully honest oldsters answered to a person, "Never." Many of the men still retained their potency, and several had remarried after passing the century mark.

Men among the healthiest groups ever to have been studied, the Bulgarians of several decades ago and the Hunzas of today, are reported to have sired children after reaching the ages of 90 and 100 years, indicating that health makes for a prolonged and active sex life. It may be highly significant that the changes in the ovaries and testicles characteristic of senility are the same as those produced in experimental animals by diets deficient in various nutrients, especially vitamin E.

One of the tragedies of illness is that it usually prevents a normal sex life. Because sex is a means of expressing love and is perhaps the deepest form of human communication, a marriage without it is sterile and often an outright endurance contest. Although major sexual problems, such as impotency and frigidity, and a horde of minor ones are emotional in origin, intercourse is often not enjoyed simply because a partner is tired, has a headache, has not slept well the night before, or feels tense or depressed and wants nothing more than to be left alone.

Any person who is irritable, critical, nagging, or lacks the energy to take a bath is scarcely setting the stage for an evening of ecstasy. During my years of consulting work, dozens of men and hundreds of women have talked to me about their sex problems; and some of the commonest complaints I have heard are that feet smell bad and that the mate has halitosis. Such seemingly insignificant things can prevent a woman from having a fulfilling orgasm and a man a sustained erection.

Between 1908 and 1912, clinics for the care of venereal disease were packed with sufferers from all ranks of society; whispers circulated in the dormitories of the colleges about students whose entire careers had been ruined by attacks of venereal disease. The end-results of gonorrhea were horribly depicted, as were those of syphilis, in fake clinics conducted by venereal disease quacks. The museums of horrors were conspicuous in the districts devoted to honky-tonks and night clubs in every great city. The armies of the world were overwhelmed with the costs of caring for venereal disease; great numbers of men had constantly to be hospitalized and taken away from military service because of these infections. Moreover, at that time one hardly dared to speak either the word "gonorrhea" or "syphilis."

The glands of sex serve a double function: they provide the necessary materials for reproduction of the human being, the male sex cell uniting with the female sex cell; they also provide material which goes directly from the glands into the blood, and which determines the nature of the growth of the body. If the amount of the material secreted by the gland into the blood is insufficient, definite changes will take place in the body inclining towards the female side if the male sex issue is insufficient, and to the masculine side in the woman if the female sex tissue is insufficient.

A deficiency of the male sex material may result from absence or destruction of the gland or from failure to function, in cases where the pituitary gland does not produce the trophic hormone that stimulates the male sex gland. Again, there may be disturbance of the function of the cells ithin the gland, without actual destruction of the tissue.