Sexual health is something of an enigma for many of us: It is taken for granted when we have it and sorely missed when we don't. Furthermore, sexual health is assumed by so many of us to be automatic that we pay little attention to how it can be maintained. Here, more than in most other areas of health, people are often unaware of fundamental preventive measures they can follow to ensure healthy sexual functioning. Regrettably, the medical profession has largely ignored this issue, with most primary care physicians doing little in terms of preventive counseling in their contacts with patients.

In fact, even in situations where sexual problems are likely to occur-for example, in the aftermath of a heart attack, in association with alcoholism or other forms of drug abuse, in the medical management of people with high blood pressure-many physicians are themselves unaware ofthe requisite biomedical and psychological facts that would prevent a sizable percentage of the sexual difficulties that arise. Add to this the reality that many practicing physicians are personally uncomfort¬able discussing issues of sexuality with their patients, and it becomes obvious that there is a real vacuum of information related to sexual health even in contempo¬rary American society.

At one level, many of the sexual problems that occur are still regarded as trivial in the sense that they are neither life-threatening nor even associated with major health consequences, in the ordinary way we think about our health. But this is a skewed assessment-and an assessment that can be tossed out the window when you or someone you love is affected. After all, these seemingly "trivial" sexual problems have a great deal to do with the quality of our lives. Just ask a woman who is dealing with a nonexistent sex drive during her menopausal years, or a man who can't control his ejaculations, or a 28-year-old who can't consummate his marriage if their problem is trivial or important.

Today more than at any time in the last 50 years, sexual behavior is also linked to a number of health problems that are serious and sometimes incurable. Estimates of the scope of the worldwide HIV / AIDS epidemic grow year by year, and the notion that "it can't happen to me" is slowly evolving into a different sort of national consciousness. Less visible, but also serious, are raging epidemics of other sexually transmitted diseases, induding gonorrhea, chlamydia, genital herpes, hepatitis B and genital warts caused by the human papilloma family of viruses. According to recent estimates from the Centers for Disease Control in Atlanta, there are probably 9 million cases a year of these STDs in the United States; and the World Health Organization estimates that worldwide, there are more than 150 million cases annually. Since some ofthese conditions are linked to subsequent cases of cancer or infertility, it is clear that their ramifications are major indeed.

Fortunately, this is also a time of signal advances in the treatment of many sexual and reproductive problems. Today there are near miraculous techniques for treating infertility; a wide (and confusing) variety of treatments for problems such as impotence; more contraceptive options than ever before; and more sophisticated psychotherapeutic methods for dealing with sexual disorders than could have been imagined just a quarter~entury ago. Unfortunately, up until now, the general public has not really had much guidance in sorting through this maze of high-tech, rapidly evolving treatments and diagnostic approaches.

This book specifically and skillfully fills this void. This is a well-designed, well-researched volume that avoids technical jargon in favor of clear, accessible, easy-to-grasp information. Whether you read it cover to cover or simply put it on the bookshelf for use as a reference, you will find that this is indeed a "user¬friendly" book as well as a book that is loaded with immensely practical advice.