Your letter sadly lacks the details that would make it possible to give a sound opinion about your husband’s problem, and your reaction to it. Perhaps the most important detail that you omit is the age of your husband. I assume that since you have been married for 30 years that he is at least 55, probably a bit older.

Furthermore, I assume that he neither has spontaneous nocturnal nor early morning erections, and isn’t potent if he masturbates. Any of these would indicate that his impotence was of psychological rather than of physical origins.

The prevalence of impotence is difficult to establish. Even if it is realised that, to doctors, impotence refers only to the erectile capability of the man and has nothing to do with his libido, his ability to ejaculate normally and the quality of his orgasm, there is still room for misunderstanding. Some people mistakenly don’t use the description impotence to describe a man who is able to achieve an erection but can’t hold it long enough to penetrate a woman.

Likewise, if they are able to penetrate it is important to know if they can maintain their erection long enough to continue intercourse for a satisfactory time.

One patient came to me to complain that he had erectile dysfunction but that the doctors he had previously consulted always dismissed his problem that was one of maintaining an erection. He asked me to explain “what the point was of owning a first-class racehorse if it only looked splendid at the starting gate, but never finished the race”.

Your husband isn’t alone. According to a recent extensive American study, one man in five between 50 and 59 is, by accepted medical standards, impotent. That is to say their erection isn’t consistent with the ability to attain and maintain a penile erection rigid enough for satisfactory intercourse.

As men grow older, aged between 60 to 69, about 40 per cent had this problem, according to the US research. A British survey published in the Journal of Urology was even more pessimistic. It showed that over half the men between 50 and 70 were impotent.

Viagra has been revolutionary. It helps the overwhelming majority of men who are impotent but it is not suitable for everyone. The two large groups of men for whom Viagra, and Viagra-type drugs, are not likely to be effective are those who have had a radical prostatectomy (removal of the entire prostate gland), and those whose impotence is a complication of diabetes.

Since it seems that you are obviously very attached to your husband, your first role must be to keep him alive. I hope that as soon as he showed signs of worsening impotence you encouraged him to consult his GP who, if diligent, would have checked his coronary artery circulation. Increasing impotence is often the first indication of cardiovascular disease. In my practice all those men with impotence had a complete cardiological assessment, just as thoroughly as they would have had if they had complained of angina. They should also always be checked for diabetes. This shouldn’t just be a single urine test but, at the very least, all the appropriate blood tests.

I admire your concern for your husband’s interest. However, if his sex play, cunnilingus or whatever other techniques he employs please you, he will be happy, too. Remember that impotence doesn’t necessarily mean that your husband can’t have an orgasm.

A wander around Ann Summers branches, which I am told are women-friendly, will introduce you to the toys made famous by Sex and the City and may add excitement to your cuddles.

I assume that your husband is still exploring treatment options but, if he isn’t, he ought to make an appointment to see his GP as soon as possible.