Q:Several times I have caught my husband secretly popping a little blue pill in between sips of his red wine. He first denied it, but after a long discussion he told me he was taking Viagra.

A: Sharing sexual secrets, including the use of medicines that improve erections, is dependent on the intimacy of your sexual and emotional relationship. Some men use these medications in absolute secrecy. Some couples play sexy games revolving around where and when to pop their pill.

In my practice, ''sexual success'' is the desire of both partners to have mutually rewarding intimacy. For some older couples, that may be limited to cuddling or feeling close.

But for those couples who are motivated to have a return to their full intimate relations, there is clear medical evidence that sexual medications can improve the outcomes for both the man and the woman.

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