DEAR ABBY: Your advice to "Considering It in San Mateo" (Nov. 26), who asked you if it was permissible to have an affair because his wife of 34 years no longer wanted to have sex, was good, but you missed a couple of important points.

How is that man's hygiene? Does he bathe every day? Is he kind, loving and considerate of his wife during the day? Are her hormones imbalanced? Is she depressed or anemic?

Before "Considering It" goes jumping at another opportunity, he might want to consider showing affection and concern to the woman who has been with him for so long.

"" BETSY IN HOUSTON

DEAR BETSY: Some readers scolded me for my response to that letter, not realizing that part of my reply was tongue-in-cheek. (No, I do NOT advocate adultery.) Others felt I didn't go far enough in my reply. Read on:

DEAR ABBY: Has "Considering It" done anything to ensure that his wife is well both physically and mentally? Could her lack of interest in sex be linked to depression, post-menopausal hormone imbalance or another physical condition?

In a loving way he should urge her to see her physician and her gynecologist. If she refuses, he should contact them and ask for advice or help. He should also take a long, hard look at how he presents himself.

Finally, he might speak with a counselor, because lack of sexual activity can signal problems elsewhere in their relationship. Marriages take work &

even those that have lasted 34 years.

"" SUSAN IN NEW WINDSOR, N.Y.

DEAR ABBY: I am a nurse-practitioner, and for years I have heard women in their 40s and 50s complain about loss of libido. In our area, a group of gynecologists has begun offering bioidentical hormone replacement. This term refers to hormones that are exactly the same in structure and function as those produced by the human body.

My husband had also quoted the article regarding "having regular sex would improve your health." Do these men really think we are happy with symptoms like hot flashes, fatigue, weight gain, etc.? When I started experiencing symptoms similar to your reader's wife, I decided to see for myself. It has been several months since I started bioidentical hormone treatment, and things have improved considerably.

"" SMILING IN MIDDLETOWN, DEL.

DEAR ABBY: The writer's wife may have a medical condition such as high cholesterol or high blood pressure, requiring medication that decreases libido. She could be depressed, which affects interest in sex. Menopause can also cause significantly reduced sex drive. Some hormone replacement medicines may help with this. These conditions can be evaluated and treated by her doctor or OB/GYN.

The man should also evaluate the way he treats his wife. Men often remind their wives that they desire sex, but forget that women need romance and stimulation. Perhaps he should try a different approach?

Before stepping out of the marriage, with or without her permission, he should consider these possibilities. Infidelity is destructive for the family and personal psyche.

"" NURSE-PRACTITIONER, NEWBERRY, FLA.

DEAR ABBY: There are some great medications on the market for women with low or no libido. My husband suggested it to me &

very nicely &

and I promised to check it out. I did, and, oh my goodness, we're acting like teenagers again!

"" ONE HOT OLD LADY, AND I DON'T MEAN HOT FLASHES, GLENDALE, ARIZ.

Dear Abby is written by , also known as Jeanne Phillips, and was founded by her mother, Pauline Phillips. Write Dear Abby at or P.O. Box 69440, Los Angeles, CA 90069.