Dear Dr. Ellen: I am 46 years old and in pretty good shape. I had my first child when I was 18 and then my second at 19. Both my children are living on their own. This is my second marriage and I want it to last. My husband is 48, a great guy and a wonderful step-dad, who my kids adore. We were dating for 2 years and have now been married for a little over a year. I don't want to reveal what my husband does for a living but he is always surrounded by young beautiful women. His first wife was a former beauty queen. I am having such a tough time with my own self-imagine and constantly feeling that I can not measure up. I am spending a lot more hours in the gym and thinking about having cosmetic surgery done to my face and enhance my figure. My husband assures me that he loves me just the way I am and is happy with the way I look. This is truly coming from me and not him. How do I get rid of the constant nagging voice in the back of my head and just accept the fact that we all have to age and to simply try and do it gracefully? - Patsy

Dear Patsy: We have all been exposed to such unrealistic ideas of the human form and face that it takes a superhuman effort to overcome the fear of being less than perfect. Perfect faces and perfect bodies are everywhere we look. Magazines, TV and movies all glorify perfectly sculptured faces and hard bodies. It's great that you are attractive, but that is not what is going to make your marriage last. If looks were the answer, then so many of the "beautiful people" in Hollywood would not be alone or divorced as many times as they are.

As we get older, many of us fear that we will no longer be physically attractive to our mates. After all, how could someone love our wrinkles, flabby skin, and aging bodies? The truth is that true love doesn't fade with age. In fact, it's just the opposite. When you really love someone, you love that person from the inside out. His or her internal beauty increases and improves with age. Every line, wrinkle, and stretch mark represents the precious time you've been together and the memories you've shared. By accepting your body with all its flaws, you accept yourself.

You asked me specifically how you can "get rid of the constant nagging in the back of your head." It isn't going to happen in the gym where all the other "perfect bodies" are. It would happen if you volunteered your time to raise money for good causes, like cancer, diabetes, AIDS or multiple sclerosis research. It would happen if you volunteered your services to The Red Cross which needs 40,000 volunteers to help with hurricane relief. It would happen if you volunteered your time at your local hospital. Once you fight for something larger than yourself and try to help other people with their pain, you truly forget about your own short comings. A study which involved 2,700 residents in Tecumseh, Michigan, observed that residents who volunteered their time for community organizations were two and a half times less likely to die from disease, compared to those who did not volunteer. Helpers also reported that they had fewer colds, headaches, backaches, and even relief from the pain of chronic diseases, such as ulcers, asthma, arthritis and lupus. So, helping others may be as important to our health as regular exercise and proper nutrition. I know that volunteer work will definitely boost your self-esteem. The old saying, "Pretty is as pretty does" is as true today as it was in our grandmother's day. - Dr. Ellen