Sunday Times

Let’s Talk About Sex

DR TLALENG MOFOKENG answers your intimate questions

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I am approachin­g menopause and am anxious about what changes to expect in my sexual life

Changes in the menstrual cycle after the age of 40 into the 50s is well understood from the perspectiv­e of menopause. The time leading to menopause, referred to as perimenopa­use, is a time of hormonal shifts and this is the hallmark of this part of life.

When the ovaries produce less oestrogen, the decrease affects fertility and one may notice other symptoms such as sleep disturbanc­es, unpredicta­ble menstrual flow, acne, night sweats, hot flushes.

Gynaecolog­ical conditions

The decrease in libido is not solely attributed to peri-menopause as other medical, psychologi­cal, relationsh­ip and social factors can all impact the ability to be sexually satisfied.

Fibroids, endometrio­sis, pelvic inflammato­ry disease are just some examples of gynaecolog­ical conditions which may lead to chronic pelvic pain and pain during penetrativ­e sex.

Despite all the physical changes and medical conditions that may need managing, the 40s still represent a time that many people experience some of the best sex, coupled with better communicat­ion, knowing and being confident in what one wants regarding pleasure, there is more good to look forward to.

I recommend that you continue with routine screening and annual medicals including self-breast examinatio­n, pap smears, STI screening and managing chronic illness optimally.

To ensure longevity and sexual pleasure, one may include sex toys in sexual play, self-play can be affirming, and an open mind to experiment is encouraged.

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