How can I stop menopause from ruining my sex life?

Q. How can menopause affect my sex life?

A. Menopause is a normal part of the reproductive cycle. It is caused by a decrease in oestrogen and testosterone, leading to changes in a woman's reproductive organs, the rest of the body and, often, sexual health.

A hysterectomy in which your uterus is removed but not your ovaries does not cause immediate menopause.

Some women may experience menopause before age 40 (premature menopause).

The time in which the body is preparing for menopause is referred to as peri-menopause and has many symptoms. The most common symptoms are irregular periods, hot flashes, night sweats, sleep problems, mood changes, weight gain and slowed metabolism, thinning hair and dry skin.

Vaginal lubrication is affected by lower levels of oestrogen and a drop in blood supply to the vagina. This causes the vagina to be dry and can lead to uncomfortable and sometimes painful sex.

The clitoris may not be as easily aroused and less sensitive to touching. All these changes can happen alone or in combination and can lead to less interest in sex.

Other factors may influence a person's level of interest in sex, including bladder control issues, cervical/bladder prolapse, mood disorders and some medications.

Vaginal dryness can be treated with water-soluble lubricants. Do not use non-water-soluble lubricants because they can affect the integrity of condoms and provide a medium for bacterial growth.

You might minimise pain by using sexual positions that allow you to control the depth of penetration. Foreplay, such as sensual massage or oral sex, can make you feel more comfortable. Experiment with erotic videos or books, masturbation and changes to sexual routines.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, DISA Clinic, 011-886-2286, visit safersex.co.za.

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