Q: I am approaching menopause and am anxious about what changes to expect in my sexual life.
A. 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 peri-menopause, 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 and hot flushes.
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.• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, Disa Clinic, safersex.co.za. Mofokeng has recently been named SA's Commissioner of Gender Equality by President Cyril Ramaphosa.Do you have a question about sex?E-mail your questions to lifestyle@sundaytimes.co.za with SEX TALK as the subject. Anonymity is assured...