Let’s talk about sex with Dr Tlaleng Mofokeng

Upgrade your sexual health

It is 2017. It is time for an upgrade in the sexual department, and Dr Tlaleng Mofokeng reveals just how to do this, even if you are enduring the “M” bomb.

Sexual health encompasses much more than the physical aspect of intercourse, and much of our general health is connected closely to emotion, psychological well-being and our relationships.

There are many changes that happen to the physical body during the pubertal years right through to the peak of our reproductive years and definitely during menopause.

Medical conditions may also have a significant impact on sexuality, and the ability to have pleasure. In SA, many women are diagnosed with breast cancer, and the diagnosis can cause emotional and physical distress. Some of the therapies used to treat cancer can also have a negative impact on your sexual life, for example, low libido, vaginal dryness, anxiety and depression, to name a few.

The impact and the manner in which these changes are handled, often depends on how well you know your body, and what expectations you have as you navigate these bodily changes.

Peri-menopause, which is the immediate time leading to the dreaded “M” bomb can cause emotional changes that can add to a woman’s loss of interest in sex and/or inability to become aroused. The resulting loss of oestrogen following menopause can lead to changes in a woman’s sexual functioning. Menopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and stroking, which can result in decreased interest in sex.

There may also be a significant decrease in blood flow that can affect vaginal lubrication, causing the vagina to be thin, pale, and dry. The lower one-third of the vagina can shrink, leading to painful sexual intercourse. In addition, radiation therapy can lead to scarring, and some of the medications often used can also lead to vaginal dryness.

The anxiety associated with fear of pregnancy eases post-menopause, and this may sometimes result in post-menopausal women relaxing more, and enjoying intimacy, and as a result have an increase in sexual satisfaction.

It is important to remember other factors that can disturb your sexual health, such as bladder control problems, sleep disturbances, stress, and relationship issues with a partner.

Seven ways to upgrade your sex life

  1. Vaginal dryness can be treated with over-the-counter water-soluble lubricants. Do not use non-water soluble lubricants, such as petroleum jelly (Vaseline), because they can cause irritation and weaken latex (the material used to make condoms). Silicone-based lubricants are also a good option, however, should not be used with sex toys made from silicone.
  2. Intimacy is the cornerstone of a healthy long-term relationship and sexual health. Being intimate does not require having intercourse; learn to understand your partner’s love language as well as your own, and express your affection. Enjoy your time together: take long romantic walks, have candlelit dinners, or give each other massages and rubs. These activities  can promote comfort, and increase communication between you and your partner.
  3. You must also continue to protect yourself against sexually transmitted infections (STIs) during menopause and post-menopause. The risk of contracting STIs is a possibility at   any point in your sexual life.
  4. Oestrogen may be used to improve the integrity of the vaginal tissue. This can be prescribed by your oncologist, and depending on risk factors, it can be used in low doses directly inside the vagina (including creams, pills and vaginal rings).
  5. Hormone therapy can also be taken at higher, systemic doses, where it can have additional benefits. Note, hormone replacement has to be done in consultation with your doctor.
  6. Your doctor may refer you and your partner to a health professional who specialises in sexual health and counselling. This can be done on an individual basis or with your partner.
  7. Educate yourself about your anatomy, sexual function, and the normal changes associated with aging, as well as sexual responses. This may help  you overcome anxiety about sexual function and performance.  Always speak to your doctor before using hormonal replacement medication or creams.

Meet our expert - Dr Tlaleng Mofokeng

Dr Tlaleng Mofokeng currently runs a reproductive clinic, DISA Clinic, in Sandton which serves women of all ages and reproductive needs. She is involved in and supports civil society organisations, and serves as the vice-chairperson of the Sexual and Reproductive Justice Coalition (SRJC).