DOCTOR'S ADVICE - Will I lose my sexual desire?

Q. Doctor, I am a fit, healthy woman, living in Mandeville. I enjoy what I guess you could call a vigorous sex life. But I just turned 35, and that has me thinking. Is it true that sex will cease to be as good as I get older? One of my friends said that women lose their sexual desire when they get to menopause.  Sex is very important to me, and I dread the thought of getting old, and not having the same joy making love. What do you think, Doctor? What is likely to happen to me?

A. First of all, your friend is very wrong. Generally, women do not lose their sexual desire when they go through menopause. I have seen countless patients who have maintained a great sex life after 'the change'. It seems like a lot of them are more relaxed about lovemaking in their 50s and 60s because they no longer have to worry about contraception, or about periods.

So I think you can look forward to the future with some confidence, and continue enjoying sex through menopause - maybe even into your 70s! Many people don't realise that today many women continue to have a good fulfilling sex life. I have even seen a few wives who were in their 80s, but who still liked a little 'dalliance' with their husbands.

That used to be very rare where most persons found that their sex lives were over by around age 55. But today, women - and men - are generally in better health than they were in the past. They eat better, and most of them get a reasonable amount of exercise. Another factor is that smoking is not as common and nicotine does have an effect on the blood vessels in the genitals as one gets older.

Alcohol also has a negative effect on one's sexual 'performance'. Illegal drugs can have the same sort of negative results - so please stay clear of them, especially cocaine!.

A very important research paper was published this summer in the Journal of the American Geriatrics Society. It looked at a large number of women who have gone through menopause, ages ranging from 60 to 89.

The finding were:

• As they got older, most women experienced a reduction in desire and arousal;
• They also experienced a reduced degree of vaginal tightness;
• Natural lubrication was reduced.

However, the authors noted that "sexual satisfaction remained unchanged across the age groups".

That last point is very important. What it means is that although older women generally have less sex than they did when they were younger, they were perfectly satisfied with what they were getting. Furthermore, if a mature woman is not producing enough natural lubrication, these days it is easy for her to use the artificial type.

Another thing to bear in mind is that when you eventually get to that age, scientists will probably have invented new 'female sex drugs', which would be the feminine equivalent of Viagra. Pharmaceutical manufacturers are currently working on these products now. And I have little doubt that when these medications are available, they will enable women to continue enjoying sex for as long as they like.

Q. My wife ands I are both aged 26, and we have been trying to get pregnant for over a year without success.  Should we get some tests done?

A. Definitely. If a couple have been having intercourse for a year and haven't conceived, then one or the other of them may have a health problem in their sex organs. I would recommend that you both go and see a gynaecologist.

Q. I heard that there is a spray called 'PSD502' that can help men with premature ejaculation. Is this true, Doctor? Is it something you would recommend for a man in his 50s? And where could I get it?

A. Well, PD502 is a fairly new product. It is a spray which contains two local anaesthetics. You spray it on your penis before sex. The idea is that the two drugs will 'numb' your organ so that you do not experience such intense sensations during intercourse. The makers claim that this helps to delay your orgasm.

PD502 might help you, and there is no reason why a man in his 50s should not try it. But in the past, there have been numerous other preparations which contain local anaesthetics, and they have suffered from the following defects:

• Often they don't work;
• If the local anaesthetic gets on the woman's tissues, they may numb her pleasurable sensations;
• Local anaesthetics sometimes produces distressing skin 'sensitivity reactions'.

If you want to give this fairly new product a try, then fair enough. Your local pharmacy may be willing to order it for you, but it could be less embarrassing to buy it via the Internet. Personally, I would recommend other methods of treating 'PE', such as the famous Masters-Johnson grip.

Q. I am 32 years old and just detected 'abnormal cells' on my smear. Does this mean I am going to get cancer?

A. Not necessarily. And even if these cells do 'turn cancerous', you will be able to have treatment at a very early stage. And you will be cured. So stay with that doctor who did your test, and continue to have cervical smears at whatever interval she suggests.

Q. Doctor, I was circumcised in America 10 years ago when I was 20. Now I bitterly regret that decision. Could I have the circumcision reversed?

A. Well, the piece of skin that was removed is gone. Nobody is going to find it, and stitch it back on. However, there are some surgeons, particularly in the United States, who are willing to try and 're-create' a foreskin. They may attempt to do this by taking skin from elsewhere in the body, or more commonly by stretching the remaining penile skin. I wish I could promise you that the results of this type of surgery are wonderful. But I cannot.

Q. I get very bad tension before my monthly menses. My doctor wants to treat this with a drug called 'bromocriptine'. Would this work? And are there any side effects?

A. Premenstrual tension or 'PMT' is very common. Many drugs have been used in an attempt to treat it, but the success rate has not been outstanding. However, it may be worth your while trying bromocriptine for a few months. Possible side effects include headache, drowsiness, blocked nose and tummy upsets.

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