Dear Doc: WILL MY HAPPY SEX LIFE END?

Q: Doctor, I am a woman who believes in looking ahead and in assessing what is going to happen to me. At the moment, I am in my 30s, and I guess I have a pretty sensational sex life. But looking ahead 10 years, I can see that I will be colliding with the menopause! So please tell me, Doc, will that mean the end of my happy sexual life?

A: Not at all! The old idea that a woman's 'love life' finishes when she reaches the so-called 'change of life' is just nonsense. In fact, research shows that many females continue to lead very active and satisfying sexual lives until many, many years beyond 'the Big M'.

Some of them actually have a better time in the sack once they are through with menopause. There are two main reasons for this:

They don't have to fret about unwanted pregnancy anymore;

With luck, they are living with a guy who has known and loved them for many years and who understands what their bodies need.

So it is really no surprise that quite a few ladies orgasm for the first time when they are well over 45. Similarly, some women have multiple orgasms for the first time.

From a sexual point of view, the main downside of the menopause is that the vagina may become a little dryer, because of the inevitable fall in female hormone levels. These days, that dryness can easily be combatted by using one of the many excellent vaginal lubricants that are now available. Also, if an artificial lubricant is not enough, a doc can prescribe a special vaginal hormone cream, which will soon restore everything to normal.

Q: I am a businessman of 34. On a recent visit to California, I regret to say that I went with an expensive 'lady of the night'. She was a wonderful girl, and I have to admit that it was a remarkable experience, though a pricey one. But, Doc, late in the evening, she insisted on showing me how she could massage my prostate gland.

I was a little doubtful about this at first, but then I found that it was a very pleasurable sensation. It helped me to get a good erection.

Does the fact that I enjoyed her massage indicate that I have some gay tendencies?

A: Not at all! The area of the prostate gland does contain some erotic nerve endings, which figures when you consider that this gland makes quite a big contribution to a man's ejaculate.

Therefore, a normal, heterosexual male is likely to feel some pleasurable sensations when the gland is stroked. But I don't actually recommend that couples do this routinely, because there are some hygiene issues.

More importantly, a visit to a lady of the night - no matter how 'high-class' she may be - is quite likely to give a guy a sexually transmitted infection (STI). So I think that you should have a check up from your doc to make sure you have not picked up chlamydia or anything else.

Q: I am a 32-year-old female virgin, and I shall be getting married soon after Christmas. My fiancé knows that I have never had sex. Doctor, I am a little concerned about what will happen on my wedding night. I read an old American medical book which said that virgin brides should go and see a gynaecologist before they get married.

I can afford this. Would it be a good idea?

A: American doctors used to be quite keen on brides having a pre-marital check-up, especially as this meant valuable income for the doc!

For most women, such a check-up would be unnecessary. But in your case, I feel that it might calm your nerves and help you to feel that you will be able to have sexual intercourse without difficulty.

I don't really think you need to consult a gyno. Instead, you could go and see any sympathetic doctor, particularly a female one who deals with family planning and related subjects. She should be able to set your mind at rest about any worries you may have.

Q: Please advise me. I am male, aged 36, and several of my friends have recently had a blood test called 'PSA'. I understand that this test is for prostate cancer. Do you think I should get this done annually?

A: Quite a lot of men have started getting this test done, probably because they know that prostate cancer is pretty common in Jamaica.

The PSA (prostate-specific antigen) is a useful test, particularly in older males. But it's important to realise that it gives a lot of 'false positives'. In other words, the result may come back 'high', even though the guy hasn't got cancer. In particular, if you have sex during the two days before the test, that may make the PSA figure shoot upwards.

So in many countries, like England for instance, it is not done routinely on all men who are in their middle years. But in the US, there is an increasing tendency to perform it on all guys aged over 45 or so. However, at your age (36), I am doubtful if it would be worth your while doing it.

Q: I am 23, and since I was a teen, I have noticed that my menstrual cycle is not normal. My menses used to arrive every three months, though things changed when I lost my virginity. I have not been able to get pregnant. Since March of this year, I have not seen my menses. So I am wondering if I am suffering from a condition called 'amenorrhoea', which I have heard about?

A: Well, amenorrhoea is not a condition. It just means 'absence of menses'. There are all sorts of possible reasons why you are not seeing your periods. These include anaemia, stress and polycystic ovary syndrome. I think the best thing to do now is to go and see an experienced doctor, who can examine you, do some tests, and then tell you why you are not menstruating. Good luck.

Q: When I was a young guy, I was a real 'skirt chaser'. But in the last few years, I have kinda calmed down. I just have one girlfriend now, and we hope to get married in 2014.

However, Doc, I do have a nagging doubt about whether I could have picked up any infections during the years when I was sowing my wild oats. What do you think?

A: Well, if you have no symptoms, then probably you are OK. But you could possibly be carrying something like chlamydia, picked up from a girl long ago. So it would do no harm to check with a doc. Please take a sample of urine with you.