Sex after menopause and when to rethink HRT

Menopause extends beyond physical changes, impacting intimacy and potentially causing discomfort during sex, vaginal dryness, and urinary issues. Dr Juanri Jonck, a Pretoria-based healthcare practitioner, emphasizes that these symptoms are not inevitable consequences of aging. Dryness, burning sensations, painful intercourse, and urinary problems can persist or worsen due to the continued low-oestrogen environment in key areas like the vagina, vulva, bladder, and urinary tract.

Embarrassment may prevent women from discussing these concerns, while some may accept discomfort as a natural part of aging. However, Dr Jonck advocates for lubricants, vaginal moisturizers, and local estrogen treatments as effective solutions for genitourinary syndrome of menopause. Contrary to common misconceptions, hormone replacement therapy (HRT) isn't a short-term solution; the underlying hormonal changes persist, making ongoing treatment necessary for some women.

There isn't a fixed age for discontinuing HRT; individual suitability should be evaluated regularly, considering the type of hormone, dosage, route, and age-appropriate adjustments. Transdermal oestradiol is recommended over oral oestrogen for a more favorable risk profile. Reassessing HRT suitability later in life depends on factors like cardiovascular health, cancer history, and individual risk factors.

Dr Jonck urges a shift in focus from age as a sole criterion to individual medical necessity, encouraging women to question whether continuing HRT is still appropriate for them. Ultimately, Dr Jonck emphasizes that sexual health should remain an integral aspect of aging well, encouraging women to maintain a positive outlook on sexual well-being as they navigate menopause.