Healthy sexuality during menopause will help prevent HIV

Date: January 1, 1970
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In Zimbabwe, and many countries in the region, some cultural practices are reinforcing gender inequalities and contributing to the spread of HIV/AIDS. One such cultural norm is post-menopausal abstinence by women, when men often have sex outside of marriage. Lest this once again point to women as somehow responsible for men’s behaviour, and thus the spread of HIV, it is important to shed light on this rarely discussed topic.

Many advocates for behavioural change point to talking more openly about HIV, AIDS and sex among youth. This same culture of openness needs to be transmitted to the older generation, particularly to women who grew up in a time when discussing sexual issues was taboo. After all, a healthy sexual relationship is important at any age.
The belief behind such cultural practices is that a woman’s menopause should not impede her man’s sexuality, and that he should not be limited in his capacity to bear more children, if he so wishes – something which becomes impossible when a woman no longer menstruates.
The term menopause refers to the time of a woman’s last menstrual period and can occur any time between the ages of 48 and 54, though the affects may begin even when a woman is in her 40s.  As the balance of female hormones within a woman’s body changes, the ovaries begin to function less efficiently.
Eventually, levels of oestrogen fall to such low levels that the woman ceases to ovulate, and menstruation stops. Symptoms related to this period of change include fatigue, headaches, mood swings, changes to skin and hair texture and quality, hot flushes and night sweats, possibly accompanied by loss of bone density.
Equally important, menopausal changes may lead to alterations in a woman’s sex drive. At their most extreme, these changes may mean a woman completely loses interest in all forms of sexual activity, a phenomenon called post – menopausal abstinence. Customarily, this form of abstinence gives the man the freedom to have sex with other women. Some wives even identify a younger wife for their husband.
However, abstinence, by its definition, is a choice. And choices should be made voluntarily, after an individual has weighed up for him or herself, the relative merits and demerits of making a decision either way. The act of withdrawing from sexual activity following menopause is not always because of choice, and if it is, it is often a choice made without a woman having enough information about how to enjoy sex after menopause.
It is also likely that women’s enthusiasm to stop having sex is directly related to the degree to which they found it satisfying or enjoyable before menopause. Men – are you still reading?
A study conducted in Nigeria showed that of almost 700 women surveyed, 71% believed that sexual life ended with menopause. This points to the commonly held notion that sex is only for procreation, not recreation, and that when a woman no longer menstruates, sex must cease to be a concern for her, as she can no longer bear her partner any children.
This system of thought seems to have its origins in the cultural and social controversies that have always been associated with female sexuality. From the moment a young girl reaches puberty to the time she grows up and advises her own daughters about womanhood and its many responsibilities, sex is spoken of as something that a woman should never initiate, and as an act that her partner should always control.
Desiring fulfilling sex, even within a marriage or committed relationship, has long connoted promiscuity and radicalism. Many societies still believe that women should only play a passive role in sexual activity, and look down on those brave enough to demand their sexual and reproductive rights.
It is at the point of puberty and the flowering of their sexuality that women first encounter problems in defining their sexual identities, and not when they reach menopause. This debate should be about women taking back their own sexuality, and feeling comfortable enough to tell their mates what they desire for a healthy sex life.
Of course, these social and cultural perceptions do not exist in a vacuum. A woman’s loss of interest in sex later on in life is also rooted in biological causes. For example, changes in hormonal levels can mean that vaginal dryness is likely to occur.
Prominent physical changes also occur to a woman’s body in mid-life. These include the often-inevitable weight gain as body muscle loses its elasticity and begins to deposit more fat, the thinning of hair, as well as the drying and wrinkling of skin.
Faced with such vast changes to their bodies, women will usually experience a lowering of their self-esteem, and therefore their sexual desire. Once more, this points to the need for more openness and communication between partners in a relationship.
Men need to be patient and understand that it may take time for both parties to adapt to the physical, biological and psychological changes that are taking place. Only through constant reassurance that they are still loved and accepted, can women ease into the changes that they experience. If it is indeed a loving relationship, the solution will never be to look for another person to gratify sexual needs and the rejection of one’s partner.
As well as this vital support, medical remedies for the symptoms of menopause are available. These include water-based lubricants, vaginal oestrogen creams and tablets that may help alleviate sexual dryness. Whatever the therapy a woman chooses to take, she must accompany this with a healthy diet rich in calcium to counter bone loss, and regular exercise to strengthen her body.
Only through communication and information sharing can women, and men, begin to challenge the negative perceptions about sex and sexuality that abound during this period of change in their lives. Not only as a means of empowering themselves, but also as a way of preventing unnecessary spread of HIV in a nation and the region. So let us look forward to greater exploration of what can be gained from richer, more open discussions about sexuality and the need for intimacy in relationships of all ages.
Fungai Machirori is a trainee media professional with the Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS). This article is part of the Gender Links Opinion and Commentary Service that provides fresh views on everyday news.

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