Dear Dr G,

I have a bone to pick with you.

I read with amusement in a newspaper report of you saying that Malaysian women are more sexually active after the age of 40.

Of course, this has stirred a great deal of discussion as it is commonly perceived that women will encounter the “hormonal shut down” when approaching the age of 50.

Can you elaborate more about this study which reveals Malaysian women bucking the trend when it comes to sexual activities as they become older. If true, why is that the case?

I have reached the good age of 45 years.

Needless to say, with my busy career and children, sex has been the last thing in my mind.

The last time I had sex was well over one year ago.

The intimacy between my husband and I had become so sparse, our relationship has also been distant.

The question I would like to put Dr G on the spot this week is – one year without sex, is it harmful?

Regards

Jane

I would like to apologise if my statement had offended anyone. The attitude towards sex and the frequency of sexual intercourse among men and women have always been a subject of regular studies.

In one of the studies, 1,941 women and 2,016 men were recruited for online or in person-administered questionnaires, disclosing the frequency of sexual intercourse in the previous month.

The differences in frequency were also analysed after the age of 40. The overall frequency of intercourse in men and women are 8.1 and 6.2 times per month respectively.

The frequency of intercourse was noted to decline consistently after the age of 40 in females (-19%), except for Malaysia and Hong Kong, where the increases were 18% and 26% respectively.

There seems to be no correlation between socio-economic status, religious and cultural background.

This data is not a true reflection of what is really happening in the bedrooms of Malaysian couples, as the study has several flaws.

The sample size of the Malaysian participants is small (just over 200) and the method of participant recruitment tends to be biased towards urban women with a higher socio-economic background.

Despite the flaws, there are other studies also highlighting the possibility of some women having more sex after menopause as they realign their priorities in life when their children are grown up and their careers become more consolidated.

Indeed, some couples do not rank sexual relationship high in their list of priorities after the reproductive purpose is done.

This may lead to a prolonged period of abstinence, or even having separate sleeping arrangements at home.

The real question is: “Will the prolonged sexual drought be harmful to health?”

We all know that abstinence will not induce any direct detrimental damage to health.

However, some psychologists believe if one partner desires sexual intimacy, and such desire is not matched by the other partner, it may cause tension and anxiety in their relationship.

Some experts also argue the benefits of regular sexual intercourse such as lowering the risk of heart disease.

There is also evidence of increase circulation and immunity enhancement.

In one study, the long-term lack of sexual activities can result in “under-use atrophy” of the vagina and pelvic floor muscles.

This can result in pain during intercourse, and further avoidance of intimacy.

Dr G has been put under the spotlight this week for a taboo subject of sexual health, especially in women in advancing age.

When a woman is approaching the inevitable menopause, it may be a natural landmark in life to choose to abstain from sex. And the prolonged sexual abstinence generally has no health adversity.

At the same time, many women who enjoy the intimacy may also have the option to continue, or even enhance the sexual experience without the worry of children or contraception.

The real number of surveyed sexual activities for couples is often inaccurate and non-representative.

What is always important is the ability of society to discuss the issues of sexual health maturity without stigma.

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