When you go to see your doctor, you may be surprised if they ask about your sex life (and are a little bashful to approach the topic). Chances are, they’re not trying to pry. Rather, they may discover something that directly impacts the treatments they are providing to you. The thing is, older adults often don’t think of themselves as being at risk for sexually transmitted infections, which might partly explain why infections have been rising dramatically in the over-50 age group for the last decade. It’s World AIDS Day today, and I’d like to spend some time talking about why being careful with your sex life can have a big impact on other areas of your health as well.
Protection Is Essential
The real infection danger comes from condomless sex, especially in the context of new partners. I’m not saying you need to be using a condom with your husband of 30 years, but many women today are finding themselves newly single late in life after a separation, divorce, or death of a spouse. Many I’ve talked to think they’re safe if they’ve gone through menopause because they’re only worried about their risk of getting pregnant. They figure they’re past the age when they need to worry about infections and that condoms become unnecessary once they’re through with menstruation. What these women don’t realize is that gonorrhea, chlamydia, and HIV aren’t just infections for women in their teens and 20s. According to the American Sexual Health Association, about one of every six HIV diagnoses is in adults over 50, and the rates of chlamydia and gonorrhea infection have more than doubled in the over-50 age group over the last 15 years. Condoms are the best form of protection against these diseases and are a must with new partners, whether you’re postmenopause or not.
If You Have Symptoms, See Someone
Because most older adults don’t expect to have to worry about sexually transmitted infections, many wait much longer than they should to get help when they start to have symptoms. Some amount of discharge can be normal when you’re a menstruating woman, but that discharge will decrease with the drop in estrogen levels after menopause. Some women mistakenly think new discharge, which may be their only symptom, is normal. On top of that, other changes with menopause can lead to symptoms like itchiness or pain when you have sex that may or may not be related to an infection. Sound confusing? That’s why you should seek the help of a professional rather than trying to self-diagnose. If something doesn’t seem right, go see your gynecologist or talk to your doctor.
Don’t Be Afraid to Get Tested
Part of the reason STIs aren’t dealt with as early as they could be is that women often turn down testing, especially for HIV. STI testing can easily be added to a regular pelvic exam and just require an extra step that takes about 20 seconds. An HIV test can be added to just about any blood test you might have in the doctor’s office, and some locations offer a rapid HIV test that can be done with a single drop of blood with results in a very short period of time. If you’ve recently had sex with a new partner, you should always get tested soon thereafter, just to be safe. If you have any suspicions at all, just get tested for the peace of mind. It’s better to know there’s nothing wrong than to wonder for weeks on end whether some new symptom is normal or a recent infection.
Getting Treated Is Safe and Effective
Fortunately, getting treated for an STI is relatively straightforward. Most infections can be effectively treated with a course of antibiotics as long as both partners are treated. Remember, that infection came from somewhere and if both sides of the couple aren’t treated, you’ll be back in the doctor’s office in a week or two with the same infection. For HIV, the situation is a little more urgent. If you think you’ve had sex with someone who has HIV, you should get yourself to a clinic immediately. They can give you medications that will dramatically lower your risk of getting the infection, especially if you take the first dose soon after being exposed.
HIV Is Preventable, Even If Your Partner Has It
I had Charlie Sheen on the show about two weeks ago who revealed his diagnosis of HIV to us. What was so important about that show was not the revelation, but the conversation that followed about how he and his partner at the time had been safely having sex even after his diagnosis. As the head of my medical unit, Dr. Crupain, pointed out so well in a recent blog, it’s entirely possible to protect yourself from contracting HIV, even when you know your partner has HIV. The treatments have come a long way and many people with HIV who take their medications can live out normal lives unaffected by the virus knowing their partners are at extremely low risk of contracting the virus from them.
STIs Affect More than the Sex Organs
While STIs are frequently associated with discomfort in and around the vagina in women, other systems can be affected too. Long-term infection with chlamydia or gonorrhea can lead to chronic pelvic pain that can be disabling. Gonorrhea infection can sometimes spread to the joints, leading to life-threatening illness. HIV can impact all systems of the body, from your heart to your lungs to your brain, and can eventually lead to AIDS and death if untreated. These infections are about more than a little discomfort. They can lead to serious medical complications that could have a serious impact on your overall health and day-to-day life.
Have the Conversation
The biggest challenge in preventing STIs is the stigma that surrounds talking about sex and sexual health. Unfortunately, failing to talk about these topics with your partner could put your health at risk in a way that affects all aspects of your life. Everyone should be having a conversation about sexual health with his or her partner, even those who have been together for a long time. If you have a new partner, it’s important to bring up the subject of sexually transmitted infections early on and suggest that you both get tested at some point even if neither of you has symptoms. STIs may cause no symptoms in one person and symptoms in another, and it’s best just to know one way or the other. If your partner refuses to get tested, it might be a warning sign that there’s something more going on. Stand your ground and play it safe.