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Published on July 12, 2013

Senior Health: Talking STDs with an Older Generation

Dean Family Medicine doctor F. Bradford Meyers, MD explains why "the talk" is so important for aging adults

There is some good news is in the fact seniors are staying sexually active longer in life. Several factors contribute to this phenomenon. Overall, our health is improving. We are living longer and better. Most are aware that regular exercise helps us maintain our vigor. We also now have a class of medications, the phosphodiesterase inhibitors, which help overcome some of the sexual endurance issues that normally accompany the aging process. 

Generationally speaking, it is the "baby boomers" who helped usher in the sexual revolution and who now remain sexually active and healthy enough to enjoy sex. According to an editorial published in the February 2 issue of the Student British Medical Journal, an estimated 80-percent of 50 to 90-year-olds are sexually active.

The bad news is that the incidence of sexually transmitted diseases (STD) is on the rise among seniors. This sexual activity has contributed to a rise in cases of syphilis, chlamydia and gonorrhea among 45 to 64-year-olds both in the U.S. and in the U.K. According to CDC estimates, there were nearly 900 cases of syphilis in 45 to 64-year-olds in 2000; and in 2010, that number grew to more than 2,500. In the elderly age group, 6,700 people were diagnosed with chlamydia in 2000; and by 2010, 19,000 had been diagnosed with the disease. The number of new HIV diagnoses in people over 50 has also doubled between 2000 and 2009, according to the editorial's authors.

There are several reasons why older adults may actually be in more danger from STDs than younger adults, including:

  • Lack of screening for sexual problems can increase the risk of a disease going unnoticed for years, leading to serious complications.
  • After menopause, women's vaginal tissues thin and natural lubrication decreases. This can increase the risk of micro-tears facilitating sexual transmission of certain diseases such as HIV.
  • Older people are less likely to use condoms, both because they don't consider themselves to be at risk of STDs and because they were never educated that condoms help guard against acquiring STD.
  • The immune system naturally becomes less effective as people age, which can also increase the risk of sexually transmitted infections.

The elderly are sometimes not considered to be "at risk" of an STD. Even those who are no longer sexually active may still have a sexually transmitted infection for which they were never treated nor screened. The long term neurological side effects of diseases such as HIV and syphilis may be easily mistaken for other diseases of aging.

Older individuals and their caregivers need to be taught about "safer" sex practices so that they know how to reduce their risk during sexual activity. It's important for everyone to learn how to engage in sexual activity safely so that health is enhanced rather than damaged.

What is "safer" sex?

The best prevention for sexually transmitted disease is not to have sex. However, that isn't a viable choice for many. How, then, to practice safer sex? First, know yourself. Second, know your partner. Third, use condoms. This listing may be used as a "talking paper" for use with older family members: 

1.Practice safer sex.Never have sex without a condom. Barriers are not 100-percent protective against all STDs, but they greatly reduce the risk of acquiring an STD.

2.Get tested regularly for STDs. Even those not considered at high risk for an STD should strongly consider being tested before entering a new sexual relationship. And, if being treated for an STD, wait until the treatment has been completed before resuming sexual activity. Otherwise, the STD could be passed back and forth.

3. Have sex only within a mutually monogamous relationship. Remaining faithful to a single partner is a very good way to reduce the chances of contracting an STD.

4. Know your limits. Make a rational, conscious and informed decision before embarking on a sexual relationship.

5.Talk with your partner. Clear, open and honest communication is important in all aspects of a relationship, including a sexual relationship. Both partners should talk comfortably about safer sex.

6. Don't drink or use drugs before having sex. Impairment by alcohol and/or drugs may remove rational thinking from the decision to engage in sexual activity.

7. Be comfortable saying no. Sexual activity is never an obligation.

8. Be responsible for one’s own protection. Make responsible sexual choices. Bring your own safer sex supplies. 

9. Know how to please yourself. There’s nothing wrong with masturbation and no sexual partner is safer than yourself.

10. The brain is the most important sex organ. The brain is the most important sex organ because that is where the vast majority of sexual arousal occurs. The brain is also the most important safer sex organ, allowing us to think and consider the decision to engage in sexual activity. Maintain an awareness of risk factors, transmission methods, symptoms and methods of prevention. Choose partners sensibly.

Portions adapted from: About.com. Top 10 Ways to Avoid Contracting an STD. If You Have Already Decided To Have Sex. Elizabeth Boskey, Ph.D.

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