Sexually Transmitted Infections: What’s Your Risk?

They’re on the rise. Here’s what older adults need to know to about safe sex.

Seniors have sex—you know this. What you may not realize: Sexually transmitted infections (STIs) are still a risk.

In fact, STIs are on the rise among older adults. Young people ages 15 to 24 make up half of reported STI cases, according to the Centers for Disease Control and Prevention (CDC). But among people ages 55 and 64, cases of chlamydia nearly doubled between 2014 and 2018, and gonorrhea and syphilis more than doubled.

While many STIs are just plain annoying, some may lead to more serious health issues. If you’re infected with genital herpes, for example, you’re more likely to develop human immunodeficiency virus (HIV) if you encounter it, according to Shannon Dowler, M.D., a family physician in Asheville, North Carolina, and creator of the STDs Never Get Old video.

If left untreated, chlamydia or gonorrhea can lead to a burning sensation during urination or discharge from the vagina or penis. More serious complications include pelvic inflammatory disease in women and urethra infections in men.

What’s Behind the Rise in STIs Among Seniors

There are a few key shifts that may help explain the uptick in STIs among older adults. One is longevity. “People are living longer, so they’re having sex for a longer period of time,” Dr. Dowler says.

Plus, there are more medications on the market that can help people stay sexually active—despite age-related changes and chronic health issues.

“Historically, you start putting people on medicine for blood pressure and diabetes, and their sexual function was sometimes impacted,” Dr. Dowler says. “Today we have medicine to counteract that, so people are able to enjoy an active sex life longer.”

Another factor is your changing body. It’s natural for the immune system to get weaker with every passing birthday—and that can leave older adults more susceptible to infections. Shifting hormones also chip away at the elasticity of your skin and tissues, leaving you more vulnerable to microtears that can serve as openings for bacteria.

Finally, more older adults are moving into retirement communities, as opposed to living with family members, Dr. Dowler says. Living in these communal environments makes it easier for divorced or widowed adults to meet other people their own age, and many choose to have sex.

“It’s sort of like college, except you don’t have to work or take classes,” Dr. Dowler says.

STIs Aren’t on Seniors’ Radar

This is especially true of older adults who have recently divorced or lost their spouse, and who haven’t had to talk about STIs with a new partner for a long time.

Many older adults also don’t consider themselves at risk. “One of the things that we know from research is that older adults are not great at understanding their own susceptibility to STIs,” says Maggie Syme, Ph.D., M.P.H., an assistant professor of gerontology at Kansas State University.

A major reason for this: lack of sex education. “Today, we have so much information, and most schools offer comprehensive sex education at some level,” Syme explains. “Older adults didn’t have that when they were growing up.”

5 Ways to Protect Yourself from STIs

It’s never too late to practice safe sex. Whether you’re already in a sexual relationship or you’re just thinking about having sex, there are steps you can take to protect yourself against STIs.

Step #1: Re-Educate Yourself

“Empower yourself with knowledge,” Syme says. If you’re thinking about having sex—or you’re already in a sexual relationship—it’s important to brush up on the basics of safe sex. This includes knowing which STIs are out there, your risks, and the best ways to protect yourself.

Start by doing some online research. The CDC is a great resource. This way, you’ll be better prepared when it’s time to talk to your doctor or partner about safe sex.

Step #2: Summon the Courage to Talk to Your Doctor

Your doctor can connect you with resources for safe sex, perform STI tests, and review the best STI prevention methods available to you, including condoms, female condoms, diaphragms, or a combination.

Many older adults feel uncomfortable talking about sex with their doctor and prefer that their doctor be the person to initiate that conversation. “They’re looking to the doctor to direct the discussion around their health,” Syme says.

In the real world, however, many providers don’t think to ask older patients about sex, she adds. So, it’s ultimately up to you to take control of your health. Don’t wait for your doctor to ask about sex—bring it up yourself.

Step #3: Get Tested Regularly

If you’re having sex, you can develop an STI, Syme says. In fact, you may be living with an STI and not even know it. That’s because many STIs don’t cause any symptoms. The only way to know your STI status for sure is to get tested.

Ideally, you’ll get tested before you begin a new sexual relationship. If you missed that window and are currently having sex, go ahead and make an appointment. You can go to your primary care doctor for the screening. Or find locations for free or low-cost testing clinics through the CDC.

Ask your doctor how often you should continue to get tested. It’s a good habit to get tested each time you have a new sexual partner. Going forward, you may even want to repeat the screening every year—even if you’re in monogamous relationship and your previous test came up negative.

Step #4: Come Clean with Your Partner

Talking about STIs and your sexual history with a new partner can be uncomfortable, but it’s important for both of you to understand your risks and get screened.

Besides, “if you’re not comfortable enough to talk to somebody about sexual risks and literally scrutinizing them for infections, then you probably shouldn’t be having sex now,” Dr. Dowler says.

Make sure you talk about STIs with every new partner, and that you both get screened. Watching Dr. Dowler’s “STDs Never Get Old” video with a new partner can be a great ice breaker. It might also set you both at ease if you schedule your screening appointments for the same day or week.

If you or your partner does have an STI, don’t panic. The good news, says Dr. Dowler, is that many STIs can be completely cleared up and cured—and all of them are treatable.

Step #5: Practice Safe Sex

Yes, that means it’s time for a trip to the pharmacy to pick up condoms to reduce the transmission of STIs. Male condoms are the most popular choice, but female condoms are an option, although they’re slightly less effective at preventing STIs than male condoms. Your doctor can help you find the right method for you.

Ready to be in a committed, monogamous relationship? Continue practicing safe sex until you’ve both been tested.

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