There is so much taboo about sex and older adults.
Most people are under the false assumption that when people reach a certain age that they no longer have sex. However, that’s just not true, and many tend to lead healthy sex lives. However, it can also lead to some health problems such as sexually transmitted diseases.
In fact, a 2018 Centers for Disease Control and Prevention report looking at 2017 shows there were 2.7 million cases of gonorrhea, chlamydia and syphilis cases reported among all ages including senior citizens.
The rates of STDs are especially higher with older adults. According to a recent study of patients on the AthenaHealth network, patients 60 years of age and older were often seen in office for STIs. Between 2014 and 2017, there was a 23 percent increase in the number of these patients with syphilis, herpes simplex, gonorrhea, chlamydia, trichomoniasis and hepatitis B. For the 13 and older group, there was just an 11 percent increase in these diseases.
According to University of Chicago professor of Obstetrics and Gynecology and Medicine-Geriatrics, there does look to be a rise in the number of older adults with STIs, but the rates of these STDs is still rather low compared to younger adults, which tend to have higher STI rates.
The increase in STIs is found more in men than women, especially for gay or bisexual men. However, any person, including older people, is susceptible to get an STD.
There are several speculations as to why the rise in STDs amount senior citizens. One reason may be the sense in time. The senior citizens now are the same ones who were 18 during the 1968 Summer of Love. Then, getting a sexually transmitted disease was a serious situation. After all, people were dying of syphilis.
However, with antibiotics for common sexually transmitted diseases like syphilis, gonorrhea and chlamydia are curable. And, with the birth control pills eliminating unwanted pregnancies, it means people were freer to be sexually active. There was a time when an STD could no longer kill a person.
Suddenly, herpes came about that caused some distressing feelings but wasn’t really life or death.
With the older generation suddenly becoming single again, they are becoming sexually active once more with more partners – in a time of HIV and other serious STDs. Most are still thinking about what the medical landscape was like before and not what it is now. It’s the attitude the older generation has about STDs that may be lending to the increase in STD rates among their generation.
This is a generation that didn’t date during the HIV/AIDS crisis; they still have a belief that gonorrhea is the most common infection. They don’t realize that even gonorrhea is a bad thing because of the potential to become a superbug (as noted in some cases where drugs won’t cure it). Plus, all the other new STDs emerging such as Trichomoniasis and HIV that can affect them – they don’t see this as a major concern for them. This means they’re less likely to get screened for these and other diseases.
Another reason for the rise is the lack of screening. When a patient comes in for their annual well-care checkup, Medicare is only looking for vision, memory, hearing, propensity to falling down, etc. Nothing Medicare asks for looks at the adult’s sex life. Researchers agree that putting one’s head in the sand about senior citizens do not have sex is contributing to the STD crisis. And, not routinely testing them for diseases is only going to lead to even more STD cases among them.
Most doctors don’t take the time to listen to their patients’ concerns, focusing on only the more important things of a visit such as high blood pressure and diabetes, etc. No preventative measures are being discussed that could protect them from sexually transmitted diseases as well as other things.
Even worse, the insufficient funding to the public health infrastructure makes it harder for the American public to attain the preventative information they need including senior citizens.
Another possible reason for the rise in the number of cases is the newer drugs the FDA has approved to treat sexual dysfunction in both men and women. Older groups are having a lot more sex than they did 30 years ago thanks to these drugs. Couple that with the lack of information and screening, and it’s not that big of a surprise for the spike in STD cases.
It’s important to remember that even though a person is older, it doesn’t mean they’re not having sex. A bedridden person can still have sex if they are still coherent and can give consent. Just because a person is old does not mean they are not having sex.
The best way to reduce the rate of STIs among senior citizens is to give them information – arming them with the information to protect themselves. This means making them aware that they also need to use condoms in all sexual encounters whether their partner is young or old. Age is not a protection against a sexually transmitted disease; condoms are.
Condoms can be found for both men and women. The female condom may be better for older adults, as male condoms are designed to be put on when the man has a full erection. This typically doesn’t happen for older men until penetration.
In many cases, there is a lack of accessibility for condoms for older adults. The younger generation can turn to a university health system or a locker room to get. However, most adult residence homes don’t have this option. Either they are embarrassed to ask someone to purchase condoms for them, or they have sex without a condom anyway.
Women are particularly at risk for catching an STI as their vagina dries out as they get older. When having sex, it can cause the tissue to tear and leave minor abrasions. This increases their chance of getting an STD like HIV. If a woman is using aromatase inhibitors, this can increase the tear chances.
Senior citizens who develop new symptoms and are having sex need to talk to their doctor and get tested for an STD. Even if the test is positive, there are several very effective treatments for these STIs. While prevention and knowledge are better, senior citizens should not be ignoring their symptoms for the sake of embarrassment of being sexually active at their age.
Written by Mark Riegel, MD
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