Feeling Lucky?

Getting older doesn't mean you have to give up your sex life … as long as you don't give up your condoms

The free-loving, bra-burning days of the sexual revolution might be long behind them, but Baby Boomers didn’t ditch their libidos with their Birkenstocks. And thanks to drugs like Viagra and Cialis, Boomers can look forward to robust sex lives well into their golden years.

Dr. Brad Meyers, a Dean family practitioner cites an issue of the Student British Medical Journal, which reported that eighty percent of adults between ages fifty and ninety are sexually active. “The Baby Boomers who helped usher in the sexual revolution have remained sexually active and are healthy enough to enjoy sex,” Meyers says.

Yet many have long since forgotten the sex-ed lessons from high school—if they ever got them to begin with. Some seniors on the older end of the spectrum predate the sexual revolution and were already married by the time AIDS and HIV emerged on a national level in the 1980s. Prior to that, the cautions whispered from the birds and the bees focused primarily on preventing pregnancy, not sexually transmitted disease.

Of course, unplanned pregnancy is a remote risk for older adults. So those who reenter the dating scene after years of monogamy generally think they have little to worry about. Only they’re wrong.

“Even though you can’t get pregnant, any time you have a new relationship you still have a risk of getting a sexually transmitted disease,” says Dr. Fred Melius, a gynecologist with Melius, Schurr & Cardwell.

Certainly seniors are not immune from sexually transmitted infections, or STIs. Overall infection numbers are low for seniors, especially when compared to individuals between fifteen and twenty-four, who account for approximately half of the twenty million STI diagnoses each year. Yet the U.S. Centers for Disease Control and Prevention report nearly a quarter of HIV-positive adults are over the age of fifty, and rates of infection for diseases like chlamydia and syphilis are rising faster for this group than for any other.

“The rates for some of those infections have doubled over the past decade,” says Dr. Christopher Crnich, a UW School of Medicine and Public Health assistant professor who researches infectious disease in elderly populations. “That’s always worrisome.”

Part of why STIs can be so vexing is that many infected individuals are asymptomatic, at least for a while. Other patients many not recognize the symptoms because of a lack of awareness. Meyers points out that some of the neurological symptoms of syphilis can be confused with signs of dementia and other symptoms of age. Still other individuals may avoid or delay medical treatment due to embarrassment.

Doctors are also unlikely to catch STDs as a matter of course. “There’s very little sexual health screening that happens, especially after menopause,” Melius says.

Yet Meyers and Melius point out that, in some instances, delayed STI diagnosis and treatment can lead to serious health consequences. That is why it is critical for doctors to have the talk with sexually active seniors who are not in long-term monogamous relationships.

And they need to talk about condoms.

Adults over the age of forty have the lowest condom usage rates, and ninety percent of men over fifty did not use a condom when they last had sex with a date or casual acquaintance, according to Indiana University’s National Survey of Sexual Health and Human Behavior that was published in a 2010 issue of the Journal of Sexual Medicine

But discussing sex at the doctor’s office can be easier said than done. While doctors know STIs are a risk, there are a host of other health issues to cover with older adults. Heart disease. Diabetes. Cholesterol. Other medications. STIs just fall down the list of priorities. Then there is the risk of alienating patients with uncomfortable conversations. An easier opportunity to raise the issue is when male patients request drugs for erectile dysfunction. “That’s the perfect segue,” Meyers says.

For their part, non-monogamous, sexually active seniors need to be responsible as well, says Group Health Cooperative family practitioner Dr. Mark Olinger. That starts with getting screened to know what, if any, STIs they carry. The next step is having frank conversations with any partners about expectations and sexual history. And the third part is practicing what Olinger calls “safer” sex.

“Use a condom,” he says. “Even if you know something about someone, you never know their whole history.”

Jennifer Garrett is a Madison-based freelance writer. Read her healthy living blog here

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