Sexually Transmitted Infections in Older Women
I had a patient pose the following question to me: I am 55years and have divorced for 3 years. I haven’t been sexually with anyone except my husband of 29 years. What do I need to know about sexually transmitted diseases at my age?
Single women aged 50 to 59 year is a new high risk group that are prone to sexually transmitted infections (STI). For many of these women they are newly separated, divorced or widowed and are just getting out into the dating world again. The notion of having your partner use condoms or having them screened for STI’s is not part of the conversation prior to having sex. Safe sex practices are not the highest priority. These groups of women also have low levels of estrogen as a result of menopause causing the vaginal tissue to be delicate, dry and fragile. Sexual intercourse can cause tearing which allows easy access for STI such as Chlamydia, herpes and human papillomavirus (HPV).
The recent studies show that sex is not an easy conversation to have with a health care provider so it is really up to us to bring up the topic of healthy sexual behavior for this growing group of women. During a women’s routine gynecologic exam, a sexual history should be asked along with getting routine STI cultures. The conversation should include the definition of safe sex and making sure their sexual partners are also tested for STI’s prior to becoming sexually active. The menopausal vagina might also need some additional estrogen cream to avoid the changes associated with low estrogen that result in tearing, burning and pain during sex.