Older Adults and STDs: Everything You Need to Know

Understanding the connection between older adults and STDs is important for sexually-active seniors. Recent studies released by the Centers for Disease Control and Prevention (CDC) show there are consistent increases in STDs among older adults.

Although many people—including healthcare practitioners—assume that many seniors become less sexually active, this is a common myth. Many seniors enjoy healthy, active sex lives as they age. Because of this, it’s increasingly important to open the conversation about older adults and STDs to ensure that older adults protect themselves from any risks.

Keep reading to learn more about common senior STDs and get safe sex tips!

Although once thought that as we age we become less sexual, that’s not typically the case. Sexual activity is very common for many aging adults and seniors—and because active senior sex and sex over 60 years of age is not often considered, prevention strategies and sexual health are not usually addressed between patients and their healthcare providers.

Because of this lack of open dialogue about seniors and sex, many seniors may not know they can become infected with STDs through oral or anal sex, in addition to vaginal intercourse. Without fear of pregnancy if you’re having sex over 65, using condoms may seem less important as well.

If you’re having sex over 60, it’s important to remember that contraceptives are still incredibly important to ensure that you don’t contract STDs or STIs.

Data released from the Centers for Disease Control and Prevention show that cases of common sexually-transmitted infections (STIs), such as chlamydia, gonorrhea, and syphilis, have reached historic highs in recent years—and sexually active senior citizens are seeing the steepest increases.

In comparison to all age groups studied, seniors over 60 don’t have the highest rates of STDs overall—but by age group, seniors are seeing the most concerning increases. From 2007 to 2017, STIs have more than doubled among U.S. adults aged 65 years and older.

Why are STDs in the elderly population on the rise? Researchers believe there are a few reasons—from a lack of knowledge about older adults and STDs among the elderly to a lack of awareness from doctors. Senior citizens have historically reported fewer opportunities to discuss their sexual health with their healthcare practitioner—and without an open line of dialogue, it can limit a sexually-active senior’s access to educational resources or other opportunities to reduce their risk of contracting an STI or STD as an elderly adult.

There are a number of contributing factors to increasing STDs in elderly adults. Here are some of the most prevalent causes leading to higher numbers of seniors and STDs.

• Individual lack of awareness of the transmission: Many seniors believe they’re immune from STDs and may not have an individual awareness of how STDs are transmitted. Seniors who have been in long-term relationships that ended due to the death of a partner are particularly vulnerable to this lack of awareness.
• Increased longevity of sexual activity through medication: Many older adults extend their sex life in their senior years with the support of Viagra, erectile dysfunction drugs, and hormone creams. Erectile dysfunction affects 50 percent of men aged 50–60, 60 percent of men aged 60–70, and 70 percent over the age of 70. The sales of erectile dysfunction drugs are expected to exceed $7 billion annually by 2024.
• Treatments for low libido in men and women: Although decreased sex drive tends to occur with age, many prescription medications and treatments are available to increase desire and promote sexuality and sex for older couples—so seniors can keep having sex in their senior years.
• Lack of regular screening in aging populations: Many healthcare practitioners hold the outdated view that seniors aren’t having sex. Only five percent of seniors on Medicare are routinely screened for STDs and Medicare doesn’t require STD screening in an annual wellness exam. This is a missed learning opportunity for seniors and STDs, and safe sex as you age, which can contribute to increasing STDs in elderly populations.
• Natural lowered health and immune systems through aging: As we age, our immune system can weaken and become more vulnerable to infections—including STIs in elderly populations. Plus, if you’re a senior with an age-related condition or a weakened immune system due to pre-existing condition, sex in your senior years without adequate protection can pose a unique risk.
• Increased opportunities for infections through thinning vaginal tissue: Sexually active seniors are more vulnerable to STD infections—and women in particular experience a thinning of tissue in the vagina and the vulva as they age. This can lead to micro-tears during sex and infectious diseases, such as HIV, can easily enter the bloodstream.
• Increased opportunity for sexual partners in senior communities: Retirement homes and senior communities offer an increased opportunity for sexual partners. Unprotected sex is often common since there is no fear of pregnancy—and many seniors, particularly men, rely on treatments for low libido to elevate interest in sex. Practice safe sex tips for seniors if you live in a community and are having sex in your senior years.

Many older adults feel embarrassed or ashamed of discussing their active sexuality with a healthcare provider—and because of this social taboo with STDs and senior citizens, many seniors are less likely to be diagnosed with an STD in its early stages.

If you are a sexually active senior, being open and honest with your healthcare practitioner about your sex life is absolutely necessary. Because most STDs don’t have symptoms, many older adults may not realize that they are infected until it becomes a recurring, serious issue. In some cases, the symptoms that accompany an STD are ambiguous and not easily traced to a particular diagnosis.

Even if you assume that your doctor will provide routine STD testing, it’s best to ask outright and speak openly about your needs. Doctors may incorrectly assume that seniors aren’t sexually active, leading to long-term effects for senior citizens and STDs.

It’s important to remember that asking questions and expressing concern is healthy and encouraged. Most STDs and STIs in elderly populations are easily treatable if caught in time.

If you’re a sexually-active senior, here are some common older adult STD symptoms to watch out for. Make sure you schedule an appointment with your doctor immediately if you develop any of these symptoms—or if you’re concerned about STD exposure and want to get screened.

• Burning or itching in the penis or vagina
• A foul vaginal odor
• Unexplained bleeding from the vagina
• Yellowish or watery discharge from the penis or vagina
• Pelvic pain
• Pain in the vagina during sexual penetration
• Sores, bumps, or blisters
• Burning and pain when urinating
• Frequent urination and frequent bowel movements

Now that you have a greater understanding of why older adults suffer from STDs, here is a list of common STDs that impact older adults.

Knowing these particular symptoms—as well as the transmission of the STD—can assist seniors in preventing an STD, obtaining the right diagnosis, and serving as a reminder to practice safe sex for senior citizens.

While this will reflect the most common STDs, it is not comprehensive. If you are a sexually active senior citizen, it’s important to start a conversation with your healthcare practitioner to ensure you’re getting screened for infections regularly—and practicing safe sex as you age.

HIV

HIV is a viral infection that kills cells of the immune system and can lead to a multitude of symptoms and concerns. It damages and weakens the body’s immune system. Having HIV can lead to a number of other life-threatening infections and certain cancers.

Anyone, regardless of age, can contract HIV. People typically acquire the virus from unprotected sex with someone living with HIV, through contact with HIV-infected blood, or by sharing needles with a person living with HIV. If you are a senior and you had sex without a condom or other form of protection, you may be at risk.

Symptoms

Symptoms typically begin within a month after exposure and include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and ulcers in the mouth. The initial symptoms of HIV are minor and often considered flu-like.

Although it can take more than 10 years for more serious symptoms to appear, later-stage HIV or AIDS includes swollen glands, lack of energy, weight loss, chronic or recurrent diarrhea, lack of energy, recurrent yeast infections, short-term memory loss, and blotchy lesions on the skin.

People with HIV may develop aging-related conditions at a younger age—which means that it’s important to start treatment as soon as possible. Older people living with HIV have an increased risk of dementia, diabetes, osteoporosis, and some cancers.

Prevalence

According to a 2018 study from the Centers for Disease Control and Prevention (CDC), new HIV infections are growing faster in seniors over 50 than in people under the age of 40. In fact, nearly half of the people living with HIV in the United States are age 50 or older.

Older people are much less likely to get tested for HIV—and many of the symptoms can be easily mistaken for the normal aches and pains of aging and growing older. Although HIV and AIDS have been historically stigmatized, if you are at risk due to unprotected sex, ask your doctor if you can schedule an STD screening.

HPV

Cervical cancer is caused by an STD called human papillomavirus (HPV)—and although thousands of women die every year from cervical cancer, it’s predominantly a preventable disease.

HPV is a very common sexually transmitted infection and it usually resolves without treatment. Some viruses, however, are linked to cervical cancer. The most common cause of HPV transmission is sexual activity, including vaginal, anal, and oral sex. Using a condom is the best way to reduce your chances of becoming infected with HPV.

Symptoms

Most individuals with HPV infections experience no symptoms at all. If you do experience symptoms caused by an HPV infection, it is likely genital lumps and bumps or genital itching.

Because most individuals with HPV never experience a symptom, it’s important to have your doctor screen regularly for any changes. A regular cervical screening—a pap smear—is the easiest way to catch any cancerous changes caused by HPV.

Prevalence

HPV is incredibly common and can happen at any age: about 80% of sexually active people are infected at some point but will likely never know. The virus doesn’t frequently produce symptoms and, in most cases, the body clears it on its own. One study found that women aged 35 to 60 years older who had HPV may have represented an infection acquired years ago—and lay dormant until later in life.

Unfortunately, many senior women stop going to the gynecologist once they are no longer in their child-bearing years or need a form of birth control. Older women in particular may be reluctant to get a pap smear if they have no symptoms or if they believe they are low risk.

However, screening into your senior years for HPV is very necessary. It can take over a decade for an HPV infection to develop into cancerous cells—so even if you’re not sexually active as a senior, getting a regular pap smear to check for any cancerous cell activity is vital. If you are over the age of 55, talk with your healthcare provider about the best course of action to get screened for cervical cancer.

Chlamydia

Chlamydia is one of the most common STDs in the United States. It causes infection in both men and women and can lead to permanent damage to a women’s reproductive system, making it difficult or even impossible to become pregnant.

Chlamydia spreads through vaginal, anal, or oral sex with someone who has chlamydia. Although the only way to completely prevent the chance of STDs from occurring is through abstinence, using a condom every time you have sex is vital. Plus, if you’re in a long-term monogamous relationship, you and your partner can both get tested to ensure that neither of you is carrying the infection.

Symptoms

Just like many STDs, chlamydia doesn’t always have visible symptoms—but it can cause serious health problems if left untreated. When peeing, women with chlamydia may experience an abnormal vaginal discharge or a burning sensation. For men, symptoms may include a discharge from the penis, a burning sensation when peeing, or pain and swelling in the testicles.

Men and women can also contract chlamydia in the rectum, which occurs when having anal sex or from being spread from another infected site. Some of these infections may not cause symptoms while others may experience unusual sores, smelly discharges, or burning when peeing.

Prevalence

In 2018, chlamydia infections among adults over the age of 50 accounted for approximately 20 percent of all new infections.

Gonorrhea

Gonorrhea is an STD caused by a bacterium that infects both males and females. It most often impacts the urethra, rectum, or throat—but in females, it can also infect the cervix. Gonorrhea is spread through vaginal, oral, or anal sex. Babies can also be infected during childbirth.

Symptoms

In most cases, gonorrhea causes no symptoms. However, if symptoms occur, they frequently impact the genital tract in both men and women and include:

• Painful urination
• Pus-like discharge from the tip of the penis
• Pain or swelling in one testicle
• Increased vaginal discharge
• Vaginal bleeding
• Abdominal or pelvic pain

Symptoms can also appear in other parts of the body, including the rectum, the eyes, the throat, and joints.

• Rectum: Symptoms can include anal itching, pus-like discharge, and spots of bright blood on toilet paper. Straining during bowel movements may also appear.
• Eyes: Gonorrhea doesn’t only impact your genitals—it can also appear as a symptom causing eye pain, sensitivity to light, and pus-like discharge.
• Throat: A sore throat and swollen lymph nodes are signs of gonorrhea infection in the throat.
• Joints: If your joints become infected by gonorrhea infection, you may feel swelling, heat, or pain during movement.

Prevalence

In 2019, older adults between the ages of 55 and 64 accounted for over 30,000 cases of gonorrhea.

Syphilis

Syphilis is a very common bacterial infection that is typically spread by sexual contact. The disease typically begins as a painless sore on the genitals, the rectum, or the mouth. It spreads easily from person to person through skin contact.

Symptoms

Syphilis bacteria can remain inactive in the body for decades—and without treatment, it can cause permanent damage to the heart, brain, and other organs. Many patients are infected with syphilis without seeing symptoms for years.

The first sign of syphilis is a small sore that appears at the spot where the bacteria entered the body. These typically develop within three weeks after exposure—and many people don’t even notice the sore because it’s often painless. Within a few weeks after the sore, you may experience a rash that begins on your trunk. It is not typically itchy and may be accompanied by wart-like sores on your mouth and genital area.

These symptoms typically disappear within a few weeks—or may come and go for up to a year.

Prevalence

In 2019, there were over 5,600 reports of syphilis among those aged 55–64.

Hepatitis B

Hepatitis B is a liver infection caused by the hepatitis B virus, most commonly transmitted when someone is exposed to blood, semen, or other body fluid by someone with hepatitis B. A person can become infected through sexual contact, birth, sharing needles or syringes, sharing items such as toothbrushes or razors, and direct contact with blood or open sores of a person who has hepatitis B.

Symptoms

Many people with hepatitis B don’t know they are infected with the virus because they do not experience symptoms. This can lead to chronic hepatitis B, which increases the risk of liver failure, liver cancer, and cirrhosis.

Prevalence

Older adults face the greatest burden of hepatitis B since many were born before the childhood vaccination became available. Approximately 4.7 percent of U.S. adults over age 50 have been infected with hepatitis B and the rate of chronic hepatitis is nearly two-fold higher than in younger adults.

Although most adults with hepatitis B fully recover, there is no cure if you have been diagnosed with the condition. For seniors, chronic hepatitis B can lead to liver damage, cirrhosis, and cancer. If you are an older adult worried about your exposure to hepatitis B or wondering how to manage a diagnosis, consult your healthcare practitioner regularly. Testing for liver damage and cancer are important steps to ensuring long-term health and well-being.

Genital Herpes

A common sexually transmitted infection caused by the herpes simplex virus (HSV), genital herpes can cause pain, itching, and sores. Genital herpes is only spread through sexual contact—and after the initial infection, the virus can lie dormant within the body but reactivate throughout a year.

Symptoms

Most people infected with HSV don’t experience any signs or symptoms. If your body does show symptoms, you will likely see them within two to 12 days after exposure to the virus and they may include:

• Pain or itching in your genital area
• Small red bumps or tiny blisters
• Ulcers
• Scabs

Men and women can develop these sores on the buttocks and thighs, anus, mouth, and urethra. Women can also develop sores in the vaginal area, external genitals, or cervix. Men may develop sores on the penis or scrotum.

Although there is no cure for genital herpes, medications can help ease the symptoms and reduce your risk of infecting others. If you believe you have genital herpes or you’ve been exposed to someone, consult your healthcare practitioner for medical support.

Prevalence

There is no current data on the prevalence of genital herpes in the elderly populations, however, genital herpes infection is common, with approximately 572,000 infections reported in the United States in a single year. Women are more commonly infected.

Genital Warts

According to the Mayo Clinic, nearly all sexually active people will become infected with at least one type of HPV—the virus that causes genital warts—at some point during their lives. Warts can affect tissues of the genital area as small, flesh-colored bumps.

Symptoms

Symptoms of genital warts include small, flesh-colored, brown, or pink bumps in the genital area, itching or discomfort in your genital area, and bleeding with intercourse. In many cases, genital warts are too small to see with the naked eye.

Like all STDs, having unprotected sex increases your risk of becoming infected with genital warts.

Prevalence

According to the American College of Obstetricians and Gynecologists and the American Society for Colposcopy and Cervical Pathology, genital warts are on the rise in women over 40. Although most genital warts are benign, some can progress to vulvar cancer in women.

Sex in your senior years is healthy—but in order to enjoy safe sex, seniors, need to know that there are a number of preventative measures and tips to keep in mind.

Increased Patient Education and Communication with Healthcare Providers

Transparent, honest communication with healthcare providers is vital to increasing patient education on STDs and seniors, and safe sex practices. Unfortunately, there is still a stigma and a misconception that most seniors aren’t sexually active, resulting in many doctors not communicating properly with their elderly patients.

If you are a sexually active senior, you may have to take the first step of speaking frankly about your sexual health and asking your doctor for support. Understandably, this may be awkward and embarrassing at first—but remember that you are your best advocate.

If you believe you are in need of support, STD screening, or simply more education around staying safe, broach the conversation with confidence.

Utilize Condoms and Dental Dams

Using contraceptives, such as condoms and dental dams, is the most effective way to prevent STDs and practice safe sex for seniors.

Although some seniors may not worry about using contraceptives due to the lack of pregnancy risk, using some form of protection remains an absolute necessity. Some older men may struggle to use condoms effectively due to performance issues. If that’s the case, consider an erectile dysfunction drug. There are also female condoms available for women to insert into the vagina. To stay safe during oral sex, use a dental dam.

Receive Regular Screening and Testing

In addition to speaking candidly with your healthcare provider about sex and STDs, ask your doctor about receiving regular screening and testing for STDs. If you are a sexually-active senior, determining the best screening frequency is vital.

You should also consult your doctor on the best strategy for screening, particularly when or if you become sexually active with a new partner.

Use Vaginal Lubricants

One common challenge for older women who are staying sexually active is vaginal tearing—which can increase vulnerability and transmission of STDs. The easiest way to reduce the risk of tearing is to use a vaginal lubricant during sex.

There are a number of over-the-counter moisturizers or lubricants available for women. If you suffer from vaginal thinness, you can also start taking a prescription vaginal estrogen product to help. Consult your healthcare practitioner for a recommendation.

Increase Partner Communication

Being transparent with your partner about your sexual past and any potential risks is not only a respectful act—but it will also encourage closeness between the two of you. Although STDs have been stigmatized for decades, there is no shame in having an STD. Every year, millions of adults are diagnosed with an STD and many are treatable with the right medication.

If you are exploring a sexual relationship with a new partner, make sure to disclose any diagnoses you may have so they’re aware of any potential risks.

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