Seniors & Sex
It may be time to talk about STDs – with Grandmom
By Kate Markal
After the passing of her longtime spouse, Susan Stein, 73, turned to the internet for a fresh start. She first joined virtual meet-up groups for widows and widowers over the age of 65, and when she felt ready, made the jump to online dating.
All these decades later, Stein says, the dynamics of dating haven't really changed since the last time she was looking for romance. "There are players out there," she says. "Before you meet in person, they want to jump into your bed!"
But that's not all she discovered. Before she got in the thick of dating, Stein shared her experiences with a therapist she was seeing – and discovered that there are more perils to dating than impatient suitors. Sexually transmitted diseases (STDs) are on the rise nationwide – and South Jersey seniors don't get a pass.
In 2017, nearly 2.3 million cases of chlamydia, gonorrhea and syphilis were diagnosed in the United States, according to the CDC. While the overall numbers remain lower in sen­iors than in younger, more sexually-active age groups, one of the steepest rates of increase in STDs over the past decade has been in adults over 65.
In an age when people are living longer and healthier lives, their interest in sex remains robust. Several major surveys report that among people age 60 or older, more than half of men and 40 percent of women are sexually active. New partners usually enter the picture after years of monogamy, either following the death of a spouse or after divorce. But free from the worry of unwanted pregnancy, the sex they're having is often unsafe.
"Older adults are thinking, 'Well, I'm not going to stop having sex just because I'm 70 years old," says Samuel Weiner, MD, a primary care physician at Virtua Health.
Also, he adds, "there's a pretty clear correlation between when Viagra came onto the market and when the STD rate started to jump in seniors."
Many seniors are simply unaware the sex they're having is dangerous, says Terrie Ginsberg, DO, a geriatrician at Rowan Medicine's New Jersey Institute for Successful Aging.
"Many elderly patients I see say their families never discussed sex," says Ginsberg, who notes that most seniors she sees do not use condoms.
Rebecca Rosenau, director of Senior Services at Samost Jewish Family and Children's Services of Southern New Jersey, adds that even when confronted by the cold facts, seniors are often in denial that the dangers to intimacy go beyond broken hearts.
She recalls a senior she counseled recently who, having moved into an assisted-living residence after more than 50 years of marriage, found herself at the center of a new male neighbor's affection. As the woman discussed the possibility of entering a new relationship with this man, Rosenau gave her the talk, focusing on the dangers of STDs.
"Her first response was, 'Don't worry about me, I can't get pregnant,'" Rosenau recalls, noting that such a reaction is all too familiar. "I told her chances are he's being that flirty with other people," she adds.
The damage STDs can do to the body can be worse for seniors, due to their declining health. The immune system weakens with age, which makes it easier for infections to spread and become more systemic, according to Weiner.
"Also, many elderly people have other preexisting chronic conditions, like diabetes or cardiovascular disease, and an STD could set off, or exacerbate, other underlying problems," he says.
Aging also presents unique challenges when it comes to sex. In women, the shape of the vagina changes and natural lubrication decreases over the years. With the friction of intercourse, they're vulnerable to micro abrasions that make it more likely they will be infected. In men, impotence and other signs of erectile dysfunction can make it difficult to have sex and wear condoms. Arthritis, which becomes more common with age, can create problems when handling condoms and wrappers, Weiner adds.
Although it's often not the case, a discussion of sexuality should be a regular part of checkups for seniors, says Ginsberg.
"Sex needs to be high on the list with all the other issues adults discuss with doctors," she says. "It helps longevity and quality of life overall."
Or as Stein puts it: "We're still alive at this age, sexually. Once you hit meno­pause, you're not dead."
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