Q:
I am recently divorced at age 50 and I am dating again. What do I need to know about sexually transmitted diseases these days?
A:
I'm glad to hear that you're dating again—and even happier to hear you ask about safe sex. Age in no way protects you from sexually transmitted diseases (STD). In fact, if you are postmenopausal and not using at least a topical estrogen, your vaginal tissue may be even more vulnerable to infection.
These days, most of us think of HIV and AIDS when we think of sexually transmitted diseases, but the reality is that chlamydia is a far greater risk for women. In fact, it is the most commonly reported disease in the United States and one whose numbers continue to rise. While this bacterial infection can easily be cured with antibiotics, it often goes undiagnosed and untreated, leading to pelvic inflammatory disease (PID). A consequence of PID is chronic pelvic pain. That's why the Centers for Disease Control and Prevention recommends that older women with new or multiple sex partners receive annual screenings.
Gonorrhea is another STD you should be concerned about. Like chlamydia, antibiotics can easily cure this bacterial infection. However, also like chlamydia, it can go undiagnosed, resulting in PID. It can also increase the likelihood of HIV infection.
One STD you probably don't have to worry much about is human papillomavirus (HPV). It's an incredibly common sexually transmitted virus that causes nearly all cases of cervical cancer. By the time you're in your 50s, however, you've likely been infected already and shed the virus or had an HPV test for the virus. Regardless, unlike many other STDs, there is really no way to prevent it in middle-aged and older women other than abstinence or monogamy with someone who is not infected. An HPV vaccine to prevent most cases of the virus has been approved for girls aged 9 to 26. The vaccine, Gardasil, is not effective if you've already been infected, and it doesn't protect against all strains of HPV.
Pap tests remain the recommended screening option to detect abnormalities that may develop into cervical cancer. An HPV test also may be used to identify high-risk HPV types on a woman's cervix.
Other common STDs include syphilis, genital herpes, trichomoniasis, bacterial vaginosis and, of course, HIV. It's a dangerous world out there!
Ideally, you should ask your partner to be tested before you have sex with him or her. Even then, you should use a latex condom until you are sure your partner is disease free and certain that the two of you are in a monogamous relationship. HIV, for instance, may take as long as six months after the initial infection to appear on a test.
Condoms can protect against most STDs, but not all. Genital herpes, syphilis and chancroid (painful ulcers), for instance, can be spread through skin-to-skin contact even without intercourse.
Also make sure you get tested and screened for STDs at least annually or until you are committed to a completely monogamous relationship.
Oh, one more thing: Have fun!
