Physicians Warn Older Adults That Menopause Offers No Shield Against Infection

Dating and intimacy remain part of emotional and physical well-being for older adults, including people who are divorced, widowed, remarried or returning to dating after decades.

Dr. Rhea Rogers, a board-certified physician, said visual impressions cannot confirm health status. "You can't tell by looking at someone if they have a sexually transmitted disease," Rogers said. "You say, 'Oh, they look healthy.' You can't tell by that." She added that advancing age does not lower the risk: "Getting older does not make you immune to getting a sexually transmitted disease. Just because you retired, your sexual health didn't."

Rogers identified human papillomavirus, or HPV, as the most common sexually transmitted disease, citing the Centers for Disease Control and Prevention for the point that the virus can cause cancer later in life. She also noted that a weakened immune system limits the body's ability to fight exposure, and that infections frequently travel in pairs. "When we treat people for chlamydia or gonorrhea, we treat for the other one as well," Rogers said. She added that PrEP, pre-exposure prophylaxis taken to prevent HIV infection, does not protect against other sexually transmitted diseases.

Gerontologist Sam Cradduck said menopause removes pregnancy risk but not infection risk. "A lot of people think, 'Well, I've been through menopause, I can't get pregnant. I don't need to protect myself,'" Cradduck said. "Menopause doesn't protect you from gonorrhea or syphilis or HIV or HPV." Cradduck also said syphilis acquired years earlier can surface later, appearing in communities where older adults live. "That lives forever in you," Cradduck said. "We've seen neurosyphilis in communities."

Cradduck also addressed product compatibility. "Wearing a condom is important, but a lot of condoms and a lot of lubricants don't go well together, and so you will impair the integrity of the condom with certain lubricants," she said. She added that people with a latex allergy should not use a latex condom.

Aging expert Amy O'Rourke said prevention begins with testing and direct conversation. She suggested opening by stating that an active sex life matters to you, then asking how a partner views testing and what precautions the two will take. O'Rourke also said naming specific diseases works better than using the term STDs. "STD seems like a distancer, like you don't really hear syphilis. When I hear syphilis, my ears perk up," O'Rourke said. "I think it's important to really say what those diseases are, and then what do we get if we have it and it progresses and you're older? I want to say the word cancer."

Rogers said a recent test does not replace ongoing caution. "That test might have been one month ago and things have changed," she said. She also addressed couples who were each widowed and each had one known partner: "They only had one sexual partner that they know about. I used to get this all the time.. You only know what the person told you. You don't really know, so still protect yourself."

The Aging Untold program lists three priorities: partners, practices and protection. It also directs readers toward current prevention tools, including advanced screenings, immune supports and daily PrEP. The program states it is educational and informational, not medical advice, and directs anyone seeking personal guidance to a licensed physician.