Middle-aged Britons are on the brink of a sexual health crisis, experts have warned, after a surge in the number of sexually transmitted infections in the over-45s.
The problem is most pronounced in women over 65 – there has been a dramatic 25 per cent increase in the diagnosis of STIs over the past five years.
And the increase among men of the same age is almost 15 per cent, according to the most recent analysis from watchdog Public Health England.
Cases are also rising among those aged between 45 and 64, with an 8.6 per cent increase among men and 6.7 per cent among women. In contrast, cases in the under-45 age bracket have fallen by 8.4 per cent over the same period.
Middle-aged Britons are on the brink of a sexual health crisis, experts have warned, after a surge in the number of sexually transmitted infections in the over-45s
Sexual health specialists say a ‘perfect storm’ of factors is to blame: older people enjoying a more active love life due to pills such as Viagra, coupled with ignorance about safe sex and a lack of health campaigns aimed directly at them.
As divorce rates rise, so do the number of middle-aged Britons beginning new relationships. More than ten per cent of men and 14 per cent of women aged 50 to 70 report having three or more sexual partners over the past five years.
In total, 418,000 new STIs were diagnosed last year, and 30,000 of those were caught by the over-45s. Experts fear the true number could be even higher than suggested as many in this age group are too embarrassed to seek help – or do not realise they are at risk.
As Dame Sally Davies, the Chief Medical Officer, warned in her landmark report into mid-life health last year: ‘Better communication is needed to inform older people of the sexual health risks they face.’
Here, Britain’s foremost sexual health experts detail the crucial information middle-aged people need to be aware of – and how to broach what can be a vital, but toe-curling, topic of conversation…
Dr Elizabeth Carlin is a consultant in sexual health and HIV medicine and is president of the British Association for Sexual Health and HIV
Dr Elizabeth Carlin is a consultant in sexual health and HIV medicine and is president of the British Association for Sexual Health and HIV. She says:
Times are changing. Today, it’s not just teenagers and twentysomethings who are coming through our doors, but more people over 45. Most patients, of course, are shocked when they are told they have an STI. They never expect it to happen to them.
Indeed, many older women admit that STIs hadn’t even crossed their mind – the days of them becoming pregnant are over and they hadn’t thought to use a condom.
The plain fact is that anyone can get an STI. It doesn’t matter if you’ve got a high-flying job, are married, single or someone’s grandmother, the risk is still the same if you have sex without a condom or checking someone is STI-free. Many infections don’t cause symptoms – the only way to be sure is to be tested.
In fact, many over-45s could do with taking a lesson from the younger generation.
While the vast majority of infections are in young people, rates in this group are falling steadily year on year, and regular sexual health check-ups are seen as the norm.
If they are at risk, middle-aged women should add sexual health testing to their existing screening repertoire of cervical smears and mammograms.
For those who remember testing as invasive and uncomfortable, things have moved on. Nowadays, we can test for a wide variety of bacterial infections with a single urine test in men, and woman are able to self-swab from the genital area.
Examinations are usually only needed for those with symptoms. Ideally, both you and your partner should be tested at the same time.
By all means go to the clinic together, but we recommend separate consultations.
These days, a quick internet search of STI tests reveals a whole host of screening you can have. But it’s unlikely you will need all the possible options.
Everyone should be screened for the main infections, such as chlamydia and gonorrhoea, syphilis and HIV.
Swabs to test for viruses such as herpes may be taken if there are signs or symptoms, but they are not taken routinely, nor are blood tests.
Epidemiologist Dr Gwenda Hughes is head of STI surveillance at Public Health England
Epidemiologist Dr Gwenda Hughes is head of STI surveillance at Public Health England. She says:
Report about the threat of untreatable STIs are not just hype. The main cause for concern is gonorrhoea, which is the second most common sexually transmitted infection in the UK after chlamydia. So-called super-gonorrhoea is a term used to describe strains of the infection that have become highly resistant against one of the antibiotics normally used to treat them. The first outbreak was reported in the UK two years ago, but these were all treated successfully thanks to an alternative antibiotic that is still effective.
The bacteria that cause gonorrhoea are particularly smart – they have evolved to resist nearly all the drugs we have used. And when the drugs we currently use stop working, we will have run out of options.
There have been three reports of gonorrhoea infections abroad – in Japan, France and Spain – that were resistant to almost all drugs. We can’t say when these strains might arrive in the UK and become widespread. It could be just a few years. Time is not on our side. This is why safe sex is so important in all age groups – but many people over 45 in particular may not give STIs much thought. Remember that syphilis rates are the highest they have been since the 1950s – and are rising in all age groups.
Dr Anne Connolly, of the Faculty of Sexual and Reproductive Healthcare at the Royal College of the Obstetricians and Gynaecologists
Dr Anne Connolly, of the Faculty of Sexual and Reproductive Healthcare at the Royal College of the Obstetricians and Gynaecologists. She says:
Few people like using condoms – and women who are post-menopausal often have vaginal dryness that can be aggravated by the use of them.
However, lubricant gels really can help. Avoid anything oil-based, such as Vaseline, as this can weaken latex, rendering it ineffective. Instead, go for water-based gels, and avoid anything scented or perfumed, as this can irritate sensitive and delicate skin.
Whatever do you do, stay away from KY Jelly as this can make the dryness worse. If in any doubt, speak to a pharmacist.
When it comes to STI testing, to be fair to those of us who aren’t teenagers or in our 20s, it can be a bit of a minefield to try to get advice or an appointment at a GUM clinic.
So much of the funding and services are directed at young people as they do account for the bulk of diagnoses. But it does rather feel as if older people have been forgotten about – and are considered not to have sex. The abortion rate is rising in the over-40s, too.
Another problem is that some people are diagnosed with an STI only once it has gone on to cause complications.
An example of this is pelvic inflammatory disease, caused by untreated chlamydia. This can cause chronic pain, bloating, fever and pain during sex – and can be present sometimes for years before symptoms develop.
This means you may not be able to work out how long you’ve had it, or who gave it to you.
Lorraine McGinlay is a psychosexual therapist and a spokeswoman for the College of Sexual Therapy and Relationships.
Lorraine McGinlay is a psychosexual therapist and a spokeswoman for the College of Sexual Therapy and Relationships. She says:
It’s the conversation that no one wants to have – but it’s much better to have a sexual health chat long before you actually get intimate. It’s a bit like ripping off a plaster – you just have to do it.
Bringing up the issue is not about casting a judgment or aiming a personal slight at your partner. This is about being open, honest and transparent. Any decent partner should respect you for bringing the matter up to protect not only your health, but their own health too.
If your partner refuses to discuss the matter or have a test, you have to ask yourself: ‘Do I really want to have sex with this person?’
When approaching the subject, stay calm and keep a matter- of-fact tone, even if you are feeling mortified inside.
You could perhaps say something like: ‘It feels like our relationship is getting quite serious and as part of that we’re heading towards having sex.
‘I think it’s important we discuss our sexual health history, so we can start our sexual relationship with nothing to worry about.’
Don’t be afraid to stress how important this is to you or suggest getting tested at the same time –remind them many infections are symptomless.
And even if they were faithful to their former partner, can they be 100 per cent sure that no one has ever cheated on them?
This is why, for peace of mind, it never hurts to get tested.
Rowan Pelling is editor of monthly adult literary magazine The Amorist
Rowan Pelling is editor of monthly adult literary magazine The Amorist. She is a mother of two and lives in Cambridge. She says:
Who would have thought members of Generation X would grow up to be so sexually irresponsible?
You expect that sort of thing from the baby-boomers, who were young in the Swinging Sixties and free-love Seventies. But my lot were supposed to be risk-averse after growing up in the shadow of AIDS.
Most of my friends entered long-term relationships, having cosy domestic sex for years, until everything started falling apart in mid-life.
The one upside for a newly single middle-aged person after the horrors of separation or divorce is the chance to go a bit wild.
The last thing on most minds is a sexually transmitted infection. In fact, the last time they thought about syphilis was aged 15, when they were studying Henry VIII.
And even if they are anxious about STIs, my peers don’t have the vocabulary for it. As a 53-year-old female friend recently confided: ‘It’s hard enough to go on a date with a stranger without summoning the courage to ask them, “When did you last visit the sexual health clinic?” ’
Another fiftysomething acquaintance says it is almost impossible to get men of her age to wear a condom. Even the middle-aged dater’s patron saint Bridget Jones went to bed with two men in the latest movie without taking proper precautions – hence the title, Bridget Jones’s Baby.
Plenty of people my age have never been to a sexual health clinic for tests and they feel there’s stigma attached.
My opinion? What’s more romantic than safeguarding your lover’s wellbeing? Embarrassment only lasts a day or two, but some STIs last a lifetime.