STDs in Women Over 40?

Featured Article, HIV/AIDS, Sexual Health, Women's Health
on May 1, 2013
STDs in women over 40 are becoming more prevalent.

From the “Say it ain’t so” file: Sexually transmitted diseases (STDs) in women and men in their 40s, 50s and older are on the rise.

According to a 2012 article in Student BMJ, a British journal, STDs have doubled in 50- to 90-year-olds in the U.S., United Kingdom and Canada over the past 10 years.

In particular, cases of syphilis, gonorrhea and chlamydia are climbing in 45- to 64-year-olds. Trichomoniasis (aka “trich”), caused by the parasite Trichomonas vaginalisis, is also on the upswing in women 40 and over, according to a 2011 study, involving 7,593 American women ages 18 to 89. Women 50-plus had the highest rate of trich infection, 13 percent, followed by women in their 40s at 11 percent.

Even HIV is becoming more common among mature audiences: According to the Centers for Disease Control and Prevention, people 50 and over now account for 15 percent of all new HIV and AIDS diagnoses.

Why STDs are growing among 40-plus populations

Why the uptick in STDs in women and men over 40? Couples who’ve been married for 20 or 30 years may find themselves divorced or widowed, and because people are living longer, healthier lives, they continue to be sexually active, explains Dr. Leandro Mena, an expert in infectious diseases and a member of the board of directors for the American Sexual Health Association. Indeed, the article in Student BMJ reported that 80 percent of 50- to 90-year-olds are sexually active.

“Older people don’t think about using condoms because reproduction isn’t an issue for them,” says Mena, an associate professor at the University of Mississippi Medical Center in Jackson. “But correct and consistent condom use significantly reduces the risk of transmission.”

Medications that treat erectile dysfunction may also be contributing to the rise in STDs, he says. Whether people have a onetime sexual encounter while traveling for business or pleasure or multiple partners closer to home, the likelihood of contracting an STD is real.

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Most common STDs in women and men of-a-certain-age

Trichomoniasis. About 70 percent of people who carry “trich,” also known as trichomonas vaginalis, don’t show symptoms, so the infection can be easily transmitted during sex. Symptoms may show up within five to 28 days of being infected but they could be delayed even further, and may come and go, according to the Centers for Disease Control and Prevention.  Symptoms in women include vaginal discharge, itching, burning and redness of the genitals and painful urination. Men may develop itching or irritation in the penis or discharge and burning after urinating or ejaculating.

How it’s diagnosed: Via microscopic examination of vaginal secretions in women. There’s no routine test for men,

Treatment: Usually a single dose of the oral antibiotics metronidazole or tinidazole; though some women may need a seven-day course of metronidazole or a five-day course of tinidazole. Male partners of women with trich should also be treated. About one in five people treated for trich gets infected again within 3 months after treatment, according to the CDC.

Syphilis. This bacterial infection is spread by contact with syphilis sores on the genitals, or in the vagina, anus or rectum. Because the sores are often painless and heal on their own, they may be overlooked, says Mena. However, weeks later, an infected person may develop a rash on his or her body or on the palms of the hands or soles of the feet, along with general malaise, headache, and sores in the mouth, groin or underarm areas. After these symptoms clear up, usually within a few weeks, the infection enters a latency period that can last up to 20 years, says Mena. When it reemerges it has affected the skin, bones, central nervous system, or organs, such as the heart. The disease is most infectious during the first few years a person has it, Mena says.

How it’s diagnosed: Via a blood test or microscopic examination of tissue from a sore.

Treatment: Typically treated with penicillin. Dosing is dependent on how long a person has had it.

Chlamydia. Caused by a bacterium, chlamydia is spread by vaginal, anal or oral sex. Symptoms in women—discharge or burning during urination—and in men—discharge, burning during urination and sometimes pain or swelling of the testicles—don’t show up for weeks after infection, if at all. But the bacterium is still taking a toll. In women, chlamydia eventually causes pelvic inflammatory disease (PID), which leads to infertility, ectopic pregnancy or chronic pelvic pain. Chlamydia can also cause rectal pain, bleeding and discharge, reports the CDC.

How it’s diagnosed: With a urine sample or vaginal or rectal swab

Treatment: Typically treated with a single dose of the oral antibiotic azithromycin or seven days of doxycycline.

Gonorrhea. Also caused by a bacterium, gonorrhea can be transmitted via oral, anal or vaginal sex. Some symptoms resemble those of chlamydia. Women may develop vaginal discharge, burning while urinating, a sore throat, lower abdominal pain and/or fever. Having sexual intercourse may hurt, too. Men may also experience pain while urinating, discharge, the urge to urinate, tender or swollen testicles or a sore throat. If it’s not treated, gonorrhea can cause PID and chronic pelvic pain in women. In men, it can cause inflammation of the tubes attached to the testicles and may affect the ability to have children. Gonorrhea can also cause a life-threatening infection of the blood or joints.

How it’s diagnosed: With a urine sample or vaginal rectal or throat swab.

Treatment: With a single injection of the antibiotic ceftriaxone. Many people with gonorrhea also have chlamydia, so anyone treated for gonorrhea should also be treated for both.

HIV. About two-thirds of people develop a flu-like illness—with swollen lymph nodes, a sore throat, a rash, and headache, two to four weeks after they are exposed to the HIV virus, says Mena. Symptoms eventually subside. “Very often people don’t remember they had these symptoms,” he says. Months to years later, a person will develop opportunistic infections, characterized by symptoms such as fatigue, weight loss, fever, night sweats, chills and swollen glands, which signal AIDS.

How it’s diagnosed: Via a blood or saliva test. There are several tests available; some can detect HIV within 10 to 14 days after exposure, though they’re expensive and not widely available, says Mena. Most tests detect HIV within four to six weeks. The earlier a diagnosis is made, the more effective treatment is.

Treatment: With at least three antiretroviral drugs—sometimes combined in a single tablet. (More than 20 such drugs are available.) You’ll have to take medication for the rest of your life to suppress the virus. “We can control HIV, but there’s no cure,” says Mena.

How to protect yourself—and your partner

In addition to condom use, sexual etiquette is important. If you develop an STD, tell your partner so he or she can get tested and treated, preventing further spread of the infection.

And “if you’re planning to start a relationship with someone, go together and get tested for STDs,” says Mena. He also recommends that anyone who has more than one sexual partner be tested at least once a year for STDs. “If you are at all concerned that you may have acquired an STD, it makes sense to see your doctor,” he says.