The Science of STIs

When it comes to sexual health, as we age, we're often caught in a different kind of stigma — the assumption that we're not having any sex. The reality? That's just not true. Since 1996, scientific studies have noted that STIs are on the rise in older populations.

Other studies note that, "A range of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV have been reported among older adults. Risk factors for STIs in older populations include (a) normal sexual changes associated with aging (e.g., increased time to attain an erection, decreased vaginal lubrication, decreases in sexual hormones); (b) psychosocial changes (e.g., loss of partner or spouse and re-entering the dating scene); and (c) risky sexual behaviors, including no or infrequent use of condoms."

Newer studies look at this in more depth, noting that whilst sexual behaviors decrease somewhat with age, widely held beliefs that older adults are not having any sex are simply false. They also note that, with a growing range of products designed to support genital comfort and function, as well as better supplements and healthier lifestyles, many adults are enjoying healthy, long-lasting sex lives. But with this, STIs amongst this population have also begun to rise. This is where things get complicated. Many older adults aren't so much stigmatized by their own worries when it comes to STI risk and testing, but rather from either a lack of awareness on their part — or from doctors who might not think to run tests for STIs, instead attributing all problems to 'aging'.

Common STIs

CHLAMYDIA is one of the most common sexually transmitted infections and often presents with mild or no symptoms in women. When symptoms do occur, they may include abnormal vaginal discharge, painful urination, and discomfort during intercourse. If left untreated, chlamydia can lead to pelvic inflammatory disease (PID), which may cause infertility. It is treatable — a healthcare provider can advise on appropriate care.

GONORRHEA is another widespread STI that can infect the cervix, urethra, and throat. Women may experience increased vaginal discharge, painful urination, and bleeding between periods. In many cases, symptoms are mild or mistaken for a urinary tract infection. If left untreated, gonorrhea can also cause PID and long-term reproductive issues. It is a treatable bacterial infection — speak with a healthcare provider about current treatment options.

GENITAL HERPES is caused by the herpes simplex virus (HSV) and results in painful blisters or sores in the genital area. Women may also experience flu-like symptoms, itching, and discomfort while urinating. There is no cure for herpes, but antiviral treatments are available to help manage symptoms — speak with your healthcare provider.

HUMAN PAPILLOMAVIRUS (HPV) is the most common sexually transmitted infection, and certain strains can cause genital warts, while others are linked to cervical cancer. Many women with HPV have no symptoms, but abnormal Pap smear results may indicate an infection. The virus often clears on its own, but treatment for warts is available — your healthcare provider can walk you through your options. Vaccination is also available to prevent infection with high-risk strains.

SYPHILIS is a bacterial infection that progresses through several stages if left untreated. The first stage often involves a painless sore called a chancre, which can appear on the genitals or inside the vagina. If not treated, syphilis can progress to a rash, fever, and — in later stages — severe complications affecting the brain and heart. It is treatable, especially when detected early, so consult a healthcare provider if you have any concerns.

TRICHOMONIASIS is a parasitic infection that can cause vaginal irritation, itching, and a strong-smelling yellow-green discharge. Some women may experience pain during urination or sex, while others have no symptoms at all. It is treatable with medications — a healthcare provider can advise on options.

HIV, the virus that leads to AIDS, can be transmitted through sexual contact and affects the immune system. Early symptoms may include flu-like signs such as fever, fatigue, and swollen lymph nodes, but many women do not experience symptoms for years. HIV is a serious condition that requires medical care; effective treatments are available, and a healthcare provider can guide next steps.

BV, Yeast Infections, and UTIs

Now, if all those weren't concern enough, there are also issues such as bacterial vaginosis, yeast infections, and UTIs. All of these can look (and feel) like STIs, but these can arise all by themselves due to a change in our vaginal environment. Additionally, sex can contribute to these issues since sexual activity can introduce new bacteria into or around the vagina and vulva. However, these are not thought of as STIs, nor are they typically contagious.

BV is caused by an imbalance of bacteria in the vagina, whilst a yeast infection is caused by an overgrowth of fungus; BV is usually treated with prescription antibiotics, whereas yeast infections can often be treated with over-the-counter anti-fungal medications.

Similarly, UTIs — as many of us know — can go hand in hand with sex. This is for a similar reason: the introduction of bacteria that gets into the urethral opening and triggers an infection.

You can read more about BV and yeast infections, and more about UTIs, by searching reputable health resources or speaking with your healthcare provider.

STIs & Stigma

Research into mental health stigma and sexually transmitted infections highlights how deeply connected these issues are. Studies show that people diagnosed with STIs often face significant stigma, which can lead to emotional distress, social isolation, and even avoidance of healthcare services. This stigma is often rooted in societal attitudes, moral judgments, and misinformation about transmission and personal responsibility.

Many individuals with STIs experience anxiety, depression, and low self-esteem due to fear of judgment or rejection. Research indicates that stigma can prevent people from seeking medical care, disclosing their status to partners, or accessing mental health support. Many older adults experience shame, embarrassment, or denial after an STI diagnosis, which can lead to increased anxiety, depression, and social isolation.

There is a common misconception that older individuals are not sexually active, making them feel judged or dismissed when seeking care. This can worsen feelings of loneliness and discourage open discussions about sexual health — and it can prevent people from getting tested or treated. Many doctors may not routinely discuss sexual health with older patients, which leads to undiagnosed infections and untreated mental health concerns. That needs to change.

Don't let stigma get in the way of your health. Remember, you can do STI testing online, in the privacy and comfort of your own home.