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Sure, older persons are having intercourse – we have to speak about it

You may be uncomfortable with the idea that your parents, grandparents, or older neighbors are still sexually active, but the reality is that they can very well be.

Research from around the world, including Australia, shows that older adults continue to have sex and value sexual intimacy as an important part of their lives.

Sexual intimacy is an important part of older people’s lives. Image: Getty Images

Sexual activity can have positive mental and physical health benefits for older adults. But where there is sex, there is also the possibility of sexually transmitted infections (STIs). Age does not provide immunity to sexually transmitted diseases, and people of any age can get an infection if exposed to an infection during sexual contact.

Over the past few decades, STI rates in older age groups have increased in a number of Western countries, including the United States and the United Kingdom. Australia is no exception.

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While younger people continue to have a much higher rate of sexually transmitted diseases than older people, our recently published research shows that the rate of chlamydia, gonorrhea and syphilis diagnoses between 2000 and 2018 among Australian women aged 55 to 74 years has increased faster than that of younger women.

It is clear that the prevention and screening of sexually transmitted diseases in older women and their partners requires more attention.

Given that younger people are more affected by some of the effects of STDs such as infertility, STD prevention and testing should continue to give priority to adolescents and young adults. However, little research has examined the effects of sexually transmitted diseases on the elderly with increasing chronic illness and drug use.

In terms of sexual health, older people also face health challenges related to aging. Image: Shutterstock

It’s hard to say exactly why STI rates are rising in older Australians. Some of the factors likely to contribute to this are: dating and casual sex normalize in older cohorts as the baby boomers retire; low condom use rates due to limited STI knowledge; and the irrelevance of postmenopausal pregnancy prevention.

Older adults are not mentioned in any sexual health document. It’s a problem previously highlighted by the Australian Medical Association and is reflected in the lack of testing or treatment guidelines for this age group.

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Discussions about STIs and the need for testing are therefore unlikely during visits to a general practitioner unless the patient’s complaint is related to an STI symptom. And since many STIs can be asymptomatic, STIs are likely to be overlooked.

Our previous research, as part of the Sexual Health Aging Perspectives and Education (SHAPE) project, has shown that there are a number of barriers preventing older patients and general practitioners from having sexual health conversations. Other studies have confirmed that these problems are common.

Barriers that discourage general practitioners from asking about sexual health include lack of time, primacy over other health concerns, respect for privacy, lack of education, and the mere assumption that sexual matters are not important to older patients.

Consultations between the elderly and their GPs can end in stalemate if neither party brings up the issue of sex. Image: Getty Images

At the same time, elderly patients may be reluctant to bring up sexual matters, citing embarrassment and concerns that their problems are not being taken seriously. Older adults may also be unaware of the signs and symptoms of sexually transmitted diseases and may not realize that many sexual problems, such as sexual dysfunction, can be treated.

The result is often a stalemate – general practitioners leave it to their elderly patients to initiate sexual health conversations while elderly patients wait to be asked. This way, older adults may miss the opportunity to get sexual health information and STI testing in primary care.

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While older adults are likely to have years of sexual experience, they may have had little or no formal sex education in their teens. Knowledge of sexual health varies among older Australians, but is generally lower than among younger age groups.

In addition, some older people’s understanding of sexual health may be out of date. For example, after years or decades of monogamy, a person who is divorced or widowed and begins to explore new sexual relationships may need to update their knowledge of safe sex.

In addition, people may find themselves in a different sexual context than when they were young, for example when dealing with the challenges of sexual intimacy following prostate cancer or breast cancer.

Older people have been overlooked for targeted sex education and campaigns. Image: Getty Images

Everyone deserves accurate, non-stigmatizing information in order to maintain their sexual health and enjoy their intimate life.

While older adults do not need information about ‘the birds and the bees’, there are other knowledge gaps such as STI prevention and testing that should be addressed through sexual health initiatives tailored to older adults.

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Existing resources for promoting sexual health are predominantly aimed at young people and are therefore irrelevant or unattractive to older adults. There are currently few sources of information on sexual health aimed at older Australians.

With sexually transmitted diseases becoming more prevalent among older Australians, the need for accessible and engaging sexual health promotion materials aimed at this group can no longer be ignored.

In the next phase of our research, we examine the sexual health priorities of older adults themselves; and exploring the types of resources best suited for this cohort. We are currently looking for participants 60 and older to conduct a survey about their preferred ways of accessing sexual health information and the type of content they would find useful.

Our research will advance the development of effective and engaging sexual health resources that meet the needs of older Australians as everyone, regardless of age, has the right to positive sexual health.

Banner: Getty Images