STIs may seem a problem more suited to college students. However, any sexually active person can become infected. If you are exchanging body fluids with a sexual partner, you are at a higher risk of getting an STI.
With STIs, bacteria and viruses cause infections in the penis, vagina (birth canal) and the cervix (at the upper end of the vagina). STIs caused by bacterial include: bacterial vaginosis, chlamydia, lymphogranuloma venereum, gonorrhea, syphilis and trichomoniasis. Viral STIs include: viral hepatitis (hepatitis B and C), genital herpes, human papillomavirus, human immunodeficiency virus (HIV leads to Aids). Along with unpleasant symptoms and social embarrassment, they can cause complications including cancer of the cervix, pregnancy outside of the womb, and infertility.
It may be surprising to learn that rates of chlamydia, gonorrhea and syphilis have been rising in Canada since 1997. For instance, 62,971 cases of genital chlamydia, 9,233 cases of gonorrhea and 1,127 cases of infectious syphilis were reported in 2004. Most were in the younger population. However, the number of STIs in older Canadians has increased.
The rate of chlamydia in men over age 60 has increased 270 per cent (see Table 2). The number of infections has also gone up in women. Between 2002 and 2004, the rate in women over age 60 increased 67 per cent. In women aged 40 to 59, it rose 19 per cent.
From 1997 to 2004, the rate of gonorrhea in men aged over 60 rose by 253 per cent. Rates in men aged 40 to 59 also rose significantly. In women, gonorrhea rates have increased across all ages. Women aged 40 to 59 had the greatest increase in number of cases. In 1997, there were 42 cases, while in 2004 there were 131 cases.
Of all STIs, syphilis seems of particular concern for older adults. It seems more likely to affect them. More men than women tend to have syphilis, but in both genders, it is largely reported in those over age 30.
In recent years, almost every urban city in Canada has reported outbreaks of syphilis. In Alberta between 2002 and 2004, syphilis rates increased from 14 to 74 cases. In 2004, 86 per cent of male cases occurred in those aged 30 years and older. The highest rates among men in 2004 were in the 30 to 59 year old age group.
To be safe from STIs, you should only have sex with one uninfected partner, who in turn is only sexually active with you. Although using condoms reduces the chance of getting an STI, it does not eliminate the risk. Some STIs, including herpes and genital warts, can be transmitted even when a condom is used. Avoiding sexual activities involving penetration can prevent many STIs. Women at risk of an STI should make sure regular Pap and STI tests are done during an annual physical.
Suspect a sexually transmitted infection if you have genital pain, abnormal discharge, itching or bleeding. Symptoms may include:
It is also possible to have an STI with no symptoms at all. If you have any signs or symptoms, or are concerned, see your doctor.
When you visit your doctor, be sure to mention if you:
Let your doctor know if you think you were infected in another country. STIs in other locations may be resistant to the antibiotics used to treat cases in Canada.
Remember honesty is the best policy! Do not be shy if your doctor asks you questions about things you would not normally discuss. Your doctor may ask whether you:
Your doctor may also ask you if you have ever used injection or other drugs, and whether you have had sexual encounters with a sex-trade worker. Do not be offended. Your doctor needs this information to understand your risk of getting certain sexually transmitted infections.
Your doctor may also test you for other sexually transmitted diseases, including human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Again, do not be offended! It is always better to be safe than sorry.
Depending on your history, you may need to repeat the HIV test. It can sometimes take months after exposure before your body responds at a level that can be detected by the test.
Some resolve on their own, while others require prescription medication. If your doctor prescribes an antibiotic, be sure to finish the entire course.
Go back to your doctor if your symptoms do not improve. Symptoms may continue after treatment for a number of reasons. The STI may be resistant to the treatment your doctor prescribed, or another STI may be causing your symptoms.
Some cases of gonorrhea in Canada and the United States have been resistant to the antibiotic ciprofloxacin. Certain cases of syphilis have not responded to the antibiotic azithromycin. Returning to your doctor for follow-up after treatment is key.
Once you are diagnosed, you must tell your sexual partner about the infection. Treatment is necessary for both of you. Although this can be hard to discuss, it is important. Making sure your partner knows and is properly treated will prevent you from getting re-infected. It will also stop the spread of infection to others.
With most STIs, it is a good idea to stop having sex until seven days after both partners have been treated. With certain infections, your local public health department will contact you. They will want to make certain all of your sexual contacts are aware of their possible exposure to an STI.
Sexually transmitted infections can happen in middle-aged and older adults. Recognize the symptoms and get medical care if you think you may have an STI. Finally, remember that open communication is important in the fight against sexually transmitted infections.