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Family Health Magazine - prevention

Seniors and STIs
An issue for anyone who is sexually active

Many of us think of sexually transmitted infections, or STIs, as only a concern for the young. It is true that in Canada, those under age 30 are most likely to contract STIs. However, infections have begun to increase in people over age 40, including seniors.

Three STIs are on the rise

Gonorrhea, chlamydia and syphilis are the three STIs increasing among middle-aged and senior Canadians. Since 2000, cases of gonorrhea have increased by about half, chlamydia by about two-thirds, 66 per cent, and syphilis has increased ten times! Bacteria causes all three STIs.

It is easy for older people to mistake certain STI symptoms with other issues. A symptom such as pain with peeing can be mistaken for a bladder infection or prostate problem. However, the cause might also be chlamydia or gonorrhea. Problems with fatigue, some heart troubles, and even hair loss can be caused by syphilis.


More men over age 60 are being diagnosed with gonorrhea. It may cause no symptoms, or give men a burning feeling when peeing, painful or swollen testicles, a yellow or white discharge, or burning and itching at the opening of the penis. Sometimes these symptoms are mistaken for a bladder or prostate infection, or another prostate problem. If you have any discharge from your penis or pain with peeing, ask your health care provider about STIs.

Women might also have no symptoms, or may have burning when peeing, discharge from the vagina, belly pain, or pain during sex. A woman may also have bleeding between periods, or new bleeding from the vagina if she has reached the end of her periods (menopause). As in men, these symptoms might be attributed to a bladder infection. If you have vaginal discharge or irritation, pain with sex, new or changed bleeding from the vagina, or pain with peeing, ask your health care provider about STIs.

In both men and women, symptoms that can occur in the area of the anus and rectum are pain, pain with bowel movements, bleeding, an itchy anus, and discharge. These symptoms can be similar to hemorrhoid symptoms.

If not treated with antibiotics, gonorrhea can cause pelvic inflammatory disease (PID) in women. This may lead to chronic pain and infertility. In men, untreated gonorrhea can cause epididymitis (inflammation in a part of the testicles) and infertility. It is possible for gonorrhea to spread through the blood to infect the joints and cause pain. It can also be passed to a baby during birth.

Testing for gonorrhea is easy. It can be done through a urine (pee) test, or a swab test. Ask your health care provider about testing if you are concerned or have any symptoms.
Gonorrhea is also simple to treat, though it can be resistant to some antibiotics. If you have gonorrhea, you may be given one dose of free antibiotics to take by mouth right away. You may also be given an injection of an antibiotic, especially if you are a man who has sex with men.


The symptoms of chlamydia are much like those of gonorrhea. It also causes burning pain with peeing, discharge from the penis or vagina, and pain in the genital area. Chlamydia can cause PID and infertility, and infect babies born to affected mothers. Testing is done through urine test or by a swab. It can be treated immediately with one dose of an antibiotic. Often those with gonorrhea or chlamydia are treated for both conditions, since they often are caught together.


Syphilis is affecting men a lot more than women lately. There are also outbreaks in men who have sex with men. Syphilis is passed the same way as chlamydia and gonorrhea – through sexual intercourse, anal and oral sex, or to a baby from a pregnant mother.
Syphilis has four stages. In the first, an open sore called an ulcer is found where the bacteria enter, usually in the anal or genital area. Since the ulcer is painless, it might not be noticed. Sometimes the infection goes away, but it can also progress to the secondary stage. Symptoms include a rash, fever, tiredness or fatigue, hair loss, swollen glands, and other sores around the genitals.

Syphilis is often called ‘the great imitator’ because it is similar to many other health problems. Secondary syphilis may cause tiredness, balding, and a rash. If you have these symptoms, talk to your health care provider and ask about syphilis.

The tertiary (late) stage of syphilis may damage the brain and heart. In the heart, it can cause valve problems and aneurysms, and can show as a new heart murmur. In the nervous system, the symptoms of syphilis are called neurosyphilis. Neurosyphilis starts many years after the person is first infected. It can include problems with balance and walking, as well as changes in the brain like dementia and confusion.

A blood test is used to check for syphilis. It can be treated with antibiotics. Depending on the stage of the syphilis, more than one dose may be needed. Be sure to tell your health care provider about your current sexual activity, and also the type of sex you had even twenty years ago. This information allows your risk of syphilis to be evaluated.

Other STIs

Many other STIs exist. For instance, human papilloma virus (HPV) causes genital warts and cancer of the cervix and anus. It can now be prevented with a vaccination (shot). Herpes simplex virus (HSV) often causes sores and blisters around the mouth or genitals. It can be passed even when using a condom, especially if sores have broken out. To learn more, talk to your health care provider or check the links in the For More Information sidebar.

Are you at risk?

If you have had sex with anyone who had more than one partner, now or in the past, you could be infected. As Canadians age, it is expected there will be more infections in middle-aged adults and seniors. The number of STIs in these age groups is increasing for several reasons.

  • Even though 80 per cent of people 50 to 90 are sexually active, older people are less likely to think they are at risk.
  • Since most STIs affect younger people, health care providers are less likely to ask older adults about their sexual behaviour.
  • Health care providers may attribute symptoms of STIs to another common cause, like a bladder infection. This means seniors are less likely to be tested, even when they have symptoms like genital pain or bladder issues. Ask your health care provider if an STI could be causing your symptoms, and whether testing is appropriate.
  • Although condoms are one of the best ways to prevent STIs, seniors are less likely to use them. Often, they do not think they are at risk, or are not concerned about pregnancy.
  • Some people feel embarrassed about sex. This means they do not buy condoms or talk to their partners or health care providers about it. However, since most seniors are having sex, it is worth asking your health care provider about barrier methods like condoms.
  • Certain health changes in older people can make it harder to get rid of infections in comparison to those who are younger. For instance, the immune (defense) system may be slightly lowered. Other normal changes, such as less lubrication and thinning skin in the vagina, appear with age. These changes put seniors at higher risk for infections like human immunodeficiency virus (HIV). In older women, STI symptoms of genital pain or pain with sex may be attributed to dryness of the vagina. Ask your health care provider if the cause of your discomfort might be an STI.
  • The rise in use of erectile dysfunction drugs, like Viagra, may increase the number of sexually active older people. This in turn may heighten the risk of passing STIs.
  • Today’s seniors are healthier and more active overall. They may be more likely to continue being sexually active and so risk catching an STI.
  • More older adults now leave long-term relationships and begin dating. The rise in number of sexual partners also might contribute to the rise in STIs.


You can protect yourself from catching an STI. First, talk to your sexual partner about this health issue. Understand how much your partner knows about STIs. This allows you to make an informed decision about sex with that person. Some people feel awkward discussing it at first. However, sex is a very normal and healthy part of life, and talking about it is important.

Using a condom every time you have sex, whether penile, vaginal, anal or oral, goes a long way to prevent STIs. Be sure to use each condom only once. Put it on before any contact with the penis takes place. If you switch sex acts, such from anal to oral, use a new condom. A dental dam can be used as a barrier for oral sex on a woman. You can get condoms over-the-counter from any pharmacy, from many grocery stores, and often free from health care offices. If you have not used condoms before or for a long time, ask your health care provider about different types and how to use them properly.

Getting tested for STIs is important for anyone having sex, and even for people who used to have sex. Some STIs cause symptoms decades later. Request a test from your health care provider or go to an STI clinic in your community. When you get tested, ask for information about different STIs and how to protect yourself. It is a good idea for both you and your partner to be tested before you start having sex. You can get an STI any time, and often there are no symptoms, so get tested regularly. Your health care provider can help you decide how often tests are needed. This will depend on how many partners you have, how often you have new partners, and whether you are concerned about certain STIs. You may be asked to repeat a test, since some infections take a while to show up.
If you have an STI, you must take any medication given to you as directed. Follow your health care provider’s instructions about safer sex. These instructions could include using a condom and avoiding sex until the infection is cleared.

Your health care provider may tell you that your STI is a ‘notifiable’ disease. This means your doctor must tell your local public health agency about it. This is done to keep track of certain STIs in your province or in Canada. Every province has a different list of which STIs must be reported. Sometimes, public health will call to ask for the name of your sexual partner so that person can be contacted. If this happens, do not worry. Partners are not given your name. They will just be told that they have been in contact with someone with an STI.

Do not hesitate to ask questions or discuss concerns you have about STIs. Your health care provider has probably answered similar questions before, and will be happy you are looking out for your health.

FAMILY HEALTH is written with the assistance of:
College of Family Physicans of Canada
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of:
College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [PR_FHab15]
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