You're reading “The Checkup With Dr. Wen,” a newsletter about addressing medical and public health challenges. Click here to receive the full newsletter, including answers to readers' questions and summaries of new scientific research, delivered to your inbox.
Many readers were shocked to read my latest column about the sudden rise in sexually transmitted diseases among older adults. But not everyone was surprised.
“I say to you, Baby Boomers!” writes Diane from Arizona. “We are the generation that came of age during the sexual revolution. People were having casual sex before settling down, and are starting to have sex again after divorce, separation or the death of a partner. My single friends are using dating apps to have sex, just like their grandkids are, but they're not using condoms.”
Janie Steckenrider, an associate professor of political science at Loyola Marymount University, has data to back up Diane's observations. Her research shows that the aging of the Baby Boomer generation has coincided with a surge in STIs among the older age group. “The Baby Boomer generation is all over 55, and they make up 73 million of the roughly 100 million people over 55,” she explained. Between 2010 and 2023, there has been a roughly seven-fold increase in gonorrhea and a nine-fold increase in syphilis in the 55+ age group.
Steckenrider recently conducted a survey of sexual attitudes and behaviors among people over 60. One of the questions asked how often they worried about catching a sexually transmitted disease. A staggering 91 percent said they rarely or never worried about it.
Follow this author Leana S. Wen's opinion
“This suggests that the risk of contracting a sexually transmitted disease is not recognized by older adults,” Steckenrider said.
As I've covered in my column, this is in part because health care providers are less willing to talk to their older patients about sexual health. But there are notable exceptions: Steve, a family physician in Wisconsin, says he discusses sexual behavior with anyone, regardless of age. “In my experience, while some patients feel uncomfortable at first, most are happy to be able to talk about it and eventually feel relieved,” he writes.
These conversations often turn to topics related to sexual health, such as incontinence, low libido, vaginal atrophy, erectile dysfunction, and other treatable conditions that can get in the way of a fulfilling sex life. “I learn a lot of different things that patients might be too embarrassed to talk about themselves,” Steve explained.
I think Steve's approach is brilliant. Healthcare professionals are taught in their medical training that assumptions are dangerous. Stereotypes about patients can lead to misdiagnoses and inappropriate treatments. This is especially true when it comes to older adults and sexual activity, where there is a clear disconnect between reality and doctors' perceptions.
Discussing sexual health during doctor's appointments for older adults should become the norm, just as it is for younger people. But as several readers pointed out, cultural change shouldn't be limited to the doctor's office.
“I think it might be fair to try to treat changes in an older person's sex life in the same way as we do with teenagers going through puberty,” James, from Vermont, wrote. “There should be plenty of general information that can be provided about what to expect, when to be concerned, and how to seek further advice.”
“What if you worked with a retirement community and gave a talk to older people?” asked Mary Ann from Maryland. “I spend the winters in Florida with other 'snowbirds,' and I think many of them would come to a talk about sex.”
I think Mary Ann is right. When I was Baltimore City's health commissioner, our team presented a series of healthy living talks at senior centers across the city. The seminars on heart disease, nutrition, and exercise were popular, but nothing compared to a seminar on sexual health, which drew unprecedented numbers of attendees. There is a thirst for information.
These awareness-raising events are an important touchpoint to provide up-to-date information on STI risks and prevention, and the events can also be used to distribute condoms to overcome another barrier that several readers pointed out.
Chris, from South Carolina, was one of those who wrote that he hated getting funny looks from cashiers when he bought condoms — “They must be wondering what some old man is doing with them” — and he too thought that making condoms available in group living facilities could reduce stigma and increase usage.
Meanwhile, Dinah from Florida encouraged people to take matters into their own hands. “I'm a retired science teacher and I do what I tell my students,” she wrote. “With any new partner, use a condom. Always. I bring a condom with me in case they don't have one. If they don't want to use a condom, don't sleep with anyone else. And get tested.” [for STIs]. “
This is solid advice for anyone who is sexually active: We already know how to stop the rise in STIs among older people; it's the same strategies that have been used for years to reduce the spread of STIs among younger people: educate people, test them, provide condoms, and talk openly about sexual health without stigma or stigma.
