Dr Kathryn Fox is an Australian medical doctor and bestselling crime writer, best known for her forensic thrillers featuring pathologist Dr Anya Crichton. Drawing on her medical expertise, she crafts gripping, authentic crime fiction and is also a passionate advocate for forensic medicine education and public engagement.
Recently divorced, in her 60’s, Mary was beginning to date again. She rediscovered a part of herself she thought she wouldn’t find again. She presented with burning on passing urine. A pharmacist prescribed her antibiotics for a suspected urinary tract infection. But her symptoms only worsened.
That’s when she saw her GP who examined her and did a swab. This wasn’t a urine infection, it was Chlamydia, a sexually acquired infection (STI).
Mary was shocked, not just at the diagnosis, but that it could happen at her age. She had lived through the peak HIV/AIDS but didn’t think safe sex was relevant to her now.
We tend to link sexually transmitted infections (STIs) with young people. But that isn’t today’s reality.
According to the Royal Australian College of General Practitioners (RACGP), 72 per cent of people aged over 60 are still sexually active. Meanwhile, chlamydia, gonorrhoea and syphilis are increasing, including in the older age bracket. In some instances, the rates in older people are rising faster than in younger groups.
They’re also more likely to be underdiagnosed compared with younger patients.
None of this is surprising, given that living longer and better quality of life mean that people are more likely to date after divorce or death of a spouse and find new partners in later life.
It’s partly a question of perception. People who’ve come out of monogamous, long-term relationships don’t tend to think of themselves at being at risk. Safe sex awareness was lower during their youth and if unwanted pregnancy isn’t a concern, condoms are less likely to be used.
What’s important to realise is that postmenopausal changes can make women more vulnerable to infection, while lower condom use and changing relationship patterns increase exposure.
Patients (and some doctors) can feel embarrassed about discussing intimate relations with older patients, and symptoms of STIs are often mistaken for more familiar conditions including urinary tract infections, post-menopausal changes, ‘prostate troubles’, skin irritation, fatigue, or even just vague discomfort – which is why they’re so easily missed.
Safe sex campaigns have tended to focus on young people as those most at risk so it’s easier to assume it’s a young person’s problem.
It’s advisable to discuss new sexual activity with your doctor because partners can still spread infections, even without having symptoms.
When symptoms do occur, they can include:
Late diagnosis can lead to:
Another emerging issue is antibiotic resistance. Some sexually transmitted infections – particularly gonorrhoea – are becoming harder to treat, with resistance to older antibiotics now more common. While current treatments are still effective in most cases, this is being closely monitored, as options become more limited.
It’s possible to enjoy a full, active life as you age. Being informed means making informed choices and as always, prevention is better than cure. Be transparent about sexual activity with your doctor, no matter how awkward it seems, because it matters.