With more middle-aged people dating, or starting new relationships than ever before, are we taking enough care and consideration of our sexual health?
When we think of the faces behind recent statistics that are showing a rise in sexually transmitted diseases (STDs), we probably picture someone young. Those irresponsible students and twentysomethings playing around and not thinking through the consequences of their actions. But not so much. It is becoming clear that a large proportion of people contributing to those statistics are in fact, middle-aged. The Irish Family Planning Association (IFPA) annual report highlighted an increase in women aged over 50 coming to the clinics for sexual health services, including sexually transmitted infection screening and menopause check-ups.
The association said there was a perception that once women reached menopause, that they no long needed sexual health services. But that’s not the case. Minding our sexual health all through our life is as important as looking after our physical and mental health.
Unplanned pregnancies
For many women, perhaps coming out of a long marriage or relationship, they perhaps don’t seem to think they have to go back to the good old days of contraception and protection. Yet there are more unplanned pregnancies in the 40-plus age group than the younger ages.
"We definitely see an innocence and a lack of knowledge in middle-aged women seeking our services," says Caitriona Henchion, medical director of the IFPA. "We see women not knowing if they need emergency contraception or whether they are experiencing menopausal symptoms. They're not sure even in their late 40s and early 50s whether they still need contraception."
The recommendation for contraception is very simple, yet perhaps not widely known. Until you have not experienced periods for two full years and you are under the age of 50, or one full year without periods after the age of 50, you need to still consider contraception. Amid constant talk of falling fertility as we age, many women are confused about their contraception needs.
This lack of knowledge about sexual health needs is apparent not just in the number of unplanned pregnancies in older women, but the rise of STDs in that age group as well. According to Henchion, advice from GPs can sometimes vary in quality and quantity, and so any sexually active woman over the age of 40 needs to seriously consider both her health risks and contraception needs.
Regular screening
The recommendation is that anyone who is sexually active needs regular screening. This seems to be something that many women feel unable to do. But emerging from a marriage or long-term relationship where the partner may have had other sexual partners means that STD screening is imperative.
“Discovering an unfaithful partner is a really common reason that we see older women coming to our clinics for screening,” says Henchion. “Our advice would be that the first thing to consider when starting with new partners is to ensure you have safer sex with condoms.”
But condoms don’t protect against everything, so the recommendation from the IFPA would be that if in sexual relationships you need to have testing twice a year.
“Obviously the people I see are a self-selecting group who are sexually active and attending our services, but certainly I would see a lot more people in the 50-plus [group] who are openly talking about their wants and needs and their problems with it, which is great,” explains Henchion. Who they do not see are the men and women not seeking sexual health services, or asking openly about their needs.
One of the reasons there is a rise in general of STDs is because far more tests are being carried out, and therefore, more positive results. The tests are better now for chlamydia and gonorrhoea, so whereas a few years ago tests had less than 75 per cent detection rate, today it is 99 per cent. The tests themselves are simple. For men with no symptoms it is a straightforward urine sample and blood test, and for a woman, a vaginal swab and blood test in a nurse-led clinic.
Simple rule
According to Henchion, “the simple rule would be if you have a new partner for a few weeks, get tested.” But for many people, we perhaps don’t even know what to look for.
The top three STDs in terms of prevalence would be chlamydia, warts and herpes, and although many of the symptoms are obvious such as bleeding or physical warts, in more than 50 per cent of cases there are no symptoms. How many cases are picked up is through automatic testing when going for certain contraception options such as the coil.
Henchion believes we need better sex education and awareness for all generations. “I see 21-year-olds coming in with no understanding of how STDs such as herpes and warts can still be spread even though they are using condoms. And for sexually active people in middle age, there is often a significant lack of knowledge.”
For now, until sexual health education is more widely available, there are plenty of support services including GPs, well woman/well man sexual health clinics and the Guide Clinic at St James’s Hospital. The IFPA offers free advice, and there are plenty of online services such as HealthyIreland.ie.
“The key message is that early detection makes a huge difference in reducing risk of pelvic infection and obviously reducing the risk of passing it on,” warns Henchion. “Anyone, whatever age, who is sexually active needs to mind their sexual health.”
Middle-aged, single and on fire – or talking ourselves celibate?
For many women who have reached the supposed sexual prime of their 40s and 50s, their body image is shattered along with their energy. A recent survey suggested some women in this age bracket have the lowest confidence of any other age group regarding body image, and it’s affecting their sex lives. Yet another survey highlighted the fact that some women in middle age are having the best sex of their lives. If both surveys are right, is it all just down to attitude, and can changing your attitude change your sexual mojo?
In the two decades since the iconic shenanigans of the "man-eater" Samantha shocked a nation in Sex and the City (while women everywhere sniggered at the delight of it), middle-age sex is becoming mainstream. The BBC were at it with Happy Valley, and even Cold Feet caught up. First time round, Adam and co were in their youth, but now that they are heading towards 50, who is the one having all the sex? Karen. Middle-aged, single and on fire. Now that ordinary middle-aged women are being shown to be – gasp! – sexual, it begs the question: what does this mean for us? Is this liberating or intimidating?
It seems your answer to that question is the difference between having an active sex life in and beyond middle age and putting away the sexy knickers and taking out the comfy slippers.
Like tight skin and fashionable clothes, sex used to be the domain of the young. But now middle-aged women can have tight skin, fashionable clothes and sex as well. It all depends on your attitude. If you think your sex life is over at 50, it will be.
“Attitude is so important,” says sex therapist Kate McCabe. “I see women challenging traditional values and beliefs that you are past it sexually after a certain age. Women are having babies later, new relationships later, are mentally and physically healthier and anxious to be active and participate fully in every aspect of their lives.”
In fact, a regular, happy sex life can benefit our physical, mental, emotional and social wellbeing, improving health and prolonging life. This generation of middle-aged women have opportunities to redefine what stereotype they fit into, experiencing greater sexual, financial, social and intellectual freedom than at any previous time. Contraception has meant we are not overburdened with childbearing, and openness about sex means that issues which might have caused discomfort and difficulty can be addressed. The increase in divorce and separation now means that middle-aged dating is an acceptable social norm.
So why are all middle-aged women not taking advantage of the chance to flirt their 50s away and sex up their 60s?
“Sex must be worth it,” explains McCabe. “I see women who come into therapy to see how they can best improve their sex life, even to the extent that they’ll bring in their partners and manage to engage in that conversation.”
And it’s women of all ages. McCabe has clients in their 60s and 70s. “They are definitely getting out there, and they want really good, honest information on how to make the most of their sexual potential.”
But what about those women who are talking themselves celibate because of lack of confidence? Media plays a huge part in how women can often rate themselves. According to McCabe, feeling sensual has nothing to do with how you look.
“Finding intimacy is a brave step. Overcoming hang-ups to really explore our own sensuality is vital. And much of it relies on getting the right attitude.”
