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Safe Sex Rules Still Apply

Once you’ve reached menopause, just because you can’t get pregnant doesn’t mean you can’t contract a sexually transmitted infection (STI).

The STIs, also referred to as “sexually transmitted diseases” or “STDs,” include HIV, hepatitis B and C, syphilis, chlamydia, gonorrhea, genital herpes, and human papillomavirus (HPV), which can cause cervical cancer and genital warts. Herpes and HPV infections can be acquired at any age and may lie dormant for years, posing the risk of transmission to a new partner; typical STI testing often does not reveal these two types of infections.

STIs are more easily passed from man to woman than from woman to man.

All of the above infections must be a lifelong concern for any sexually active woman who is not in a long-term, mutually monogamous relationship. In fact, the group in which STI rates are rising most rapidly is adults at midlife and beyond. For example, the Centers for Disease Control and Prevention reported that cases of syphilis and chlamydia rose 43% among US adults age 55 or older between 2005 and 2009.

STIs are especially a concern for women because they are more easily passed from man to woman than from woman to man. If exposed, women are twice as likely as men to contract HIV, hepatitis B, and gonorrhea. Also, because STIs are less likely to produce symptoms in women than in men, they are harder to diagnose until serious problems develop.

Women with severe vaginal atrophy who are sexually active may be at increased risk for STIs.

Women with severe vaginal atrophy who are sexually active may be at increased risk for STIs since their dry, thin vaginal tissue is susceptible to small tears where infection can begin.

For these reasons, following safer sex guidelines (see table below) is crucial for all women who are not in a long-term, mutually monogamous relationship.

Safer sex guidelines for women of all ages
Choose a partner carefully.
Discuss sexual histories with your partner, and don’t let embarrassment compromise your health.
Always insist that a male partner use a latex condom for genital, oral, and anal sex unless you are in a long-term, mutually monogamous relationship. Never use petroleum-based products like Vaseline or baby oil to lubricate condoms because they can cause condoms to break.
Don’t let a male partner’s erection difficulties keep him from using a condom. Dream up some erotic or stimulating methods for putting on the condom to keep his erection going. If all else fails, get a female condom.
Have an annual physical exam, including a Pap test and lab tests to identify STIs if you are at any risk.
If you are exposed to an STI or have received a confirmed diagnosis, urge any partners to be tested and treated.
Consider having both you and your partner checked for STIs before starting a sexual relationship.
 
Adapted from Menopause Practice: A Clinician’s Guide, 4th ed. Copyright 2010, 
The North American Menopause Society.

Be aware that STIs can be passed from woman to woman.

Although lesbians have fewer STIs than heterosexual women, be aware that STIs can be passed from woman to woman. Some additional precautions apply specifically to sex between women:

  • Prevent transfer of any body fluids (including menstrual blood and vaginal fluids) into cuts, scrapes, or other openings.
  • During oral or vulva-to-vulva sex, cover your partner’s vaginal area with a dental dam or similar latex barrier to avoid contact with secretions.
  • Avoid sharing sex toys. Either clean them in hot, soapy water or use a new condom before switching users.

Keep in mind that oral sex with a partner who has a cold sore or fever blister can transfer the herpes virus to you if your mouth or genitals come into contact with the sore.

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