Understanding Sexually Transmitted Infections and How to Keep You and Your Partner Protected
Whether it’s on Valentine’s day or any day of the week one thing is for certain, most of us have sex. Sex is a natural part of life regardless of your age. More sex leads to a healthier life as it can provide tons of health benefits. Sex can lead to a better night sleep, boost your immune system, help improve your mental health, and, according to the Journal of Epidemiology and Community Health, improve heart health. Culturally, conversation around sex and the human body has been vastly destigmatized. Sex is seen as less taboo, foreign and shamed, which allows for easier and open education around the subject. Sexual wellness is now openly considered a major health factor when determining one’s overall health. As most doctors say, sex is part of a healthy lifestyle.
In 2020, it is now well known, that sex is not age exclusive. Many older adults remain sexually active for longer. For seniors, sex is more accessible than ever as senior dating sites are rampant, lifespans are longer, and Viagra and estrogen like medications can increase sexual prowess. Though this increase in sexual livelihood is great, it’s important to recognize the dangers of intercourse. Even though the conversation around sex has changed, it doesn’t mean there aren’t precautions to take when engaging in intercourse. Sex can lead to a multitude of health problems and infections if the right safety procedures aren’t implemented. Sexually transmitted infections (STIs also known as STDs [sexually transmitted diseases]) can run rampant regardless if you are a teenager or a senior. These diseases can lead to a lot of serious temporary and permanent health issues if protection is not used. Though some seniors are past the age to get pregnant, it doesn’t mean there aren’t other dangers out there. Through this article, we will discuss the top sexually transmitted infections and how to keep yourself and your partner safe. Even though sex may be a normal part of life, it still must be met with safety and precaution to stop the spread of disease.
Unfortunately, according to CBC News and Statistics Canada, STIs are increasing at an alarming rate across Canada. Specifically, rates of chlamydia, gonorrhea and syphilis have all increased from 2006 to 2017 (most recent year of data available) by 49, 81 and 178 percent respectively. This translates to there being more than 126,700 chlamydia infections, 28,300 cases of gonorrhea and 4,300 cases of syphilis across Canada in 2017. In July of 2019, Alberta declared a provincewide out break of syphilis where syphilis numbers rose drastically from 161 cases in 2014 to 1,536 cases by the end of 2018. For seniors, these infections have significantly increased as well. From 2005 to 2015, chlamydia infections increased 142 percent (148 to 507 cases), gonorrhea 87 percent (102 to 267 cases) and syphilis 5 percent (359 to 526 cases). Keep in mind, those suffering from one STI may be suffering from a second at the same time. In an interview with CBC, regional medical officer Dr. Ibrahim Khan states "You're just not dealing with syphilis. You're dealing with HIV [human immunodeficiency virus], you're dealing with hepatitis C, you're dealing with addiction, you're dealing with other mental health issues. So it becomes very overwhelming for our staff on the ground and the staff in the regional office". This fact ultimately complicates things as healthcare, outreach, treatment and education of these infections must be made available for Canadians.
Why are STI Rates Increasing?
Though there are multiple reasons, a lot of the issue can be pointed to miseducation, lack of conversation, STI testing and not using protection. As sex and infection is an awkward (and sometimes demoralizing) topic to bring up, the conversation about protection and wellness is often simply not discussed. For seniors, this is ten-fold as loved ones and retirement homes may not be educating their seniors about safe sex. Though it is getting better, not recognizing seniors as sexual beings is a common factor. Due to seniors being older in age and unable to get pregnant, some believe they can have unprotected sex as there are no other dangers. In general, risky sexual behavior seems to be increasing as education to reduce the risk haven’t been enough to decrease risky practices as according to the World Health Organization. Specifically, it can be more difficult to change sexual behavior in marginalized populations due to having a lack of proper sex education, STI testing or access to safe sex products. Furthermore, resistant strains of these diseases have increased as they become more apparent in society. For example, antibiotic resistant strains of gonorrhea have been identified, making it hard for doctors to treat the disease.
Most Common STIs and How to Treat Them:
Below we will identify the most common STIs, their signs and symptoms, health effects and their treatments. All these infections are caused and spread through unprotected genital, anal, and oral sex. Though younger adults may be more prone to these infections (mostly due to young adults engaging in riskier sex practices and multiple partners) it doesn’t mean older adults cannot be infected as well. These infections do not discriminate by age! Be sure to check out the resource tab below for more information and tips on how to further minimize your risk of infection. Don’t be afraid to ask your doctor or other healthcare professionals on how to increase your sexual wellness! For family members, it might be important to ask about your senior’s sex life to ensure they are properly educated.
Be sure to book an appointment with your doctor if any of the below symptoms or infections apply to you. If you are unsure of infection, get tested just to be safe. If you can keep track of your symptoms with a journal. At Senior Homecare by Angels, we can help contact your doctor and set up these appointments if you so desire. Ask any Senior Homecare by Angels caregiver for help contacting your doctor, Alberta Health Services (dial 811) or other sexual wellness clinics. We can also provide transportation if you cannot travel there on your own!
-Caused by the bacterium Chlamydia trachomatis.
-Most commonly reported bacterial STI.
-Mostly affects women ages 15-24, though, it affects men and women of all ages.
-Can be transmitted from mother to child during childbirth.
-Called the “silent disease” as those infected have no symptoms or are unaware they have the condition.
-Only way to confidently know that you have chlamydia is by getting tested. The bacterium is diagnosed through a urine sample or swabbing of the infected area. It is recommended you get retested three months after your initial treatment.
Signs and Symptoms
-Though some patients may not have any symptoms at all (especially in the early stage), others will start to see signs and symptoms of infection around two weeks after exposure.
-Even when the signs and symptoms occur, they are mild and fleeting making them easy to overlook and forget about.
-The bacteria can infect the rectum which may cause rectal pain, bleeding or discharge.
-Those infected through oral sex don’t often have symptoms, though, eye infection (conjunctivitis) can occur through contact with infected genital secretions.
-In rare cases men and women might develop Reiter’s Syndrome arthritis which cause inflammation and swelling in the joints.
Signs for Women Include:
-Pain during sex
-Lower abdominal pain
-Painful (burning feeling) while urinating
-Vaginal bleeding between periods or after intercourse
Health Risks for Women
-Untreated chlamydia in women can lead to pelvic inflammatory disease (PID). PID is an infection in the uterus and fallopian tubes causing pelvic pain and damage (such as scarring) in the fallopian tubes, ovaries, cervix and uterus.
-PID can also lead to infertility and increase the chance for life threatening ectopic or tubal pregnancies (when the pregnancy is not in uterus but rather in the fallopian tube or elsewhere).
-If a pregnant woman has chlamydia her child may be at risk of being born prematurely and/or develop eye infections or pneumonia.
Signs for Men Include:
-Painful (burning feeling) while urinating
-Discharge from the penis
-Burning or itching at the opening of the penis
-Pain and/or swelling in the testicles
Health Risks for Men
-Chlamydia can cause scarring of the urethra making urination painful and difficult. This can also lead to infertility.
-Infection near the testicles (epididymitis) can cause scrotal pain and swelling.
-Chlamydia can spread to a man’s prostate gland causing prostatitis. Results in pain in the lower back, groin and can cause pain while urinating.
Who is at Risk?
-Any sexually active person can be infected with Chlamydia. There is no risk if neither you nor your partner have been infected with the bacteria. Keep in mind, the only way to be certain you aren’t infected is to be tested.
-Young adults are mostly at risk as there is an increase in having multiple partners and risky sexual behavior without protection. However, Chlamydia still affects older adults as well.
-Those with prior STIs are more susceptible to other infections.
-Chlamydia trachomatis is treated with antibiotics. A doctor may give you a one-time dose or daily medication to be taken multiple times a day for five to ten days.
-With medication, the infection will usually go away within one to two weeks. Intercourse should not happen during this time for risk of reinfection or spread of the disease.
-If you are positive for chlamydia, it is recommended your partners get treated as well, even if they don’t show symptoms.
-Even through you may have been treated for chlamydia in the past, it does not provide immunity for reinfection in the future.
-Caused by the bacterium Neisseria gonorrhoeae (also known as “the clap”).
-Affects the urethra, rectum, throat and cervix in females.
-Recently has become increasingly antibiotic resistant.
-Infection can spread through bloodstream and infect other parts of the body like the joints.
-Testing is the same as chlamydia.
-Like chlamydia, untreated gonorrhea can lead to more risk of infection of other STIs.
Signs and Symptoms
-Like chlamydia, gonorrhea sometimes will not cause symptoms (especially in females). If symptoms do occur, they will be present two to seven days after infection.
-Early stages of gonorrhea are often misdiagnosed to be a bladder or vaginal infections as the symptoms are non-specific.
-Unlike chlamydia, people infected through oral sex may have a sore throat and swelling in the lymph nodes.
-Gonorrhea can affect the eyes causing eye pain, increased sensitivity to light and discharge from both eyes.
Signs for Women Include:
-Same signs as chlamydia (see above).
Health Risks for Women
-Same risks as Chlamydia including PID (see above).
-If a person is infected with gonorrhea and is pregnant, the infection can be spread to the child during delivery. This can cause blindness, joint infection and blood infections in the child.
Signs for Men Include:
-Same as chlamydia.
Health Risks for Men
-Same as chlamydia.
Who is at Risk?
-Same as chlamydia.
-Though gonorrhea is becoming increasingly antibiotic resistant, the infection is still able to be treated with certain antibiotics.
-Cetriaxone (Rocephin) is usually given as an injection and azithromycin (Zithromax) is given orally.
-Babies who develop the infection will also be given antibiotics.
-Caused by the bacterium Treponema pallidum and has four stages of infection (primary secondary, latent and tertiary). Each stage has different signs and symptoms.
-Though syphilis can be spread via sexual contact, it can also be spread through sharing needles and/or through broken skin lesions. Contact with the sore through sexual activity is the main pathway to infection.
-As syphilis can spread from interaction with broken skin, someone may contract syphilis through kissing if the lesion is on the lips.
-Syphilis is usually infectious during the primary and secondary stages and early in the latent stage.
Signs and Symptoms
-Unlike chlamydia and gonorrhea, syphilis develops in stages.
-Known as the “great imitator” because of the wide range of symptoms it can cause. These symptoms can easily cause misdiagnosis as they are similar to other conditions or infections.
-Symptoms vary within each stage and often overlap with each other. Some symptoms don’t occur in the same order or may not be present until years later.
Primary syphilis (First Stage)
-Development of a small sore called a chancre is present on the spot where the bacteria first entered your body (genital area, throat, anus etc.).
-A sore (sometimes multiple) will appear at the infection site. These sores will be firm round and painless. Since these sores are painless and may not be in an easily recognized spot, they often go unnoticed.
-The sore lasts around three to six weeks and will go away on its own with or without treatment.
-If you do receive treatment at this stage, it will stop the infection from progressing to secondary syphilis (stage two). If not, the second stage will begin after a month or so.
Check out the link here for pictures of each stage of infection. Beware, images are quite graphic.
-Within a few weeks after the initial healing process, you may develop a rash that may cover your entire body as well as wart-like sores in your mouth or genital area.
-These rashes will look like reddish brown spots on the palms of your hands and bottom of your feet.
-The rash will not be itchy and will be easy to overlook other than its obvious visual presence.
-Those at this stage will sometimes have a fever, swollen lymph glands, sore throat, hair loss, muscle aches, and tiredness.
-These symptoms may appear and disappear within a few weeks to as long as a year.
-As with the last stage, if treatment is not given at this time, the infection will progress to the latent and (potential) tertiary stages.
-Known as the hidden stage where no symptoms are present.
-The latent stage can last for years where previous signs and symptoms never occur- ending the progression of the disease.
-In certain cases, the infection progresses to the tertiary stage (though most people do not progress into this stage).
-Most people with untreated syphilis do not get to the tertiary stage.
-For those that do (around 15%-30%), tertiary syphilis is the most destructive as it affects many different organs and bodily functions.
-Tertiary syphilis damages your brain, nerves, eyes, heart, blood vessels, muscles, joints and bones
-Happens around 10-30 years after the initial infection.
-This stage can lead to death if not treated properly.
Neurosyphilis and Ocular Syphilis
-When syphilis spreads to the brain and nervous system (neurosyphilis) or eyes (ocular syphilis).
-Can happen at any of the stages.
-Symptoms include headaches, lack of coordination, paralysis, numbness, blindness or onset of dementia.
-Mothers often transfer the infection to their child if they are infected with syphilis while pregnant.
-Babies can be infected either through birth or through the placenta.
-The infection in infants leads to low birth weight, rashes on the hands and feet, or saddle nose (where the bridge of the nose collapses).
-During the birthing process, syphilis can lead to a stillborn, early birth or death after birth.
-Untreated babies can develop serious health problems like cataracts, deafness or be prone to seizures.
Who is at Risk?
-Those living with HIV or if your partner is positive for syphilis.
-If you are a man who has sex with men as 64% of syphilis cases are among men engaging in sex with other men.
-Same risks as chlamydia and gonorrhea.
-When treated in the early stages, syphilis can be easy to cure.
-At every stage penicillin (antibiotic) is used to kill the bacteria. If you are allergic to penicillin, penicillin desensitization (medication given in a controlled and gradual manner to build tolerance) is usually undergone.
-A single injection of penicillin is given to the patient if that patient has had syphilis for less than a year. More doses may need to be given if you have been infected longer than a year.
-If you are pregnant and are infected with syphilis, the mother is given penicillin. Once the child is born, it is recommended the child is tested and receive antibiotic treatment if they are positive for syphilis
-After the first day of treatment some may suffer from the Jarisch-Herxheimer reaction. This is when the patient has a reaction to products released by the death of harmful microorganisms in the body when undergoing antibiotic treatment.
-Symptoms include chills, nausea, aches, pains and headaches. These symptoms will usually last a day then go away soon after.
-After initial treatment, your doctor will likely ask you for periodic blood tests and exams to make sure you are responding well to the penicillin dosage (depending on the stage).
-Sexual contact with new partners is not recommended at this time.
-Your doctor will also test you for HIV just as a precaution.
Even though we only touched on the top 3 STIs present among Canadians, there are loads more. Whether it’s HIV, Hepatitis A,B or C or even HPV (human papillomavirus), STIs are a growing concern and should be taken seriously. Check out the resources tab below for more information on the infections we did not explore in this article.
STI Prevention and Safe Sex Practices
Luckily, most of these infections can be easily avoided. Adopting the best safe practices while engaging in intercourse can save you and your partner from unneeded infections and downstream health concerns. Taking the time to plan the course of action can save you from weeks to potential years of long-term medical treatment because of an STI. Below we will breakdown the best safe sex practices to protect you and your partner.
Condoms are by far the easiest thing to use to prevent unwanted pregnancies and STIs. Though some seniors are past the age for pregnancy, condoms can be used exclusively to prevent the spread of STIs and disease. Condoms are a protective barrier that prevents skin to skin contact and exchange of bodily fluids (such as semen). As indicated above, STIs are transferred via the exchange of bodily fluids. Though there are other forms of contraceptives, condoms (when used properly) exclusively prevent STI transfer as there is no exchange of bodily fluids.
For more information on how to use condoms as well as their effectiveness click here. Keep in mind there are both male and female condoms, and condoms that are latex free, see what works best for you!
If you are curious about birth control options click here.
Where to get Condoms
Condoms are one of the most readily available forms of contraceptive on the market. Every drug store will carry condoms in the sexual wellness isle. Some stores even provide you with free condoms. If getting to a drug store isn’t possible, you can get condoms at gas stations, grocery stores and even online stores! If you want something more specific you may need to visit a sexual wellness store.
Use Other Forms of Protection
Condoms are, by far, the best form of protection for penetrative sex. However, there are other forms of protection for those that engage in other sexual activities. Dental dams, latex gloves and spermicide are all available to reduce spreading of STIs through oral sex and/or foreplay.
Where to get other types of protection
Like condoms, most of these items are readily available at the same stores.
Establish Communication with Your Partner
When thinking about intercourse, have open communication with your partner. Remember, instance of unprotected sex can lead to life changing health issues. Addressing each other’s concerns as well as previous sexual history is a great start to practicing safe sex. Be understanding to your partners needs as well as yours. Don’t judge, be open and if you or your partner is uncomfortable, don’t force things. Not having sex is a totally viable option. Consent is the most important thing when it comes to intercourse. If someone says no, it means no, that goes for both you and your partner.
Furthermore, it’s totally acceptable to address STIs and discuss whether you or your partner is infected or at risk. Even if your partner is at risk or is infected, don’t shame them. It can be hard enough to disclose the infection due to societal judgements. Be kind, understanding and responsible. If you or your partner is struggling with an STI, make an appointment with your doctor for professional help.
As a lot of STIs don’t show symptoms or don’t show symptoms till much later, it’s better to be safe than sorry. Even if you don’t think you are at risk for infection, get tested anyway just to be sure. If you catch the infection early, there is greater chance of curing the infection quickly. If you have had unprotected sex or experienced something as small as a condom ripping, you could be prone to infection. Testing will also prevent you from spreading the infection, especially if you never knew you had it in the first place.
Where to Get Tested
As stated above a simple blood, urine, mouth or genital swab test will quickly let you know if you have been infected with a STI. STIs don’t discriminate by age and if you have multiple partners you are more at risk. Therefore, the more partners you have the more you should get tested. Depending on the infection, the tests may vary. As some STIs have long incubation periods (time to when the infection has taken hold), you shouldn’t get tested until at least a week or two after initial intercourse.
In Canada, testing is free at your doctor’s office, at walk-in clinics, sexual health clinics, public health units and community centres.
For STI testing clinics in St. Albert, Edmonton, Sherwood Park, Spruce Grove and surrounding communities, check out the resource section at the bottom of the article.
Be Careful with Multiple Sexual Partners
Though it is completely normal to have multiple sexual partners over the course of your life, risky sex practices can be more common the more partners you have. The more monogamous a person is, the less likely they are to contract an infection with a partner that is not at risk or does not already have an infection. If you are engaging in sex with multiple partners, make sure you are protected. It is easier to gloss over someone’s sexual history if there is not a committed or previously establish relationship. Stay protected!
Don’t be Afraid to Ask for Help
The language around sex has changed considerably over the course of time. People are way more willing to openly discuss their sexual health with others, doctors and healthcare professionals. Even sexual wellness stores promote safe, healthy, and destigmatized sex, rather than showcasing it as a taboo practice. This openness has helped people become empowered and, in turn, be able to ask the questions they never thought they could (or were too afraid to ask). More than ever, there are multiple outlets for those trying to navigate the world of sex. Don’t be afraid to ask your doctor, pharmacist, or nurse for answers to your questions.
Be Careful with Alcohol and Drugs
Though Alcohol and Drugs can’t formally increase your chance of catching and STI, it can impair your ability to make safe choices. Be careful with how much you are consuming and the sexual activity you are partaking in. Consent is very important when it comes to sex. Therefore, alcohol and drugs should be avoided as they are known to impede appropriate behavior. Remember, if someone says no, it always means no. If you are going to drink, be with friends that can take care of you and help you make the right decisions. Know your limit.
Safe sex is usually helped if both partners are clean. Even if neither partner has an STI, showering before and after sex is usually a good practice to reduce infection. Remember, STIs aren’t the only method of infection. Other bacterial or viral infections can still be spread through poor hygiene, kissing and human contact. If you are using toys be sure to clean them after every use to reduce spread of contaminates. Most toys will come with instructions on how to clean them if you are unsure. Be sure not to douche after sex as this can increase the risk of STIs. Vagina’s have a lot of natural good bacteria that helps the body fight STIs. Douching not only gets rid of these beneficial bacteria but can lead to yeast infections, other bacterial infections as well as other major health risks.
As technology evolves, contraception, protection and education has changed. Experiments with different contraceptives are always ongoing to have sex be more accessible and safer than ever. For example, Male birth control pills and gels are currently in the works as well as self-lubricating condoms. Sex education is also evolving as curriculums are changing to account for the rise in risky sex practices and new forms of contraception. Sex education is also now being extended to developing countries to educate those with less opportunity for proper education. Unfortunately, the biggest issue in these countries is meeting the demand of contraceptive methods as well as family planning services. It is also difficult to adopt contraceptive these methods as tradition and society may prohibit this practice in certain cultures.
At Senior Homecare by Angels our experienced caregivers can help you set up appointments with your doctor and/or transport you to seminars for more information. Feel free to ask any Senior Homecare by Angels caregiver for advice on how best to contact healthcare professionals.
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Alberta Health Services-Sexual and Reproductive Sources
STI Clinics in Edmonton, St. Albert, Sherwood Park, Spruce Grove and Surrounding Areas
Alberta Sex Positive Education and Community Centre
Ready or Not Alberta
Alberta Health Services STI Facts
Alberta Community Council on HIV
Sexual Assault Centre of Edmonton
Sexuality Later in Life
Government of Canada Fact Sheet on Chlamydia
Mayo Clinic Chlamydia
Government of Canada Fact Sheet on Gonorrhea
CDC Gonorrhea Fact Sheet
CDC Syphilis Fact Sheet
Syphilis in Alberta
Benefits of Sex
Global News Senior STI Rates
Global News STI Increasing Infection Rates
CBC Increase of STIs in Canada
Global News STI Stats Video
Safe Sex for Seniors
Everything You Need to Know About STI Testing and Sexual Health
Syphilis in Alberta
Why Male Birth Control is so Hard to Make
Bill and Melinda Gates Foundation-Family Planning
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