Globally, the rates of common sexually transmissible infections (STIs) are increasing among people aged over 50. In some cases, rates are rising faster than among younger people.

Recent data from the United States Centers for Disease Control and Prevention shows that, among people aged 55 and older, rates of gonorrhoea and chlamydia, two of the most common STIs, more than doubled between 2012 and 2022.

Australian STI surveillance data has reflected similar trends. Between 2013 and 2022, there was a steady increase in diagnoses of chlamydia, gonorrhoea and syphilis among people aged 40 and older. For example, there were 5,883 notifications of chlamydia in Australians 40 plus in 2013, compared with 10,263 in 2022.

A 2020 study of Australian women also showed that, between 2000 and 2018, there was a sharper increase in STI diagnoses among women aged 55–74 than among younger women.

While the overall rate of common STIs is highest among young adults, the significant increase in STI diagnoses among midlife and older adults suggests we need to pay more attention to sexual health across the life course.

Why are STI rates rising among older adults?

STI rates are increasing globally for all age groups, and an increase among midlife and older people is in line with this trend.

However, increases of STIs among older people are likely due to a combination of changing sex and relationship practices and hidden sexual health needs among this group.

The “boomer” generation came of age in the 60s and 70s. They are the generation of free love and their attitude to sex, even as they age, is quite different to that of generations before them.

Given the median age of divorce in Australia is now over 43, and the internet has ushered in new opportunities for post-separation dating, it’s not surprising that midlife and older adults are exploring new sexual practices or finding multiple sexual partners.

It’s also possible midlife and older people have not had exposure to sexual health education in school or do not relate to current safe sex messages, which tend to be directed toward young people. Condoms may therefore seem unnecessary for people who aren’t trying to avoid pregnancy. Older people may also lack confidence negotiating safe sex or accessing STI screening.

Hidden sexual health needs

In contemporary life, the sex lives of older adults are largely invisible. Ageing and older bodies are often associated with loss of power and desirability, reflected in the stereotype of older people as asexual and in derogatory jokes about older people having sex.

With some exceptions, we see few positive representations of older sexual bodies in film or television.

Older people’s sexuality is also largely invisible in public policy. In a review of Australian policy relating to sexual and reproductive health, researchers found midlife and older adults were rarely mentioned.

Sexual health policy generally targets groups with the highest STI rates, which excludes most older people. As midlife and older adults are beyond childbearing years, they also do not feature in reproductive health policy. This means there is a general absence of any policy related to sex or sexual health among midlife or older adults.

Added to this, sexual health policy tends to be focused on risk rather than sexual wellbeing. Sexual wellbeing, including freedom and capacity to pursue pleasurable sexual experiences, is strongly associated with overall health and quality of life for adults of all ages. Including sexual wellbeing as a policy priority would enable a focus on safe and respectful sex and relationships across the adult life course.

Without this priority, we have limited knowledge about what supports sexual wellbeing as people age and limited funding for initiatives to engage with midlife or older adults on these issues.

How can we support sexual health and wellbeing for older adults?

Most STIs are easily treatable. Serious complications can occur, however, when STIs are undiagnosed and untreated over a long period. Untreated STIs can also be passed on to others.

Late diagnosis is not uncommon as some STIs can have no symptoms and many people don’t routinely screen for STIs. Older, heterosexual adults are, in general, less likely than other groups to seek regular STI screening.

For midlife or older adults, STIs may also be diagnosed late because some doctors do not initiate testing due to concerns they will cause offence or because they assume STI risk among older people is negligible.

Many doctors are reluctant to discuss sexual health with their older patients unless the patient explicitly raises the topic. However, older people can be embarrassed or feel awkward raising matters of sex.

Resources for health-care providers and patients to facilitate conversations about sexual health and STI screening with older patients would be a good first step.

To address rising rates of STIs among midlife and older adults, we also need to ensure sexual health promotion is targeted toward these age groups and improve accessibility of clinical services.

More broadly, it’s important to consider ways to ensure sexual wellbeing is prioritised in policy and practice related to midlife and older adulthood.

A comprehensive approach to older people’s sexual health, that explicitly places value on the significance of sex and intimacy in people’s lives, will enhance our ability to more effectively respond to sexual health and STI prevention across the life course.

Jennifer Power, Associate Professor and Principal Research Fellow, Australian Research Centre in Sex, Health and Society, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What we consider “fringe” or “mainstream” changes over time. That applies to health and medicine too.

For instance, massage was once considered a fringe therapy but in the 19th century it morphed into what we know today as physiotherapy.

Likewise, Swiss doctor Maximilian Bircher-Benner wasn’t taken seriously when he said we should eat oats and fruit for breakfast. But he was onto something: he invented muesli.

There has also been traffic in the other direction. Legitimate medical therapies have turned up in the weird health borderland of beauty and “wellness”.

When untrained or barely trained people use these therapies, they can do real harm.

Here are five examples of wellness trends that borrow from mainstream medicine.

1. Ozone therapy

Ozone (O₃) is a form of oxygen. Ordinary oxygen (O₂), sometimes with ozone added, can be applied to wounds via a bag or sealed chamber to help them heal. It does this by helping the body fight infection and form collagen.

But “ozone therapy” – the weird, unlicensed version – puts ozone, or ozone and oxygen, directly into the person’s body. It can go in via the lungs, or via intravenous injection, or it can be pumped into the rectum or vagina.

Practitioners claim it can reduce inflammation, or even treat cancer or HIV/AIDS, despite no evidence for such health benefits.

It can also cause fatal air embolisms – bubbles of gas in the bloodstream that can block blood flow to vital organs.

2. Vitamin drips

If you don’t get enough of a certain vitamin or mineral through your diet, you can take a supplement. But if that doesn’t work, in some cases, you might need to go to hospital or a doctor’s surgery to get a medically supervised infusion that’s delivered into the vein (an IV infusion).

For instance, iron infusions help people with serious iron deficiencies.

But celebrity endorsements have helped fuel the rise of “vitamin drips” at wellness centres and therapy lounges. These drips promise all sorts of outcomes, from boosting your immune system, to treating pain or depression.

IV needles in untrained hands can be dangerous. They can cause phlebitis (inflammation of the vein) and infiltration (when the IV fluid or medication leaks into the surrounding areas). They can also lead to infection.

And unlike therapeutic vitamin IV infusions administered in hospital, these non-traditional treatments are not regulated by Australia’s Therapeutic Goods Administration. So you might also not be getting the magic IV potion you’re paying for.

3. Botox

The bacterium Clostridium botulinum produces a neurotoxin – a poison that affects nerves. For decades, it’s been used therapeutically to treat excess sweating and migraine, among other conditions. Today, we call this neurotoxin Botox.

Since about the 1990s, health professionals have been injecting it into people’s faces to temporarily paralyse the muscles that cause wrinkles.

It’s legal, it’s a registered product, and in trained hands it’s safe to use.

But as of September 2 this year, it’s been wrapped in an extra layer of regulation.

People who deliver any non-surgical cosmetic procedures – including Botox – will now be required to demonstrate higher skill levels under tougher policies.

This comes after several cases where nurses allegedly imported injectables from overseas. But these products weren’t registered for use in Australia and may not have been safe to use.

4. Apheresis

Apheresis is the process of separating blood into its component parts by spinning it at high speed in a special machine.

Clinicians use this process to separate out and remove specific molecules or antibodies in some diseases – what’s called “selective apheresis”.

For example, if a person has very high cholesterol that doesn’t respond to normal treatments, they can undergo lipid apheresis to “wash out” harmful lipoproteins from their blood.

It’s easy to see how the idea of “washing” your blood could be misunderstood and misapplied.

English actor Orlando Bloom announced earlier this year that he’d undergone apheresis to remove microplastics from his blood.

Microplastics in the body are a cause for concern – but there’s no evidence to suggest apheresis can cleanse human blood of them.

5. Hyperbaric therapy

When a diver gets “the bends” from too much nitrogen forming in their body, they can be treated in a hyperbaric oxygen chamber, where they receive 100% oxygen in a pressurised chamber.

But hyperbaric therapy is also touted as a treatment for autism, Alzheimer’s disease, cancer, strokes, and post-traumatic stress disorder.

There isn’t enough good science to back up any of these claims. There also isn’t enough science to suggest it makes your skin look younger.

The key message?

The history of medicine is full of stories about when mainstream forms of medicine have harmed instead of healed.

Humans have also always wanted to manage their own health. This has been going on for centuries, with both risks and benefits.

But just because a therapy has been used in a hospital for one reason doesn’t necessarily mean it works in a wellness clinic for another.

People can be easily convinced by aggressively marketed wellness therapies, which can be magnified by social media and celebrity endorsements.

However these therapies can come with a lack of evidence to support their wider uses, and they may harm.

Caveat emptor – let the buyer beware.

Philippa Martyr, Lecturer, Pharmacology, Women’s Health, School of Biomedical Sciences, The University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.