Why STIs Are On The Rise In Older Adults

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Three Little Words

Sexually Transmitted Infections (STIs) are often thought of as something that predominantly plagues younger people… The truth, however, is different:

❝Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over-50s.

These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.❞

~ Dr. Justyna Kowalska

Read more: Managing The Rise In STIs Among Older Adults

That said, there is a gender gap when it comes to the increased risk, for example:

❝A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women❞

~ US Dept of Health & Human Services

Source: CDC: | Sexually Transmitted Disease Surveillance

Is abstinence the best preventative, then?

It is inarguably the most effective, but not necessarily the best for everyone.

This is because for most adults, a healthy sex life is an important part of overall wellbeing.

See also: Mythbusting The Big O

Even in this case there is a gender gap in:

  • the level of importance placed on frequency of sexual interactions
  • what act(s) of sexuality are held to be most important:

❝Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life.

Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101).

Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.❞

~ Dr. Lee Smith et al.

Source: Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults

If you have the time to go into it much more deeply, this paper from the Journal of Gerontology is much more comprehensive, looking also at related lifestyle factors, religious/political backgrounds, views on monogamy or non-monogamy (of various kinds), hormonal considerations, the impact of dementia or other long-term disabilities that may affect things, widowhood, and many other elements:

The National Social Life, Health, and Aging Project: An Introduction

What’s the best preventative, then?

Regular health screening for yourself and your partner(s) is an important key to preventative health when it comes to STIs.

You can Google search for a local STI clinic, and worry not, they are invariably discreet and are well-used to everybody coming in. They’re just glad you’re being responsible about things. It’s also not their job to judge your sexual activities, even if it’s something you might have reason to wish to be secretive about, try to be honest there.

Secondly, most of the usual advice about safe sex still goes, even when there’s no risk of pregnancy. For example, if there’s at least one penis involved, then condoms remain the #1 barrier to all manner of potential infections (we know, almost nobody likes condoms, but sometimes the truth isn’t what we want to hear).

Lastly, if there’s at least one vagina involved, then please for the love of all that is holey, do not put anything there that could cause a yeast infection.

What can cause a yeast infection? Pretty much anything with sugar, which includes but is not limited to:

  • Most kinds of food that Cosmo-style “liven things up in the bedroom” advice columns might suggest using (including fruit, honey, chocolate sauce, whipped cream, etc)
  • Hands that are not clean (watch out for bacteria too)
  • A mouth that has recently been eating or drinking anything with sugar in it, and that includes many kinds of alcohol, as well as milk or hot drinks that had milk in

Yeast infections are not nearly so serious as the STIs the other measures are there to avoid, but they’re not fun either, so some sensible policies in that regard are always good!

On a related note, see also: How To Avoid UTIs

Recap on the single most important part of this article:

At all ages, it remains a good health practice—unless one is absolutely celibate—to regularly get oneself and one’s partner(s) checked for STIs.

Take care!

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  • How To Do HIIT (Without Wrecking Your Body)

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    How To Do HIIT (Without Wrecking Your Body)

    High-Intensity Interval Training, henceforth “HIIT”, is a well-researched and well-evidenced approach to exercise that gives powerful health benefits.

    Specifically, health benefits that we don’t get from moderate exercise (as important as that is too) or endurance training.

    Super-quick overview of the benefits first:

    *remember that most forms of exercise aren’t very good for fat loss, because our metabolism will slow afterwards to compensate. So HIIT flipping this one is quite a big deal.

    What actually is it?

    HIIT means exercise sessions in which one alternates between high intensity “maximum effort” bursts, and short recovery periods during which more moderate exercise is performed.

    An example for runners could be switching between sprinting or jogging, changing mode each time one passes a street light.

    ❝A total of only two minutes of sprint interval exercise was sufficient to elicit similar responses as 30 minutes of continuous moderate intensity aerobic exercise❞

    ~ Trewin et al. (2018)

    Read more: Acute HIIT elicits similar changes in human skeletal muscle mitochondrial H₂O₂ release, respiration, and cell signaling as endurance exercise even with less work

    What did you mean about not wrecking your body? Is that… Likely?

    Hopefully not, but it’s a barrier to some! We are not all twenty-something college athletes, after all, and our bodies aren’t always as durable as they used to be.

    HIIT relies on intense exercise and short recovery periods, but what if our bodies are not accustomed to intense exercise, and need longer recovery periods? Can we still get the same benefits?

    The trick is not to change the intensity or the recovery periods, but the exercise itself.

    For HIIT to work the “intense” part has to be best-effort or approaching such. That part’s not negotiable. The recovery periods can be stretched a bit if you need to, but with the right tweaks, you ideally won’t have to do that.

    Great! How?

    First, note that you can do resistance interval training without impact. For example, if you crank up the resistance on an exercise bike or similar machine, you will be doing resistance training along with your cardio, and you’ll be doing it without the impact on your joints that you would if out pounding the pavement on foot.

    (Running is fine if your body is used to it, but please don’t make HIIT your first running exercise in a decade)

    Second, consider your environment. That exercise bike? You can get off it any time and you’re already at home (or perhaps your gym, with your car outside). Not so if you took up mountain biking or road racing.

    Third, go for what is gentle in motion, even if it’s not resistance work per se. Swimming is a fabulous option for most people, and can absolutely be done with HIIT principles. Since vision is often obscured while swimming, counting strokes can be a good way to do HIIT. For example, ten strokes max effort, ten strokes normal, repeat. Do make sure you are aware of where the end of the pool is, though!

    Fourth, make it fun! Ok, this one’s not about the safety quite so much, but it is about sustainability, and that’s critical for practical purposes too. You will only continue an exercise routine that you enjoy, after all.

    • Could you curate a musical playlist that shifts tempo to cue your exercise mode intervals?
    • Could you train with an exercise partner? Extra fun if this has a “relay race” feel to it, i.e. when one person completes a high intensity interval, the other person must now begin theirs.

    Need some pointers getting started?

    There are a lot of HIIT apps out there, so you can just search for that on your device of choice.

    But!

    We at 10almonds have recommended 7-Minute Workout before, which is available for iOS and for Android, and we stand by that as a great starting choice.

    Enjoy!

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  • How to Permanently Loosen a Tight Psoas

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    What Is Your Psoas?

    Your psoas is a deep muscle in your lower back and hip area that connects your spine to your thigh bone. It helps you bend your hips and spine, making it a hip flexor.

    In today’s video, Your Wellness Nerd (the YouTube channel behind the video below) has revealed some great tips on loosening said tight hip flexors!

    How to loosen them

    First off, the big reveal…your tight psoas is likely stemming from an overlooked cause: your lower back! The video kicks off with a simple technique to loosen up that stiff area in your lower back. All you need is a foam roller.

    But, before diving into the exercises, it’s essential to gauge your current flexibility. A basic hip flexor stretch serves as a pre-test.

    Note: the goal here isn’t to stretch, but rather to feel how tight you are.

    After testing, it’s time to roll…literally. Working through the lower back, use your roller or tennis ball to any find stiff spots and loosen them out; those spots are likely increasing the tension on your psoas.

    After some rolling, retest with the hip flexor stretch. Chances are, you’ll feel more mobility and less tightness right away.

    Note: this video focuses on chronic psoas issues. If you have sore psoas from a muscular workout, you may want to read our piece on speeding up muscle recovery.

    Is That All?

    But wait, there’s more! The video also covers two more exercises specifically targeting the psoas. This one’s hard to describe, so we recommend watching the video. However, to provide an overview, you’re doing the “classic couch stretch”, but with a few alterations.

    Next, the tennis ball technique zeroes in on specific tight spots in the psoas. By lying on the ball and adjusting its position around the hip area, you can likely release some deeply held tension.

    Additionally, some of our readers advocate for acupuncture for psoas relief – we’ve done an acupuncture myth-busting article here for reference.

    Other Sources

    If you’re looking for some more in-depth guides on stretching your psoas, and your body in general, we’ve made a range of 1-minute summaries of books that specifically target stretching:

    The final takeaway? If you’re constantly battling tight psoas muscles despite trying different exercises and stretches, it might be time to look at your lower back and your daily habits. This video isn’t just a band-aid fix; it’s about addressing the root cause for long-term relief:

    How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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  • Grains: Bread Of Life, Or Cereal Killer?

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    Going Against The Grain?

    In Wednesday’s newsletter, we asked you for your health-related opinion of grains (aside from any gluten-specific concerns), and got the above-depicted, below-described, set of responses:

    • About 69% said “They are an important cornerstone of a healthy balanced diet”
    • About 22% said “They can be enjoyed in moderation, but watch out”
    • About 8% said “They are terrible health-drainers that will kill us”

    So, what does the science say?

    They are terrible health-drainers that will kill us: True or False?

    True or False depending on the manner of their consumption!

    There is a big difference between the average pizza base and a bowl of oats, for instance. Or rather, there are a lot of differences, but what’s most critical here?

    The key is: refined and ultraprocessed grains are so inferior to whole grains as to be actively negative for health in most cases for most people most of the time.

    But! It’s not because processing is ontologically evil (in reality: some processed foods are healthy, and some unprocessed foods are poisonous). although it is a very good general rule of thumb.

    So, we need to understand the “why” behind the “key” that we just gave above, and that’s mostly about the resultant glycemic index and associated metrics (glycemic load, insulin index, etc).

    In the case of refined and ultraprocessed grains, our body gains sugar faster than it can process it, and stores it wherever and however it can, like someone who has just realised that they will be entertaining a houseguest in 10 minutes and must tidy up super-rapidly by hiding things wherever they’ll fit.

    And when the body tries to do this with sugar from refined grains, the result is very bad for multiple organs (most notably the liver, but the pancreas takes quite a hit too) which in turn causes damage elsewhere in the body, not to mention that we now have urgently-produced fat stored in unfortunate places like our liver and abdominal cavity when it should have gone to subcutaneous fat stores instead.

    In contrast, whole grains come with fiber that slows down the absorption of the sugars, such that the body can deal with them in an ideal fashion, which usually means:

    • using them immediately, or
    • storing them as muscle glycogen, or
    • storing them as subcutaneous fat

    👆 that’s an oversimplification, but we only have so much room here.

    For more on this, see:

    Glycemic Index vs Glycemic Load vs Insulin Index

    And for why this matters, see:

    Which Sugars Are Healthier, And Which Are Just The Same?

    And for fixing it, see:

    How To Unfatty A Fatty Liver

    They can be enjoyed in moderation, but watch out: True or False?

    Technically True but functionally False:

    • Technically true: “in moderation” is doing a lot of heavy lifting here. One person’s “moderation” may be another person’s “abstemiousness” or “gluttony”.
    • Functionally false: while of course extreme consumption of pretty much anything is going to be bad, unless you are Cereals Georg eating 10,000 cereals each day and being a statistical outlier, the issue is not the quantity so much as the quality.

    Quality, we discussed above—and that is, as we say, paramount. As for quantity however, you might want to know a baseline for “getting enough”, so…

    They are an important cornerstone of a healthy balanced diet: True or False?

    True! This one’s quite straightforward.

    3 servings (each being 90g, or about ½ cup) of whole grains per day is associated with a 22% reduction in risk of heart disease, 5% reduction in all-cause mortality, and a lot of benefits across a lot of disease risks:

    ❝This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes.

    These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.❞

    ~ Dr. Dagfinn Aune et al.

    Read in full: Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies

    We’d like to give a lot more sources for the same findings, as well as papers for all the individual claims, but frankly, there are so many that there isn’t room. Suffice it to say, this is neither controversial nor uncertain; these benefits are well-established.

    Here’s a very informative pop-science article, that also covers some of the things we discussed earlier (it shows what happens during refinement of grains) before getting on to recommendations and more citations for claims than we can fit here:

    Harvard School Of Public Health | Whole Grains

    “That’s all great, but what if I am concerned about gluten?”

    There certainly are reasons you might be, be it because of a sensitivity, allergy, or just because perhaps you’d like to know more.

    Let’s first mention: not all grains contain gluten, so it’s perfectly possible to enjoy naturally gluten-free grains (such as oats and rice) as well as gluten-free pseudocereals, which are not actually grains but do the same job in culinary and nutritional terms (such as quinoa and buckwheat, despite the latter’s name).

    Finally, if you’d like to know more about gluten’s health considerations, then check out our previous mythbusting special:

    Gluten: What’s The Truth?

    Enjoy!

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  • Feminist narratives are being hijacked to market medical tests not backed by evidence

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Corporations have used feminist language to promote their products for decades. In the 1980s, companies co-opted messaging about female autonomy to encourage women’s consumption of unhealthy commodities, such as tobacco and alcohol.

    Today, feminist narratives around empowerment and women’s rights are being co-opted to market interventions that are not backed by evidence across many areas of women’s health. This includes by commercial companies, industry, mass media and well-intentioned advocacy groups.

    Some of these health technologies, tests and treatments are useful in certain situations and can be very beneficial to some women.

    However, promoting them to a large group of asymptomatic healthy women that are unlikely to benefit, or without being transparent about the limitations, runs the risk of causing more harm than good. This includes inappropriate medicalisation, overdiagnosis and overtreatment.

    In our analysis published today in the BMJ, we examine this phenomenon in two current examples: the anti-mullerian hormone (AMH) test and breast density notification.

    The AMH test

    The AMH test is a blood test associated with the number of eggs in a woman’s ovaries and is sometimes referred to as the “egg timer” test.

    Although often used in fertility treatment, the AMH test cannot reliably predict the likelihood of pregnancy, timing to pregnancy or specific age of menopause. The American College of Obstetricians and Gynaecologists therefore strongly discourages testing for women not seeking fertility treatment.

    Woman sits in a medical waiting room
    The AMH test can’t predict your chance of getting pregnant.
    Anastasia Vityukova/Unsplash

    Despite this, several fertility clinics and online companies market the AMH test to women not even trying to get pregnant. Some use feminist rhetoric promising empowerment, selling the test as a way to gain personalised insights into your fertility. For example, “you deserve to know your reproductive potential”, “be proactive about your fertility” and “knowing your numbers will empower you to make the best decisions when family planning”.

    The use of feminist marketing makes these companies appear socially progressive and champions of female health. But they are selling a test that has no proven benefit outside of IVF and cannot inform women about their current or future fertility.

    Our recent study found around 30% of women having an AMH test in Australia may be having it for these reasons.

    Misleading women to believe that the test can reliably predict fertility can create a false sense of security about delaying pregnancy. It can also create unnecessary anxiety, pressure to freeze eggs, conceive earlier than desired, or start fertility treatment when it may not be needed.

    While some companies mention the test’s limitations if you read on, they are glossed over and contradicted by the calls to be proactive and messages of empowerment.

    Breast density notification

    Breast density is one of several independent risk factors for breast cancer. It’s also harder to see cancer on a mammogram image of breasts with high amounts of dense tissue than breasts with a greater proportion of fatty tissue.

    While estimates vary, approximately 25–50% of women in the breast screening population have dense breasts.

    Young woman has mammogram
    Dense breasts can make it harder to detect cancer.
    Tyler Olsen/Shutterstock

    Stemming from valid concerns about the increased risk of cancer, advocacy efforts have used feminist language around women’s right to know such as “women need to know the truth” and “women can handle the truth” to argue for widespread breast density notification.

    However, this simplistic messaging overlooks that this is a complex issue and that more data is still needed on whether the benefits of notifying and providing additional screening or tests to women with dense breasts outweigh the harms.

    Additional tests (ultrasound or MRI) are now being recommended for women with dense breasts as they have the ability to detect more cancer. Yet, there is no or little mention of the lack of robust evidence showing that it prevents breast cancer deaths. These extra tests also have out-of-pocket costs and high rates of false-positive results.

    Large international advocacy groups are also sponsored by companies that will financially benefit from women being notified.

    While stronger patient autonomy is vital, campaigning for breast density notification without stating the limitations or unclear evidence of benefit may go against the empowerment being sought.

    Ensuring feminism isn’t hijacked

    Increased awareness and advocacy in women’s health are key to overcoming sex inequalities in health care.

    But we need to ensure the goals of feminist health advocacy aren’t undermined through commercially driven use of feminist language pushing care that isn’t based on evidence. This includes more transparency about the risks and uncertainties of health technologies, tests and treatments and greater scrutiny of conflicts of interests.

    Health professionals and governments must also ensure that easily understood, balanced information based on high quality scientific evidence is available. This will enable women to make more informed decisions about their health.The Conversation

    Brooke Nickel, NHMRC Emerging Leader Research Fellow, University of Sydney and Tessa Copp, NHMRC Emerging Leader Research Fellow, University of Sydney

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

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  • Minimize Aging’s Metabolic Slump

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    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I know that metabolism slows with age, are there any waypoints or things to look out for? I don’t know whether I should be eating less, or doing less, or taking some other approach entirely. What’s recommended?❞

    Age and sex count for a lot with this one! As metabolism is in large part directed by hormones:

    • For men, declining testosterone (often from around 45 onwards) can result in a metabolic slump
    • For women, declining estrogen with the menopause does have an effect, but progesterone is the bigger factor for metabolism in the sense you are talking about.

    In both cases, simply taking more of those hormones can often help, but please of course speak with an endocrinologist if that seems like a possible option for you, as your circumstances (and physiology) may vary.

    If you’d like to go to that conversation well-armed with information, here are some good starting points, by the way:

    And if you’re wondering about the natural vs pharmaceutical approaches…

    About your metabolic base rate

    We tend to think of “fast metabolism good, slow metabolism bad”, and that’s a reasonable general premise… but it’s not necessarily always so.

    After all, if you could double your metabolism and keep it there all the time, without changing anything else, well… You’ve heard the phrase “burning the candle at both ends”? So, having at least some downtime is important too.

    See for example: Sleep Deprivation & Diabetes Risk

    What’s critical, when it comes to base metabolic rate, is that your body must be capable of adequately processing what you are putting into it. Because if your body can’t keep up with the input, it’ll just start storing the excess chemical energy in the quickest and easiest way possible.

    …which is a fast track to metabolic disorder in general and type 2 diabetes in particular. For more on the science and mechanics of this, see:

    How To Prevent And Reverse Type 2 Diabetes

    As for portion sizes…

    Your body knows what you need, so listen to it. There is no external source of knowledge that can tell you how much food you need better than your own body itself can tell you.

    You may be wondering “how exactly do I listen to my body, though?”, in which case, check out:

    The Kitchen Doctor: Interoception & Mindful Eating

    As for exercise…

    When you exercise, your metabolic rate temporarily increases. After most kinds of exercise, your metabolism slumps again afterwards to compensate.

    There are two ways to avoid this:

    …which makes it pretty effective indeed

    Would you like this section to be bigger? If so, send us more questions!

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  • State of Slim – by Dr. James Hill & Dr. Holly Wyatt

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    The premise of this book is “people in Colorado are on average the slimmest in the US”, and sets about establishing why, and then doing what Coloradans are doing. As per the subtitle (drop 20 pounds in 8 weeks), this is a weight loss book and does assume that you want to lose weight—specifically, to lose fat. So if that’s not your goal, you can skip this one already.

    The authors explain, as many diet and not-diet-but-diet-adjacent book authors do, that this is not a diet—and then do refer to it as the Colorado Diet throughout. So… Is it a diet?

    The answer is a clear “yes, but”—and the caveat is “yes, but also some associated lifestyle practices”.

    The diet component is basically a very low-carb diet to start with (with the day’s ration of carbs being a small amount of oats and whatever you can get from some non-starchy vegetables such as greens, tomatoes, etc), and then reintroducing more carbohydrate centric foods one by one, stopping after whole grains. If you are vegan or vegetarian, you can also skip this one already, because this advises eating six animal protein centric meals per day.

    The non-diet components are very general healthy-living advices mixed in with popular “diet culture” advices, such as practice mindful eating, don’t eat after 8pm, exercise more, use small plates, enjoy yourself, pre-portion your snacks, don’t drink your calories, get 8 hours sleep, weigh all your food, etc.

    Bottom line: this is a very mixed bag, even to the point of being a little chaotic. It gives sometimes contradictory advice, and/but this results in a very “something for everyone” cafeteria approach to dieting. The best recommendation we can give for this book is “it has very many ideas for you to try and see if they work for you”.

    Click here to check out State of Slim, and take your pick!

    Don’t Forget…

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    Learn to Age Gracefully

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