Sometimes the most important health questions are the ones you’re too mortified to ask. You know your doctor’s a professional who’s heard it all before, but there’s just no way you’re bringing up that foul odor or that weird burning sensation after sex. We hear you.

In our “Too Embarrassed to Ask” series, we’ll tackle your most uncomfortable questions. (And when you’re done reading, just clear your browser history. We’ll never tell.)

Did you know sexually transmitted infections, also known as STIs and STDs, are on the rise in the United States, especially among older adults? That might be surprising, but it’s true!

In fact, for people over age 65, the rates of certain STIs at least doubled from 2008 to 2018. One possible reason? Our society tends to think sex is only for the young.

“I think we, as a society, really stop discussing sexuality or thinking about sexuality past a certain age, because I think we make assumptions that older people are not sexual beings,” Dr. Ina Park, associate professor of family community medicine at the University of California, San Francisco, told Yahoo Life.   “And I'm here to tell you that's absolutely not the case. I think we're really doing a disservice to folks.”

An overview of common STIs

Three STIs in particular are surging among older people: chlamydia, syphilis, and gonorrhea. But there are other STIs to be aware of, as well.

Chlamydia

• Often no symptoms, but can include burning or itching
• If untreated in women, can lead to pelvic inflammatory disease, a chronic painful condition
• Treatable with antibiotics

Syphilis

• Often no symptoms, but you may see a sore where your body had contact with the bacteria
• Can lie dormant in body for decades
• If untreated, can damage the liver, heart, brain – and even be fatal
• Treatable with antibiotics

Gonorrhea

• Often no symptoms, but can include pain while urinating or unusual discharge
• If untreated, can spread to the blood and be life threatening
• Treatable with antibiotics

Trichomoniasis

• Often no symptoms, but can include pain while urinating, itching, or discharge
• If left untreated, can cause infection in the urethra or prostate gland in men. Women may be more susceptible to infection with HIV.
• Treatable with antibiotics

Herpes

• Often no symptoms, but can include blisters and sores
• Not curable, but treatment can help control symptoms
• Herpes doesn’t usually cause serious health problems

Hepatitis B

• Symptoms appear 1-4 months after infection and can include abdominal pain, fever, and jaundice
• Most people recover, but 2-6% of infected adults end up with chronic (incurable) Hep B
• In some people, chronic Hep B can lead to cirrhosis, liver cancer, and death
• Hep B can be prevented with a vaccine

HIV

• Sometimes no symptoms, but can include flu-like symptoms 2-4 weeks after infection
• Not curable, but medication regimens can help control the virus and prevent spread
• If left untreated, HIV causes AIDS and is fatal

What you’ll notice from this overview is that many people have STIs without knowing it. And it’s important to remember that STIs can spread through vaginal, oral, and anal sex. If you are sexually active, you should use a condom or a dental dam to protect against STIs.

Why are STI rates increasing in older adults?

There are several reasons for this rise in infections in older adults, from broad societal changes to personal embarrassment.

Lack of sexual education

Because of the myth that older adults are no longer sexually active, older adults receive little education about sexual health and safe sex. They might not think they’re at high risk of STIs, or if they are aware, they might feel awkward bringing it up with their doctor.

Lack of screening

Since older people don’t have sex (HA!), why bother screening for STIs? Additionally, since infertility is what many people associate with STIs, it can be easy to forget that STIs can have other serious consequences.

Longer sex lives

Thanks to medicines like Viagra, which helps men combat erectile dysfunction, and lubricants to help women combat discomfort during sex, both men and women are enjoying longer sex lives than prior generations did.

Lack of condom use

In the past, the primary reason for promoting condom use was to prevent unwanted pregnancies. With that risk out of the way, sexually active older people might be less likely to use one.

Getting past embarrassment

Talking about your sex life with your friends can be embarrassing, so it’s no surprise you might find it hard to bring up to your doctor. But getting screened is critical if you’re having sex with a new partner – and even more so if you’re experiencing any symptoms like discharge or sores.

Sometimes it’s easiest to just admit you’re uncomfortable rather than trying to act casual. You could say, “I feel so awkward talking about this, but I’m noticing this gross discharge. I’m wondering if it could be an STI.”

Or you could bring up an interesting article that got you thinking: “I was reading that STIs are becoming more common among people my age. The stats were kind of alarming. Can I get a screening?”

Embarrassing? Eh. Maybe for thirty seconds. Once the conversation gets going, you’ll probably forget all about it. So if you think you might be at risk of an STI, set up an appointment today!

Medicare and STIs

Of course, you’ll be covered under your Medicare plan, just as you would for any other infection. Curious how your co-pays compare to other Medicare plans in your area? Check out our easy-to-use Find a Plan tool.