Sexual Health in Later Life: A Practical Checklist

Sexual activity and risk in older adults, an area routinely left out of both advice and services. STI rates in older adults have risen, and assumptions that they are not sexually active mean testing is rarely offered.

Key takeaways

• STI rates in older adults: have risen in recent years
• Contraception after 40: still needed until menopause is confirmed
• Most useful single change: Use condoms with new partners at any age.
• Commonest mistake: Assuming STI risk ends with fertility.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

Do

• Use condoms with new partners at any age
• Ask for STI testing; it will rarely be offered unprompted
• Raise vaginal dryness or pain; topical treatment is effective
• Continue contraception until advised it is no longer needed

Do not

• Assuming STI risk ends with fertility
• Tolerating painful sex rather than seeking treatment
• Stopping contraception on the basis of irregular periods alone

The numbers behind the list

Every item above comes from these figures, published in the guidance listed at the foot of the page.

If you change one thing

Use condoms with new partners at any age. It heads the list. If you take nothing else from this page, take that.

Where to go next

• Why Sexual Health in Later Life Matters, Explained Simply
• What People Get Wrong About Sexual Health in Later Life
• Sexual Health in Later Life — the reference entry
• Sexually Transmitted Infections: What Published Guidance Supports
• The Evidence on Contraception Choices, Without the Hype

When to speak to a doctor

Report any bleeding after the menopause to a GP urgently — it always needs investigation. Seek assessment for painful sex, unusual discharge, or genital lumps or sores. Never take PDE5 inhibitors with nitrate medicines such as GTN spray.

Where this comes from

• NHS — Sexual health services
• British Menopause Society — genitourinary syndrome of menopause

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.