* THE PHYSICAL PART

When you become sexually active with a new partner, the reality is that you need to think about avoiding a sexually transmitted infection (STI). And midlife women are at much greater risk for STIs than most people appreciate. Many of my patients seem to think chlamydia, gonorrhea and herpes are limited to 20- and 30- year-olds who are having random hook-ups. Trust me, it’s not as if these bugs ask to see proof of age before infecting someone!

Another thing to know. Women are at higher risk than men, since STIs are more easily passed from male to female than vice versa. In fact, if exposed, a woman is more likely than a man to contract hepatitis B, gonorrhea or HIV. The risk is even higher for postmenopausal women, since thin vaginal walls are more likely to get microscopic tears during intercourse, creating an easy portal for infection.

Women who have common STIs are less likely to have symptoms than men, which means diagnosis is often delayed or missed. That’s why the age group in which STI rates are rising most rapidly is that of adults at midlife and beyond.

(In fact, rates of syhilis among women aged

45-49 grew by 129 per cent from 2002-2010.)

A lot of women are reassured by the fantasy that the typical midlife guy is “low-risk”, especially if he’s just ended a long marriage. That’s true if he and his wife were monogamous – but a lot of marriages end because someone wasn’t monogamous. And if you’ve had the thought,

I’m not worried… he’s a nice guy, I’ve got news for you. Sometimes the nice guys are the ones most likely to have an infection. Face it:

Creepy guys probably have a harder time getting someone to sleep with them.

The solution? Know your enemy (the bugs, not the guys) and protect yourself.

The best shield

Here’s what you may have told yourself: I’ll always insist on a condom, so I have nothing to worry about, right? Not really. Condoms are not foolproof. First of all, HPV, herpes and a number of other STIs live not in semen but on skin, so intercourse isn’t necessary to transmit them. Since a condom covers only the penis, short of strapping on a garbage bag to cover a man’s scrotum, anus and surrounding skin, there is no such thing as total protection.

Still, using a condom consistently remains the best way to lower your risk of getting an STI. But studies show that single women in midlife with new partners rarely report consistent condom use. (I even hear this from my very responsible, hyperaware patients.) One possible reason: Women over 40 are generally dating men over 40. Sometimes way over 40. In general, the older a guy gets, the more difficulty he has in getting and maintaining an erection, even in the best of scenarios. Add a few glasses of wine and a condom, and it’s game over.

So while my patients all intend to use condoms, they often don’t. I see and treat a lot of infections in women who decided to skip the condom “just this once”. Don’t be one of those women – and don’t depend on a man to be prepared.

Talking to a partner about your respective STI histories and current status is key. To do this, you need to be screened – especially important since the majority of these infections have no symptoms in their earliest stages. Screening for STIs is not done automatically when you go to your doctor, nor is it part of a Pap smear.

So if your doctor doesn’t bring it up, you need to ask. There’s no need to go into lengthy explanations. Simply say, “I’d like a screen for sexually transmitted infections today.” Your doctor will not be shocked. Okay, now you’ve got both the mind and the body prep – go out there and have some fun!

I see a lot of infections in women who decided to skip the condom ‘just this once’. Don’t be one of those women.