DEAR DOCTOR K: I’m a single, postmenopausal woman in my 50s. Do I still need to worry about “safe” sex?
DEAR READER: I’m surprised by how often my patients ask me the same question. “Safe” sex means using what doctors call “barrier protection” – male or female condoms.
It is true that menopause brings freedom from worries about pregnancy (if your doctor is sure you have entered menopause). But menopause doesn’t change at all your need to practice safe sex. That’s particularly true if you’re entering into a new relationship or have multiple sexual partners. Even postmenopausal women need to worry about sexually transmitted infections. STIs include particularly HIV, herpes, chlamydia, gonorrhea, syphilis, the papillomaviruses that can cause cervical cancer, chancroid (a bacterial infection), hepatitis and trichomonas.
That’s right: There are a lot of them. STIs can be passed between women and their partners of either sex through vaginal, oral or anal sex.
Male condoms have been studied for many years. There is no doubt that they decrease the risk of transmitting all of the STIs.
Female condoms also reduce the risk of STIs, although there are fewer studies of their effectiveness than there are with male condoms.
Does a woman who has entered menopause really need to worry about STIs? You sure do. In fact, postmenopausal women are more vulnerable to STIs than younger women. After menopause, the vaginal and cervical tissues get thinner. This makes the vaginal lining vulnerable to developing small tears and scratches, providing places for STIs to enter the body. Also, your immune response declines with age, making it harder to fight off an STI.
As a result, using a condom to prevent STIs continues to be important, even after menopause.