Tuesday 22 January 2019

Dear Dr Nina: 'I'm in my sixties and think I have caught an STD'

A focus on sexual health is important at every age. (Picture posed)
A focus on sexual health is important at every age. (Picture posed)

Nina Byrnes

Question: I am a 60-year-old woman who has just recently started dating again. My marriage broke up 15 years ago and I was too busy raising children to think about meeting someone else. Recently, I felt it was time and went on a few dates with a man I met online. It got intimate and now I think I might have caught a STD. I have an unusual discharge and stinging pain. I am so embarrassed and ashamed. I am also terrified I have irreparably damaged my health. What do you think it could be? I can't go to my own GP.

Dr Nina replies:  I am delighted to hear you have recently reached out to seek new relationships. It sounds like you spent the last decades of your life focusing on others and have now taken time to focus on yourself. A focus on sexual health is important at every age especially when entering a new or casual relationship.

Even though you don't require contraception after menopause you are still at risk of STIs and so I always advise using a barrier method such as condoms to protect your sexual health. You should not be afraid to go to your GP about this. Discussing, diagnosing and treating causes of vaginal discharge and discomfort is something we do everyday.

You will need a urine check, physical examination, swabs and possible bloods. Your symptoms could indeed be an STI but they also could be many other things.

Vulvovaginitis is a condition that causes irritation and itch of the vagina or the skin near the entrance (the vulva). This condition is common in post menopausal women. In the absence of significant oestrogen levels, the skin of the vagina and vulva can be thin and easily irritated.

It may be that the friction of intercourse has exacerbated this issue. Those with vulvovaginitis usually complain of itch or redness and irritation. There may be some discharge visible in underwear and they may also complain of stinging or burning when passing urine.

Medical intervention is rarely required. Your GP may take a swab. If a bacterial infection is found a 10-day course of antibiotics may be prescribed. Avoid wearing restrictive clothing or tights.

Loose, white cotton underwear is best as it allows skin to breathe. Wearing a nightdress and no underwear at night can also help in some cases.

A gentle emollient or wash designed for those with eczema or sensitive skin is best. Applying a simple aqueous-based cream or one used for nappy rash may also help soothe the area. Vaginal infections such as thrush and bacterial vaginosis can cause discharge and sometime irritation. These are not STIs and are very easily treated once diagnosed.

An STI screen will involve swabs for the above as well as chlamydia, gonorrhoea and trichomonas. These are all treatable bacterial infections. Blood tests for HIV, hepatitis B & C and syphilis are also usually advised.

It is important that you seek medical help and get assessed. A general physical exam will also rule out any other gynaecological problems that may be causing your symptoms.

If you really aren't comfortable going to your regular GP about this then you could attend a well woman clinic or sexual health clinic in a hospital but I'd like to stress again your GP won't be shocked and you should have a GP that you can discuss anything with.

Do get checked - and don't be put off dating again.

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