Sex: Frisky (and Safe) After 50

Changing patterns of sexual behaviour amongst some demographics are being reflected for instance through increases in the levels of STIs diagnosed amongst those over 50, whilst practices such as chemsex and use of dating apps can also be associated with higher-risk behaviour.

Dated preconceptions regarding the sex lives of those aged 50 and over are slowly being challenged and overturned. Over 80% of people aged between 50 and 90 are sexually active these days, with two-thirds rating sex as a vital component of their relationship. Regardless of age, sex is important to one’s overall holistic health.

Miss Julie Bowring, consultant gynaecologist in sexual and reproductive health spoke to Sheerluxe on the rise of STI’s, symptoms to spot and top tips for treatment.

1. Is it true that STIs are on the rise in women over 50? If so, what are the latest stats? How has this changed in the last few years?

Prior to covid, it had been noted that the number of STIs in men and women over 50 was on the rise. Data published from Public Health England showed an increase in the total number of chlamydia infections in men and women between 45-64yrs. The effect of covid and lockdowns may mean the numbers have since decreased, but sexual health in people over the age of 50 remains an important issue.

2. What is behind this rise? Why are more women getting STIs, and which are the most common in this age group?

There are a number of reasons why this rise may be occurring. The majority of sexual health campaigns still target a younger demographic, older women may therefore be less aware about their own individual risk of an STI. During a medical consultation older women are perhaps less likely to discuss STIs with healthcare providers and likewise healthcare workers may assume incorrectly they are less sexually active avoiding the topic as a result. Compared to the current curriculum, there also would have been less focus on sexual education when they were in school.
One other major reason may be that women over 50 are less likely to use a condom if there is no risk of pregnancy.

Previous data from the US stated that the three most common STIs in adults over 50 included chlamydia, gonorrhoea and HIV.

3. What are some of the myths about STIs that persist in women 50+?

Hopefully the above answers this?

4. What are the symptoms to look out for – are some more obvious than others? Do STI symptoms change later in life?

Many men and women will often have no symptoms from STIs. All infections can exist without symptoms, but particularly chlamydia is often asymptomatic. This just highlights the importance of safe sex and routine checks when you enter a new relationship.

The symptoms, however small, to look out for are:
1. Any vaginal discharge that is not ‘normal’ for you, this can mean change in colour, amount, odour.
2. Vaginal or vulval irritation or soreness
3. Ulcers or blisters on the vulval area (outside)
4. Genital warts
5. Swollen lymph nodes in the groin
6. Pain on passing urine
7. Bleeding after sex
8. When infection spreads to the pelvis (PID: Pelvic Inflammatory Disease), women can get severe lower abdominal pain and temperature

Women presenting with the symptoms above may be misdiagnosed as symptoms can be attributed to an alternative diagnosis. Vaginal and urinary symptoms for example, may be considered to be due to the menopause rather than an STI. The opportunity to successfully treat an infection can be missed, increasing the risk of transmission and later complications.

5. When it comes to getting tested, where can you get this done? How can you find services local to you?

Sexual health testing can be carried out in a variety of settings. Most people will attend a sexual health clinic or their GP surgery. If you do not have symptoms and want to have a sexual health check for peace of mind, this can be carried out at home by ordering an online kit. This can be a good solution for people that might have embarked on a new relationship or simply want to check their sexual health.

6. If you suspect you have an STI, how soon after having unprotected sex should you get tested?

If you have symptoms or you are concerned about having an STI you should visit a sexual health clinic or your doctor to get tested. Some infections taken time to show up on sexual health screens. This means you may sometimes have to repeat a test if you have recently had unprotected sex with someone.

7. Treatment – what are your treatment options?

Infections are often treated by simple antibiotics. It is necessary to treat your partner as well as sexual contacts in the recent past. Sometimes, a “test of cure” is necessary to ensure that the infection has been satisfactorily treated.

Infections, if not diagnosed and treated promptly, can spread to the fallopian tubes and the pelvis in women. This can lead to what is known as Pelvic Inflammatory Disease (PID). This is often characterised by severe pelvic pain and raised temperature. Admission to the hospital and intravenous antibiotics are sometimes needed in severe cases.

PID can lead to blocked fallopian tubes and infertility. If the fallopian tubes are partially blocked or affected, there is also a risk of tubal ectopic pregnancy. PID can also lead to scar tissue and chronic pelvic pain which can be difficult to treat.

8. Does having one STI put you more at risk of catching another?

Having an STI may increase the risk of you becoming infected with HIV. This is because some STIs lead to inflammation and broken skin which increases the risk of HIV transmission.

9. What are your top tips for safer sex in your 50s? Do you have any insights to share with our readers?

There is still a risk of having an STI in your 50s, protecting yourself by using a condom will prevent the STIs such as chlamydia, gonorrhoea and HIV.

Sexual health tests can often be sent to you and carried out in the comfort of your own home, this is a great way to access testing if you are concerned about having an STI.

It can often be daunting talking about sex but healthcare professionals working in sexual health are trained to do this, do visit your sexual health service or doctor if you are worried about anything or have questions related to STIs.

Click here to view the full SheerLuxe article.

A regular sexual health check can be performed at any time for peace of mind. Why not book your sexual health appointment today.

Menopause and Migraines

What are migraines?

Migraines are severe and recurrent headaches which can have a significant impact on a person’s quality of life. They are often accompanied by other symptoms such as visual disturbances, nausea and vomiting, sensitivity to light and sound, irritability, fatigue and malaise.

What how can menopause affect migraines?

From the early 40s, the menstrual cycle can become more erratic, with fluctuations in oestrogen levels, leading to more frequent migraines. As these fluctuations lessen in the run up to the menopause and beyond, some women may find that their migraine improves after the menopause.

What are the options for migraine treatment during menopause?

Here are 7 possible treatments for migraine sufferers during the menopause.

Hormone Replacement Therapy (HRT): Some menopausal women may benefit from HRT, which can help stabilise hormonal fluctuations and reduce the frequency and severity of migraines. If you have migraines with aura (changes to your vision) it is often advised to use oestrogen which is delivered through the skin, as there is no increased risk of blood clots when it is given this way. Your doctor will be able to discuss and individualised treatment approach with you.
Lifestyle Modifications: Lifestyle changes can play a crucial role in migraine management. This includes maintaining a regular sleep schedule, staying hydrated, managing stress, and avoiding trigger factors (for you) like certain foods, alcohol, and excessive caffeine.
Medications: Your healthcare provider may recommend migraine-specific medications, such as triptans, nonsteroidal anti-inflammatory drugs (NSAIDs), or preventive medications like beta-blockers, calcium channel blockers, or antiepileptic drugs. The choice of medication depends on the frequency and severity of your migraines and of course, your preference.
Complementary Therapies: Some women find relief through complementary therapies like acupuncture, chiropractic care, or herbal supplements. Be sure to consult with a healthcare professional before trying these approaches.
Dietary Changes: Maintaining a healthy diet and identifying and avoiding trigger foods can be helpful. Common migraine triggers include aged cheeses, processed meats, and foods with artificial additives. Alcohol again can be a trigger for some.
Exercise: Regular physical activity can help reduce the frequency and severity of migraines. However, it’s essential to find an exercise routine that suits your individual needs and doesn’t trigger migraines.
Tracking Migraines: Keeping a migraine diary can help identify patterns and triggers, which can inform your treatment plan.

Menopause: When to Stop Contraception

The decision of when to stop contraception during menopause can vary depending on your individual circumstances and preferences. Menopause is defined as the cessation of menstruation for 12 consecutive months and is technically one day in time. It is important to understand that pregnancy can still occur during the perimenopausal transition, as ovulation can be irregular.

If you are over 50 and your periods have naturally stopped for 12 months or more, you can usually stop contraception. This only applies if you are not using additional hormonal medication.
If you are under 50 you can stop using contraception if your periods have naturally stopped for 2 years. Again, this advice only applies if you are not taking additional hormones or using the Mirena coil.
At the age of 55 you can usually stop using contraception as natural conception at this time is very rare.

If you are using the combined contraceptive pill and you have withdrawal bleeds these are occurring because of these hormones rather than your own cycle. Because these methods give an ‘artificial bleed’, you are not able to tell where you are in the menopause transition or if your periods have naturally stopped.

Some women using the progesterone only pill, progesterone implant or hormone-containing coil may not have regular bleeds which can make it difficult to know when the menopause happens.

If this is the case, your doctor can carry out a blood test to check your follicle stimulating hormone (FSH) level. This blood test can be useful in helping you work out when to stop using contraception. Speak to a doctor to arrange this, and for advice on how to interpret the results. If you would like to discuss menopause or when to stop contraception with one of our menopause specialists, click here,

Save the Date – Fibroids Instagram Live

Save The Date: Tuesday 7th February at 7pm LIVE

UK’s leading consultant gynaecologist Mr Narendra Pisal, who specialises in complex fibroid problems, will be a special guest, joining host Dawn Heels, next week on Instagram for a live event.

Mr Pisal is an expert in fibroid surgeon, specifically in minimally invasive procedures. Over the last 21 years, he has performed many key hole and open surgery. He is passionate about educating women about their treatment options for fibroids.

After a painful fibroid experience, Dawn has become an online content creator around women’s health, and she is currently on a mission to raise awareness of fibroids.

Engage with us on Dawn’s Instagram on Tuesday 7th February at 7pm for an informative and educational session on Fibroids and Fertility and have your questions answered.

Gynaecology is seen as a lifestyle medicine.

‘Gynaecology is seen as a lifestyle medicine’ says consultant gynaecologist Mr Narendra Pisal when speaking to The Times yesterday.

Gynaecology care is considerably being diminished by the NHS. The impact of failing to put women at the heart of our health services has been clear to see through the number of recent high-profile independent reports and inquiries.

Mr Pisal shares further insights from his experience in the NHS and the impact on women’s health, as waiting lists are currently the longest they have ever been. In the past decade waiting times have trebled in the NHS, leaving thousands of women with gynaecological conditions being let down, impacting on their daily actvities.

Many are facing the unacceptable choice: wait or go private.

Click here to view the full article.

Cervical Screening: Common Myths Debunked

It’s extremely important to attend your regular smear test when due – as this helps save thousands of lives each year. A smear test is a simple routine health check that unfortunately many women put off. The biggest risk factor for cervical cancer is not having a smear test and remaining unaware of the development of the pre-cancer.

London Gynaecology’s Clinical Nurse Specialist, Jennifer Byrne spoke to @wyldemoon to quash the 10 most common thoughts and worries about this check up.

Everyone who walks into the examination room feels awkward. Being anxious beforehand is normal but turning up for smear tests every three years is so important. Tell your nurse that you’re feeling nervous and remember you can always bring a friend or a family member with you.

Also don’t be afraid to ask questions – sometimes knowing exactly what’s going to happen and in what order can help. We don’t mind stopping

No procedure or exam should be painful but it might feel uncomfortable. If it gets too much, tell your nurse – we really don’t mind pausing. Most exams won’t take more than a couple of minutes.

We don’t care what your ‘down there’ looks like! We see hundreds of women every week – and they come in all shapes and sizes. We aren’t here to judge or even look – our job is to check inside the vagina and look at the cervix to make sure everything is healthy.

To keep reading more of Jennifer’s advice and tips, click here.

Jennifer offers a range of Nurse-led services including smear tests from our conveniently located clinic in the City of London, learn more click here.

Genitourinary Syndrome of the Menopause (GSM)

What is Genitourinary Syndrome of Menopause (GSM)

Genitourinary Syndrome of Menopause (GSM), formerly known as Vulvovaginal Atrophy (VVA) or atrophic vaginitis, is a condition that affects many perimenopausal and post-menopausal women. It is a group of symptoms and physical changes in the genital and urinary tract areas, primarily caused by the hormonal changes associated with menopause, particularly the decline in oestrogen levels.

What are The Symptoms of Genitourinary Syndrome of Menopause (GSM)

GSM symptoms encompasses a range of symptoms and can significantly impact a woman’s quality of life. Common genitourinary syndrome of menopause symptoms and manifestations of GSM include:

Vaginal Dryness: A decrease in oestrogen levels leads to reduced vaginal lubrication, resulting in dryness and discomfort.
Vaginal Itching and Burning: The thinning and drying of the vaginal tissues can cause itching and a burning sensation.
Dyspareunia: Painful sexual intercourse is a common symptom of GSM due to vaginal dryness and thinning of the vaginal walls.
Vaginal Discharge: Changes in the vaginal tissues can lead to altered vaginal discharge.
Urinary Symptoms: GSM can affect the lower urinary tract, leading to symptoms like urinary urgency, frequency, and an increased risk of urinary tract infections.
Urinary Incontinence: The weakening of pelvic floor muscles and changes in the urinary tract can contribute to urinary incontinence.
Recurrent Urinary Tract Infections: Thinning of the urethral tissues can make women more prone to urinary tract infections.
Pain or Burning During Urination: Urinary symptoms may also include pain or a burning sensation during urination.

Local Oestrogen Therapy: Low-dose estrogen creams, vaginal tablets, or vaginal rings may be prescribed to deliver estrogen directly to the vaginal tissues. These are very safe and can be used alongside hormone replacement therapy if needed.
Non-Hormonal Moisturisers and Lubricants: Over-the-counter or prescription moisturisers and lubricants can provide relief from vaginal dryness and discomfort.
Pelvic Floor Physical Therapy: This type of therapy can be helpful in managing urinary incontinence and improving pelvic floor muscle tone.
Lifestyle Changes: Staying well-hydrated, maintaining a healthy diet, and practicing stress reduction techniques can contribute to overall vaginal and urinary health.

It’s essential for women experiencing GSM to consult with a doctor to discuss their symptoms and explore appropriate treatment options. With proper management, many women can find relief from the discomfort and distress associated with this condition. If you would like to book in with a menopause specialist, click here.

Menopause Diagnosis: Is There a Menopause Blood Test

Is there a test for the menopause?

Most women will not require a blood test to diagnose the perimenopause or menopause. For most, the menopause diagnosis will be based on your symptoms, your age and your period history.

Blood tests can be helpful in younger women where the perimenopause is questioned, and of course some blood tests can be helpful to look at in order to gauge a picture of your overall health. These tests can be discussed with your doctor.

Menopause and Weight Gain

Does menopause cause weight gain?

Many women find it harder to control their weight as they enter the peri/menopause. Weight gain is complicated and due to a variety of factors:

Fluctuating levels of hormones: As oestrogen levels decline the way the body stores fat changes. Fat is more likely to be stored around the abdomen and thighs and is less evenly distributed compared to perimenopauslly. This can then lead to a change in your body shape even if your weight actually remains the same.
Women’s metabolic rate: (the rate at which you burn calories) slows down. Women often require fewer calories as they transition through this phase meaning that eating the same way as you have done before may cause weight gain.
Muscle mass: We lose muscle mass as we age (known as sarcopenia) and muscle helps to burn calories, less muscle mass means burning fewer calories leading to weight gain.
Symptoms: The menopause symptoms experienced as we transition through this time can be hard to manage – lack of sleep, lack of energy, fatigue, low mood to name a few. This can leave us reaching for the higher energy, less healthy snacks. These symptoms can also reduce our desire to exercise which can lead to weight gain.
Many of us are juggling relationships, work, and our menopause symptoms and we forget to take time to self-care. The stress hormone cortisol can be triggered which also causes us to gain weight

How to manage weight changes in the peri/menopause?

Maintain a Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, eat more protein, and whole grains. Fat is not your enemy – focus on eating good fats like avocados, oily fish, nuts and seeds. In short, eat the rainbow!
Regular Exercise: Engage in regular physical activity to help maintain muscle mass and boost metabolism. A combination of cardiovascular exercise and strength training can be effective.
Stress Management: Practice stress-reduction techniques, such as yoga, meditation, or deep breathing exercises, to manage stress and emotional eating.
Adequate Sleep: Prioritise good sleep hygiene to ensure you get enough rest each night.
Hormone Replacement Therapy (HRT): HRT is an excellent treatment option for managing menopausal symptoms. Discuss the benefits and risks of HRT with your healthcare provider.
Consult a Healthcare Provider: If you are struggling with significant weight gain during menopause, consider consulting a healthcare provider or a registered dietitian or nutritionist. They can provide personalised advice and recommendations.

At London Gynaecology, we have specialist menopause clinicians and nutritional therapists to support you through the menopause, if you would like to book a personalised menopause consultation, click here.

Expert Advice and Care