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Infections and Health

Divorce, Separation

Sexually Transmitted Disease In Middle-Aged Adults

by Dr. W. Gifford Jones

Saturday, April 22, 2006

"Do you know where your children are and what they are doing?" is a question that often worries parents. Today sexually transmitted disease (STD) is on the rise in the teenage population. But what about the other side of the coin? A recent report shows that there's also good reason for teenagers to ponder, "Where are my parents tonight and what are they doing?" Studies show that STD rates, particularly chlamydia, are soaring in middle-aged adults.

Dr. Colm O'Mahony is a urologist at the Countess of Chester NHS Trust in the U.K. He recently reported to the Women's Health Education and Research Society that there is now a "second wave" of STDs occurring.

The first wave is in the 16 to 21 year old population. The second wave seems to have been triggered by the increasing rate of divorce in the over-40s. Adults appear to have forgotten what they preached to their children. Practice love like porcupines, very, very carefully. This means using condoms to prevent STDs.

Dr. O'Mahony says that the second wave involves not only men, but also women. They start dating again and feel that condoms are just for kids. At this age, for irrational reasons, they feel safe from STDs. But when it strikes, and it's usually chlamydia, it's a major psychological shock. Often they feel too embarrassed to seek help from a sexual help clinic.

The number of people developing chlamydia has become a world-wide public health problem. Dr. O'Mahony reports that in Australia during 2004 there were 36,000 new cases of chlamydia, a 20 percent increase from 2003. In England during 2004 there were 100,000 new cases, again a 20 per cent increase over 2003. And in North America there are similar increases.

I see this problem in my own medical practice time and again. A divorced or separated woman tells me she now has a "new relationship". It's a pleasant—sounding term, and on the surface it appears to be a serious commitment. But there's a problem. The same patient a few months later often reports, "I have another new relationship". And in neither case has anyone thought of using condoms.

Chlamydia is transmitted by vaginal, anal or oral sex. The disease can also be transmitted from an infected mother to her baby during vaginal childbirth. Babies born to infected mothers can get chlamydia infections in their eyes and respiratory tracts, making it a leading cause of early infant pneumonia.

Chlamydia is a "silent" disease as 75 per cent of infected women and 50 percent of infected men have no symptoms. But if symptoms do occur they usually do so in one to three weeks.

In women, bacteria initially infect the cervix (opening into the uterus) and urinary canal. This may cause vaginal discharge or burning on urination.

Men, on the other hand, who have symptoms, usually complain of discharge from the penis and burning on urination. Pain and swelling of the testicles is rare.

Few things in life are fair and in this case it's women who bear the brunt of chlamydia infection. In about 40 percent of untreated cases of chlamydia infection spreads to the internal organs causing pelvic inflammatory disease.

Pelvic inflammatory disease may also be present without symptoms. But some women complain of pelvic discomfort, fever, pain with sexual intercourse and bleeding between menstrual periods. This may result in permanent damage to the fallopian tubes and sterility. Damaged, scarred tubes are also more likely to result in tubal pregnancy.

To prevent this from happening sexually active people should be tested for chlamydia every year or when symptoms appear. And other STDs such as gonorrhea, syphilis and HIV should be ruled out at the same time.

Chlamydia can be easily treated and cured by antibiotics. A single dose of azithromycin or a week of doxycycline taken twice daily are the commonly used treatments.

It's been said that life begins at 40. But divorced or separated people who become sexually involved may get more than they bargained for. They would be well advised to remember that STD sets no limitations on sex, race or whether you're under or over 40. They would be well advised to remember porcupines.


W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

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