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You are here: Home / Love may be eternal, but human sexuality is seeing some trends worth healthy notice

Love may be eternal, but human sexuality is seeing some trends worth healthy notice

Human sexuality is an eternal constant, but the recent global tumult with the pandemic and more underscores some changes in sexual behavior worth paying attention to.  In this newsletter, we focus on five trends. 

PS: Whatever plans you have for Valentine’s Day, I’m hoping you and yours find much satisfaction, affection, joy, and love — and the best health in 2022 and beyond!

1. For the sexually active, risks spike in spread of antibiotic-resistant infections 
 

Getting frisky can be risky these days, with federal authorities reporting that sexually transmitted infections (STIs) have skyrocketed for a half-dozen years now. The spread of infections like syphilis, gonorrhea (antibiotic-resistant variety, shown above), and chlamydia has increased by anywhere from 20% to 70%. It has only worsened as Americans stayed sexually active during the pandemic but with less access to STI testing and care. While these diseases can be knocked down with treatment, notably with antibiotics that are losing effectiveness due to widespread overuse, they can lead to serious, long-term consequences including infertility and blindness.

Syphilis in newborns, though still rare, has been on the increase. In 2019 alone, there were nearly 2,000 cases reported, including 128 deaths. Syphilis in newborns can result in lifelong physical and neurologic problems such as bone deformity, severe anemia, and brain and nerve problems, including blindness. California lawmakers have grown so alarmed about surging STIs that they have required insurers in the state, as of Jan. 1, to cover at-home testing.

2. Progress occurring with once-deadly viral infections

Medical science has made notable advances in preventing and treating the once-deadly and largely sexually transmitted disease HIV-AIDS. A breakthrough also has occurred in preventing female reproductive system cancers and other harms caused by the human papillomavirus virus (HPV). Will individuals’ risky behaviors, though, undercut this progress?

Those infected with the human immunodeficiency virus or HIV — a still too high but declining number — can live relatively healthy and normal lives with powerful antiretroviral drugs that can control the disease and make it a chronic condition. The medications, which have increased in number and become easier to use, can have unpleasant side effects like nausea, diarrhea, and fatigue. This is also true for antiviral drugs that can be highly effective in preventing HIV in a regimen dubbed PrEP (pre-exposure prophylaxis). Regular, sustained use of HIV-related drugs is necessary to prevent and treat the disease. Infected patients can see the load of the virus in the body diminish to undetectable levels — important in significantly reducing transmission risks. Doctors urge patients with HIV or on PrEP to use safe sex practices (especially condoms) to protect themselves from other STIs not prevented by drugs.

As for HPV, a two-dose vaccination given to 11- and 12-year-old boys and girls before they become sexually active, has proven to be safe and effective in slashing genital infections shown to cause cancer of the cervix and other female reproductive parts and the throat. The shots, which can be given to kids as young as nine, was shown to decrease HPV infections by 86% in female teens ages 14 to 19 and by 71% in women in their early 20s. But wider use of this valuable safeguard, which also is recommended for older teens and other young people, has hit a stumbling block: parental reluctance to talk with their kids about why they might get the shot or their misplaced belief that getting it will lead to early sexual activity.

3. Sex now detached from baby making 

Procreation was once a prime purpose – or at least outcome — of sex. In much of the world, including the U.S., that’s no longer true.  We’re making fewer babies, even as we have been shut in with partners during the pandemic. Those of prime family-raising age (50 and younger) are telling pollsters, “We don’t want kids” or “We’ll try for fewer of them.” As the respected Pew Research Center reported in November:

“Birth rates in the United States dropped during the Covid-19 pandemic amid the twin public health and economic crises, lending evidence to predictions from early on in the outbreak that economic uncertainty might trigger a baby bust. This continued the downward trend in U.S. fertility rates, which were already at a record low before the pandemic began. A new Pew Research Center survey finds that a rising share of U.S. adults who are not already parents say they are unlikely to ever have children, and their reasons range from just not wanting to have kids to concerns about climate change and the environment.”

4. Boomers push bounds of later-life sex 

Baby boomers were at the fore of the sexual revolution in the 1970s, and now that many are in their own 70s, they’re rewriting the expectations, attitudes, and practices regarding sex in later life.

Here’s what the trend-tracking magazine Fast Company reported: “While research on senior sexuality lagged until the ’90s, we now have a pretty clear picture that stereotypes around sex and aging are wrong. A majority of seniors are sexually active into their 70s. A majority of that subset still have vaginal intercourse, while many masturbate and practice oral sex. A quarter of all people who are sexually active between ages 75 and 85 reported having sex at least once a week. And without the concern of getting pregnant, many opt not to use protection and so sexually transmitted infection (STI) rates can actually balloon later in life.”

The New York Times magazine, in a chronicle of the longevity of one older couple’s sexuality, reported this: “[A]s baby boomers, who grew up during the sexual revolution of the 1960s and 1970s, age — the oldest are about 75 — many sex experts expect they will demand more open conversations and policies related to their sex lives. A subset of older people who are having lots of sex well into their 80s could help shape those conversations and policies … Along with pleasure, [active older adults] may be getting benefits that are linked to sex: a stronger immune system, improved cognitive function, cardiovascular health in women and lower odds of prostate cancer. And research — and common sense — suggests, too, that sex improves sleep, reduces stress, and cultivates emotional intimacy.”

5. U.S. sexual mores see major shifts

The shifts may not be occurring as fast as advocates would wish. But U.S. sexual mores are changing in many ways.

As USA Today, for example, reported about lesbians, gays, transgender and queer people: “More and more people are identifying as members of the LGBTQ community. Increased visibility educates non-LGBTQ people [according to a 2021 study by GLAAD — the Gay and Lesbian Alliance Against Defamation — that found] that 43% of non-LGBTQ people think gender is not exclusively male and female, up from 38% in 2020. And 81% of non-LGBTQ people anticipate nonbinary and transgender people will become as familiar in everyday life as gay and lesbian people have.”

Pew researchers, meantime, have reported that “Premarital sex is largely seen as acceptable, but more Americans see open relationships and sex on the first date as taboo. Most adults (65%) say sex between unmarried adults in a committed relationship can be acceptable, and about 6 in 10 (62%) say casual sex between consenting adults who aren’t in a committed relationship is acceptable at least sometimes. While men and women have similar views about premarital sex, men are much more likely than women to find casual sex acceptable (70% vs. 55%). Americans are less accepting of other practices. For example, open relationships – that is, committed relationships where both people agree that it is acceptable to date or have sex with other people – are viewed as never or rarely acceptable by most Americans.”

Doctors and patientscan really improve their talks about sex

Doctors and patients agree: It isn’t always easy to talk about sex. Each side may worry about embarrassing the other or intruding into unwelcome, deeply personal territory. But doctors see patients naked, and have, for professional reasons, intimate  contact with those in their care.

Still, as the New York Times reported: “Many primary-care doctors don’t raise the topic either. The American Medical Student Association says 85% of medical students report receiving fewer than five hours of sexual-health education  … If a man complains of erectile problems, doctors often offer drugs like Viagra and Cialis. But these can have side effects and are contraindicated with some medications … For women, the medication Addyi does very little to increase sexual desire and is only for premenopausal women. And while doctors may offer women cream or vaginal rings with estrogen, few provide tips about sexual alternatives to penetration when it hurts. ‘Most physicians don’t ask questions and don’t know what to do if there’s a problem,’ says Dr. June La Valleur, a recently retired obstetrician-gynecologist and associate professor who taught at the University of Minnesota’s medical school. ‘They think their patients are going to be embarrassed. In my opinion, you cannot call yourself a holistic practitioner unless you ask those questions.'”

U.S. News and World Report has posted a helpful guide for patients about productive ways to talk to medical caregivers about sex, urging them to be candid, direct, not to wait until problems turn into dysfunction or worse, and to use language and terms with which they are comfortable.

Good sex can have health benefits — and vice-versa

More people should know about this two-way street: Good sex can be beneficial to your good health. And your good health can be beneficial to your enjoying good sex.

Individual needs and practices vary greatly. But researchers say that grownups having sex may see cardiovascular benefits, lower stress, reduced blood pressure, better sleep, and stronger mental health. It may benefit men’s prostate health and help women avoid cramping and problems with the reproductive systems.

Sexual dysfunction can provide important warnings about big health challenges — and patients should discuss their issues with their doctors, pronto and without embarrassment. Lack of desire, for example, may offer clues to a savvy diagnostician that a male or female patients could be struggling with depression or other mental problems. Men may not be prepared to deal with serious cardiovascular and other health problems until it harms their sexual performance. Similarly, patients may try to ignore risky side effects of their prescription medications — until these affect their love lives.

Newsletter photo and illustration credits: Unsplash, National Cancer Institute, and federal Centers for Disease Control and Prevention,

Recent Health Care Blog Posts

Here are some recent posts on our patient safety blog that might interest you:

  • Here’s a bit of good news that may make patients jump for joy to start off 2022: Surprise medical bills mostly are supposed to end, effective Jan. 1. Consumers still must watch out for potential big hits on their emergency transportation costs and they will need to ensure scheduled services with medical providers occur “in network.”
  • Expectant parents have gotten an ugly exposure to a rapacious aspect of modern medicine: Over testing, over diagnosis, and over treatment, specifically with a new, fast-growing high-tech twist. The grownups — whether over-reaching to safeguard the unborn or in a simply silly way to determine the gender of their hoped-for bundle of joy — are ordering unnecessary, expensive, and too often alarming prenatal genetic blood tests. These rapid exams purport to tell whether a fetus may have the rarest of congenital diseases, the New York Times reported in some admirable digging, triggered by a stack of patients’ surprise medical bills. Reporters Sarah Kliff and Aatish Bhatia found a big problem with the high-tech prenatal screens: The tests too often are dead flat wrong.
  • It has no artificial replacement. Patients can require enormous amounts of it, suddenly and quickly, as well as on a sustained basis. But safe, abundant supplies of blood are desperately needed now, the Red Cross says, having declared what it says is its first-ever national crisis with the country facing its most dire shortages in a decade. The coronavirus pandemic has disrupted donations, which already were spare, says the nonprofit agency that collects 40% of the nation’s supply. In more regular times, just 3% of those who are eligible donate blood, and donations have fallen off a cliff since the pandemic started. Demand, however, persists.
  • The return of harsh winter conditions also has provided a tough reminder for homeowners and renters to redouble their fire safety and carbon monoxide precautions. It’s a must to triple-check alarms, indoor space heaters, and power generators, and ensure that everyone in the household knows about the deadly risks.
  • As the nomination of Dr. Robert Califf to head the federal Food and Drug Administration advances, he and the agency already are confronting a major regulatory crisis over Aduhelm, a prescription drug targeted for Alzheimer’s treatment and approved on the thinnest of evidence. An FDA sister agency, the Centers for Medicare and Medicaid Services (CMS), has joined the Department of Veterans Affairs in sharply restricting Aduhelm’s use and coverage for payment.
  • As experts drill down to discover why nursing homes and other long-term care facilities are not playing a vital role in the U.S. health system by admitting improving patients from costly care in overwhelmed hospitals, a disconcerting explanation is emerging on who is filling some of the invaluable institutional space. They might be called system hostages of sorts, poorer residents of nursing homes and other facilities whose condition has gotten better but who are trapped in institutions for distinct reasons, including the grim reality that they owe money they cannot pay, according to Jesse Bedayn of the nonprofit news site CalMatters.
HERE’S TO A HEALTHY 2022!

Sincerely,

Patrick Malone
Patrick Malone & Associates

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