Body image, sex and dating again
Undressing in front of someone new after fifteen or thirty years is a specific kind of frightening, and almost nothing written for divorced people addresses it directly. This page is frank rather than coy, and it includes the sexual health conversation that people over fifty are systematically not having with their doctors.
Body Image and Dating Again
Returning to dating after a long monogamous relationship means navigating body image in a body that has likely changed, plus a genuinely different sexual health landscape than the one you left. STI rates among adults over 50 have risen sharply, testing habits have not caught up, and both perimenopausal and midlife-male sexual changes are physiological, not just emotional.
STI diagnoses among adults aged 55 and older have risen sharply over the past decade, driven partly by more people dating again later in life without updated safer-sex habits.
Reported consistently, not settled
CDC surveillance data compiled in the National Center for HIV, STD, and TB Prevention Atlas show large increases in diagnosed cases among adults 55 and older between 2012 and 2022: chlamydia diagnoses rose from roughly 13,774 in 2020 to about 19,766 in 2022, syphilis rose from about 712 cases in 2012 to about 5,160 in 2022, and gonorrhea rose from about 3,874 cases in 2012 to about 18,804 in 2022. These are large multi-year increases in an age group that has historically had low STI testing rates.
Routine STI screening recommendations from the CDC are based on age and risk factors like new or multiple partners, not marital status, which matters directly for someone dating again after decades with one partner.
The CDC’s 2021 STI treatment guidelines recommend that sexually active people with a new or multiple sex partners be screened for chlamydia, gonorrhea, and syphilis regardless of age, and that HIV testing be offered whenever someone or their partner has had more than one sex partner since their last HIV test. In practice, this means a newly single adult in their 50s or 60s with a new partner meets the same screening indication as a 25-year-old with a new partner, even though clinicians often do not think to offer it.
Hormonal contraception can generally continue safely into a healthy woman’s early to mid-50s, and stopping is usually guided by age rather than lab testing.
Reported consistently, not settled
For healthy, nonsmoking women without cardiovascular risk factors, combination hormonal contraceptives remain an option with no contraindication based on age alone into the early-to-mid 50s, per guidance referencing ACOG, The Menopause Society, and CDC contraceptive eligibility criteria. Since the median age of menopause is 52 and about 90 percent of women have reached menopause by 55, most guidance uses age rather than FSH hormone testing to decide when contraception can stop. Women with cardiovascular risk factors are steered toward progestin-only pills or long-acting reversible methods instead.
Vaginal dryness and tissue changes from declining estrogen, known as genitourinary syndrome of menopause, are extremely common and directly affect comfort during sex, independent of relationship status.
Genitourinary syndrome of menopause, which includes vaginal dryness, thinning tissue, and reduced elasticity, affects a large share of postmenopausal women and is under-diagnosed and under-treated because many women do not bring it up with clinicians. It is a physical, treatable condition with options ranging from vaginal moisturizers and lubricants to local low-dose vaginal estrogen, not a permanent consequence people simply have to live with.
CDC surveillance data show diagnosed STI cases in adults 55 and older rising sharply over the past decade. Screening recommendations are based on your actual sexual activity and partner count, not your age.
Ovulation continues, often irregularly, throughout perimenopause, and pregnancy remains possible until true menopause is confirmed. Most guidance recommends continuing contraception until around age 55 or until menopause is clinically confirmed.
Kaunitz AM, as reported in AJMC clinical guidance coverage, 2025, American Journal of Managed Care
What to actually do
- Get an STI panel before becoming sexually active with a new partner, and again on a routine schedule if you have multiple or new partners; do not assume your age exempts you.
- Bring up vaginal dryness or discomfort with a clinician directly. Effective, low-risk treatments exist and most go undiscussed simply because no one raises it first.
- If you are perimenopausal and dating, do not assume irregular periods mean you cannot get pregnant; talk to a clinician about contraception timing before you need it.
- Body image after a long relationship ending is a real adjustment, not a character flaw; many people report needing time to feel comfortable being seen by someone new, and that is a normal part of the transition, not a sign something is wrong with you.
- Do not skip STI testing out of embarrassment about your age or relationship history; clinicians see this constantly and rising rates in older adults mean it is a genuinely relevant precaution.
- Erectile changes and vaginal changes with age are physiological and common; both are worth discussing with a doctor rather than assuming they are unfixable or unique to you.