When we talk about safe sex, we are usually referring to using condoms. That's a good start, but it is much more than that.
Safe sex truly means reducing your risk of contracting a STI (sexually transmissible infection). Although condoms can greatly reduce the risk, they are not 100% reliable, as they can break, tear, or fall off. Plus, they must be used for all encounters that involve vaginal, anal, and oral sex. Condoms that are latex or polyurethane are best, since lambskin condoms do not prevent all STI's.
Let's go through the many considerations.
First of all, can you still get pregnant? Many women who are peri-menopausal may still be fertile. Using adequate birth control is recommended for one year after the last menstrual period. See Measuring Menopause.
But, if your are at this website, you may have reached menopause and don't have to worry about pregnancy. Many women may find themselves considering having sex after a divorce or loss of a spouse, and the rules have changed since they last entered into a new relationship.
The first rule is: Know your sexual partner. Many adults over the age of 50 have had multiple sexual partners. An honest discussion regarding a history of previous partners, whether there is a known STD and whether it has been treated, and if there is a history of having sex with individuals at high risk is mandatory. High risk behaviors include IV drug use, anal sex, having sex with prostitutes, having sex with individuals who are at high risk, and a man who is also having sex with other men. Some STI's are not curable. They include HIV, HPV, and herpes. Condoms can prevent contact with secretions that transmit HIV, but HPV and herpes are spread by skin contact, and some areas of skin are not covered by a condom.
Rule number two is: Get tested. Before entering into a new sexual relationship, ask your partner to be tested. You should be tested, too. This is OK! Sometimes these discussions can be difficult, but if you accept that this is so important to your health, you will be protecting both yourself and your partner. A visit to a primary care physician or gynecologist will include vaginal swabs and blood tests to determine if there is an STI present. See Understanding Sexually transmitted infections.
The next rule which was already discussed is: Use Condoms. Condoms should be used for vaginal, anal and oral sex. Condoms should be used with lubricants, as dryness increases the risk of a condom breaking or tearing. Plus, breaks in the skin, which can occur with intercourse that causes a vaginal tear or abrasion, increases the risk that an STI can get into the bloodstream. This is an important reason for menopausal women to use lubricants or perhaps, vaginal estrogen to improve the integrity of the vaginal tissue. Lubricants that are water or silicone based are less likely to cause deterioration of a condom, therefore, oil based lubricants are not recommended.
If sex toys are used, they should be carefully cleaned after use. There are usually instructions about proper cleaning that will be included in the product literature.
There are now several drugs that can be used for prevention. Antivirals can be used by a person with herpes, to reduce outbreaks and also the risk of shedding the virus during sexual encounters. There is also a medication for pre-exposure prevention of HIV. This drug, if taken in a population at high risk of contracting HIV, will greatly reduce the possibility of infection.
It is generally recommended that condoms be used for six months after the onset of sexual activity with a new partner. It can take up to six months for a person who is infected with HIV to test positive. Retesting is recommended, and then if the relationship is consistently monogamous, condoms can be stopped.
The safest sex is a mutually monogamous relationship. If your are exposed to multiple partners, it is best to know the symptoms of STI's and to be tested frequently.
Following the suggestions discussed can prevent avoidable diseases and a lot of grief!