Norman Swan: Hello and welcome to the Health Report with me Norman Swan. Today: A salutory story for older internet daters and some deficiencies in the raincoat department, plus some new research into cosmetic surgery which is good news for what they call dermal fillers and, if your face still has any mobility left at all after your botox and fillers some news about oral sex. But you'll have to hang on for that.

Let's start with that internet dating story. Research into the behaviour of older women in the dating market suggests they need to take a bit more care. Dr Deborah Bateson is Medical Director of Family Planning NSW which carried out the study.

Deborah Bateson: The background is that we realised in our clinics that we were seeing more women in their 40s, 50s even 60s coming in asking about having an STI test, sexually transmitted infection, and we realised we were also diagnosing more STIs particularly Chlamydia in this older group of women. We realised this was reflected in the national notification rates for STIs, so the Chlamydia rates were going up in older women as well as younger women.

Norman Swan: So this wasn't just what you'd been used to which is younger women with their first or early sexual experiences, this was the mature woman?

Deborah Bateson: That's right, we were certainly seeing a change and we wanted to try and work out what was happening, what was behind this.

Norman Swan: So what did you do?

Deborah Bateson: We know that about 1 in 3 marriages ends in divorce and we know that the women have an increasing expectation of re-partnering later in life and that the internet, internet dating in particular can facilitate this. Internet dating is affordable, it's accessible and it's increasingly acceptable. So we approached a large internet dating service -

Norman Swan: Before you go on, you'd asked these women so you'd got a sense that this was what might have been going on with these women?

Deborah Bateson: I think just anecdotally, I mean certainly in our clinical setting and certainly amongst my friends and colleagues we knew that women were using internet dating to meet new partners.

Norman Swan: And when you asked say a 60 year old woman who's coming in with Chlamydia or something even more serious than Chlamydia, what did they say to you, what was the story typically that you got from them before you did your survey?

Deborah Bateson: Very mixed stories but often it was 'look I didn't know much about this, I sort of know about condoms but I didn't know how to negotiate using condoms in that new relationship'.

Norman Swan: So it was almost like adolescence all over again.

Deborah Bateson: It is, and many of these women obviously if you're 50 now you would have been 20 what 30 years ago and you may well have missed out on those safe sex messages and certainly you're not targeted in many of today's campaigns.

Norman Swan: So you approached an internet dating service?

Deborah Bateson: We did and they were very amenable, they had a sense of social responsibility, they also realised that this older group of women often missed out on this information about how to negotiate safe sex in new relationships, or just how to negotiate new relationships.

Norman Swan: What did they know about this before you spoke to them?

Deborah Bateson: It was something that they sort of knew about but hadn't really thought about. Obviously again we tend to think of STIs in young people and it's true that the burden of STIs lies with young people. But this is a neglected group and I have to say we also found some very interesting research from the UK where they talk to GPs and these GPs said 'yes, we do neglect sometimes to give safe sex information to this group of women. We feel a bit embarrassed about raising it, we make false assumptions. We assume that the older woman sitting before us isn't sexual at all let alone meeting new partners on the internet'.

Norman Swan: What questions did you ask and how did you ask them?

Deborah Bateson: The dating service sent an email to women who'd recently logged onto their service. In fact they sent it to about 9,000 women at 40 and above, we had a couple of 70 year olds in our sample.

Norman Swan: Good luck to them.

Deborah Bateson: That was very good and they also sent it to 5,500 women aged 18 to 39 and this email invited them to click on the link to our survey which was posted on our family planning NSW site.

Norman Swan: What questions did you ask?

Deborah Bateson: We wanted to know why they were using internet dating and in fact most said they were looking for a long term partner, 65% said that. We wanted to find out whether they had met new partners and we divided these women into I hate to say it, we said older group 40 and above, I have to say I'd be ancient in that group, and 18 to 39 and what we found was that younger women not surprisingly reported meeting more new sexual partners overall in the previous year, but in fact the older women had met just as many new sexual partners via the internet in the previous year as the young women. And in fact about 42% of women in each age group had met or reported meeting a new sexual partner in the previous year.

Norman Swan: Did you ask them about safe sex in that environment?

Deborah Bateson: We asked them some hypothetical questions. If you were meeting a new partner would you carry out these safe sex behaviours? So one of the questions for instance and one of the most important questions was if you were to meet a new partner would you refuse unprotected sex, would you refuse sex without a condom with that new partner? And what we found was that the women who were 40 and above were actually riskier so they were less likely to refuse and they were more likely to agree to sex without a condom with a new partner than the younger women.

Norman Swan: Because they were probably thinking more about pregnancy than sexually transmittable diseases.

Deborah Bateson: There are all sorts of other reasons as well. It's easy in some ways to think oh well maybe the older women just don't have as much information, as much knowledge as the young people.

Norman Swan: You can also imagine that they might lack a bit of confidence if they've just had a long term marriage that's broken up, they're in their 50s and not necessarily feeling that good about themselves. That lack of confidence which you usually ascribe to young adolescent women may actually apply to them as much if not more.

Deborah Bateson: I think that's absolutely right, we didn't find it in our study but overseas research has shown this particular group called the recently single group, women who have come out of a long term relationship who are now emerging on the dating market again, renegotiating new relationships, they may be particularly at risk of not using condoms and actually being unsafe when it comes to negotiating condoms. We did a little knowledge quiz and we didn't find much difference in fact between the older and younger women although slightly fewer of the older women knew that Chlamydia could have no symptoms for instance. And we also asked about whether women were comfortable carrying or buying condoms and again there was no difference between the age groups. But when it comes to negotiating their use that's where things seem to be a little bit different in the older group.

Norman Swan: Did you ask them about their experience of sexually transmittable diseases, whether they've had one?

Deborah Bateson: That was a little bit difficult to determine what was going on; obviously it was just their report.

Norman Swan: What did you do about this?

Deborah Bateson: Some of the other research has suggested that there are other reasons behind this non-condom use which I think is certainly useful to address. Some as you've said women may feel a bit invincible, they may feel that they've got this far in life and they are not at risk they may feel equally 'so what if I have an STI I'm no longer worried about fertility' and Chlamydia as we know can cause fertility problems but obviously there's still very good reasons to avoid STIs.

Norman Swan: Which are?

Deborah Bateson: Well for these women if they develop Chlamydia they can certainly develop ongoing pain. It's interesting actually Norman because about a third of the women in our survey gave us their contact details and were very keen to be involved in helping develop resources for other women who were negotiating new relationships at this later stage of life.

Norman Swan: They gave you contact details for what was really quite an intimate survey - that's incredible.

Deborah Bateson: Yes absolutely, so they were very happy for us to contact them again at a later date. When we first went live with this survey it was a rather quiet Tuesday morning and when we put the survey out within 4 hours we actually had almost 400 completed responses.

Norman Swan: So you're tapping into something there.

Deborah Bateson: Absolutely.

Norman Swan: Have you any idea what men in their 40s and 50s would say?

Deborah Bateson: There has actually been a little bit more research on older men and again we know that men are not using condoms in these older ages as much as they should. I mean there can be concerns around erectile difficulty for instance, certainly we can't just talk about the women in isolation, we've got to include the men in there as well and I think it's an area that's been much neglected.

Norman Swan: Dr Deborah Bateson is Medical Director of Family Planning NSW. And you're listening to the Health Report here on ABC Radio National with me Norman Swan.