Sexual Health Issues for Lesbian and Bisexual Women

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There are very few sexual health services specifically for lesbian or bisexual women. Partly due to the epidemiology of HIV (research of epidemic disease) among gay and bisexual men, and this also reflects a wider invisibility of the needs of lesbian/bisexual women in all aspects of health. Some lesbians may feel excluded by the focus of health services on family planning or contraception, or by the assumption that their sexual relationships must be with men. Lesbians and bisexual women are entitled to the same rights to appropriate and respectful services as anyone else.

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Lesbians and bisexual women are generally slightly less likely to be subjected to sexually transmitted infections (STIs) and unwanted pregnancies, but there are risks involved.

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The following provides information on some of the sexual health issues facing lesbians and bisexual women.

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• Oral Sex

• Sex Toys

• Pregnancy

• Thrush

• Bacterial Vaginosis (BV)

• Cervical Cancer

• Breast Cancer

• HIV & AIDS

• Genital Warts (HPV)

• Chlamydia

• Trichmonas Vaginalis (TV)

• Syphilis

• Hepitatis B

• Herpes

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Oral Sex

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Some STIs can be passed on through oral sex between women. There is a relatively low risk of HIV transmission, but the risk is increased if you have cuts or sores on the mouth, or the person receiving oral sex has sores on the genital area, or is having a period. Using dental dams (square of latex) can prevent vaginal fluid or menstrual blood entering into the mouth and reduces the risk of infection.

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Sex Toys

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Using sex toys (vibrators and dildos) plays a major part in the lives of many lesbian and bisexual women. Sharing these toys can transfer sexually transmitted infections if they have vaginal fluid, blood or faeces on them. Clean sex toys well, or put condoms on them, use only on one person.

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Pregnancy

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Lesbians who want to get pregnant need to take care about sperm donors, its advisable to get thorough health checks before going ahead with any attempted insemination. A safer option is to obtain sperm that has been screened for HIV and other sexually transmitted infections from a clinic.

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Thrush

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Thrush is an overgrowth of yeast causing vaginal itching and soreness, often with a white discharge. It can be passed on through sex between women, though oral sex is a low risk, thrush can be treated pessaries, tablets or creams.

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Bacterial Vaginosis

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Bacterial Vaginosis may be linked to the use of scented bath oils and some soaps, treatment is with antibiotics, either tablets or cream.

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Cervical Cancer

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All women lesbian, bisexual, or heterosexual between the ages of 25 and 64 need cervical smears every 3 - 5 years, as sex between women can transmit HPV human papilloma virus, or wart virus, which is associated with cervical cancer early detection improves the likelihood of it being cured.

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HIV & AIDS

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HIV is present in the blood and vaginal fluid (or seminal ) fluid of someone infected with HIV. Lesbians and bisexual women are not at high risk of being infected with HIV through women-to-women sex, However, the risks may increase if there is-

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• Unprotected sex with men

• Inject drugs and share equipment

• Engage in riskier sexual practices, such as sharing sex toys or activity which leads to bleeding or cuts or breaks in the lining of the vagina or anus

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Chlamydia

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Relatively uncommon in lesbians, but it can be passed on through sharing sex toys or close contact with genitals, often there are no symptoms, but may have discharge, signs of infection can also cause pain in the pelvic region. It is easily treated with antibiotics, but left untreated can lead to infertility.

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Trichomonas vaginalis

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This is a tiny parasite found in the vagina and the urethra, the infection causes a frothy, itchy discharge. It is passed on through vaginal contact or sharing sex toys. Treatment is a course of antibiotics.

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Syphilis

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This is very infectious and can be passed by close skin contact during sex or sharing sex toys. Symptoms do not always appear, but may include sores in the vagina, anus or throat. You may also develop a rash on the body and flu-like symptoms. If treated early, syphillis can be completely cured with a course of antibiotics. If left untreated it can lead to mental illness, blindness, heart disease, or even death.

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Hepatitis B

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This is a viral infection which can be passed on relatively easy during sex or when sharing sex toys. It affects people in different ways, and can be serious. A course of vaccinations can be given to protect against the Hepatitis B virus.

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Herpes

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This is a viral infection which cause painful sores on the inside of the vulva, vagina or anus (genital herpes) or on the mouth (cold sores) Herpes can be passed on through contact with a sore by touching, fondling or sharing sex toys, Oral sex, when a cold sore is present, can also transmit the virus to the partner/contact. Treatment with anti viral drugs can reduce painful symptoms and suppress further outbreaks. It is also possible to have the infection, be infectious, and have no symptoms.

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Treatment is available for all the sexually transmitted infection listed above, together with confidential advice from a consultant who specialise in sexual health and HIV. Often treatment is with antibiotics, and most can be cleared up quickly. It is vital to seek help as soon as symptoms develop, and refrain from sexual contact that could pass on any infection until it has be treated.

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Depression and Anxiety

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Lesbians have been shown to experience chronic stress from homophobic discrimination. This stress is compounded by the need that some still have to hide their orientation from family and colleagues at work, and by the fact that many lesbians have lost the important emotional support most others get from their families due to alienation stemming from their sexual orientation. These issues can be discussed with the doctor.

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For confidential advice, screening, and treatment, contact the consultant specialist in sexual health and HIV at the Sunshine Clinic.