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Gay health - Sexual health for lesbian and bisexual women

NHS ChoicesFeature

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Women who have sex with other women can pass on or get STIs. Know how to protect yourself.

Lesbians and bisexual women are not immune from sexually transmitted infections (STIs), yet can be complacent about getting tested for them, according to Ruth Hunt at the charity Stonewall. 

Sometimes, lesbian and bisexual women are told they don't need to be tested for STIs. This is not the case.

A survey of lesbian and bisexual women by Stonewall revealed that half of those who have been screened had an STI. And of those women who had an STI, one in four had only had sex with women in the previous five years.

"Women can catch STIs such as herpes, genital warts and chlamydia when exchanging bodily fluids," says Hunt.

"Any one-on-one contact, such as oral sex or using the same hand when touching yourself and then your partner, can put you at risk. Two women that are both menstruating are at a higher risk, too.

Tips for safer sex between women

  • If you're using sex toys, use a new condom for each partner or between penetration of different orifices. Sex toys should be washed with soap and water between sessions. Find out more about cleaning sex toys.
  • Avoid oral sex if either of you has any cuts or sores in the mouth or on the lips, or use a dental dam. A dental dam is a latex or polyurethane (very thin, soft plastic) square, of about 15cm by 15cm, which you can use to cover the anus or female genitals during oral sex. It acts as a barrier to help prevent sexually transmitted infections passing from one person to another.
  • Some infections can be transmitted by hands, fingers and mutual vulval rubbing. Wash your hands before and after sex.
  • Wear latex gloves and use plenty of water-based lubricant for vaginal and anal fisting.

Tips for safer sex with men

If you have vaginal, anal or oral sex with a man, use a condom. When used correctly, condoms protect against unintended pregnancy and STIs. In addition to using condoms, find out about the form of contraception that suits you best.

If you think you may be at risk of unintended pregnancy, emergency contraception (the 'morning after' pill) is available from pharmacies, your GP, hospital, family planning clinics and some sexual health clinics.

Vaginal health

The vagina is self-cleansing, so there's no need to wash inside it (douching). Vaginal soreness and vulval irritation can be caused by over use of perfumed soaps, bubble baths and shower gels.

Read how to keep your vagina clean.

After going to the toilet, always wipe from front to back (from vagina to anus).

Read more about vagina health.

Symptoms of STIs

Thrush

Thrush is caused by an overgrowth of yeast called candida. Symptoms may include vulval and vaginal itching, pain and soreness on penetration, burning when passing urine and a thick, white discharge.

It's possible for women to transmit thrush during sex through touching and sharing sex toys. Thrush can be treated with medicated cream, pessaries and tablets, which can be bought from a chemist. Go to your GP if your symptoms persist. Read more about thrush.

Genital herpes

This is caused by a virus, which can spread if you have vaginal, anal or oral sex, or share sex toys. It can also cause cold sores on the mouth and nose.

Symptoms include painful blisters and ulcers around the genital area, although some women may have no symptoms.

Anti-viral tablets can help the healing process and shorten the length of the episode. Read more about genital herpes.

Genital warts

These are fleshy growths in the vulval and anal region. They may be itchy but are usually painless.

They are caused by certain strains of human papilloma virus (HPV), which are usually sexually acquired through skin contact, such as rubbing vulvas together.

Women with genital warts do not need more regular smear tests than those without them. There are a variety of treatment options, including freezing and medicated creams. Read more about genital warts.

Trichomonas vaginalis (TV)

TV can be passed between women during any sexual activity that involves the exchange of vaginal fluid.

Symptoms include a frothy discharge, discomfort when passing urine, vulval soreness, and sometimes an unpleasant vaginal odour. Some women don't have any symptoms. TV is treated with antibiotics.

Read more about trichomonas.

Chlamydia and gonorrhoea

These STIs are caused by bacteria, which can infect the cervix, rectum, throat and urethra. There may be a discharge but usually there are no symptoms.

If the conditions are not treated, the bacteria may lead to an infection in the fallopian tubes and infertility.

Chlamydia and gonorrhoea can be passed between women through shared sex toys, hands and by rubbing vulvas together. Treatment is with antibiotics.

Read more about chlamydia and gonorrhoea.

Syphilis

Syphilis is a bacterial infection that causes a painless ulcer, usually in the genital area. It will disappear on its own but other symptoms may appear. These can include a rash on the body and swollen glands.

If it is not treated, syphilis can cause serious nerve and body organ damage later in life.

In its early stages, syphilis is extremely infectious and can be passed on by close skin contact during sex. Treatment is with antibiotic injections or tablets.

Read more about syphilis.

When to see a doctor

If you have any of the symptoms above or are worried you may have an STI, speak to your GP or visit an STI clinic. Getting tested regularly is a good idea to ensure you have a healthy sex life. NHS services are free.

Find your local sexual health services.

Read more about STIs.

Medical Review: June 08, 2012

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