Lesbians
and bisexual women are at risk for not getting good health care. Some of the
reasons for this are:
* Being
scared to tell your doctor about your sexuality or your sexual history
* Having
a doctor who does not know your disease risks or the issues that affect
lesbians and bisexual women
* Not
having health insurance. Many lesbians and bisexuals don’t have domestic
partner benefits. This means that one person does not qualify to get health
insurance through the plan that the partner has
* Not
knowing that lesbians are at risk for STIs and cancer
For these
reasons, lesbian and bisexual women often avoid routine health exams. They
sometimes even delay seeking health care when feeling sick. It is important to
be proactive about your health, even if you have to try different doctors
before you find the right one. Early detection – such as finding cancer early
before it spreads – gives you the best chance to do something about it. That’s
one example of why it’s important to find a doctor who will work with you to
identify your health concerns and make a plan to address them.
Are lesbian and bisexual women a risk of getting
sexually transmitted infections (STIs)?
Women who
have sex with women are at risk for STIs. Lesbian and bisexual women can
transmit STIs to each other through:
*
Skin-to-skin contact
* Mucosa
contact (e.g., mouth to vagina)
* Vaginal
fluids
*
Menstrual blood
Some STIs
are more common among lesbians and bisexual women and may be passed easily from
woman to woman. Other STIs are much less likely to be passed for woman to woman
through sex. When lesbians get these less common STIs, it may be because they
also have had sex with men, especially when they were younger. Bisexual women
may be more likely to get infected with STIs that are lesson common for
lesbians, since bisexuals have typically had sex with men in the past or are
presently having sex with a man.
Common
STIs that can be passed between women include:
Bacterial vaginosis. BV is
more common in lesbian and bisexual women than in other women. The reason for
this is unknown. BV often occurs in both members of lesbian couples. Sometimes
BV causes no symptoms. But over one-half of women with BV have vaginal itching
or discharge with a fishy odor. BV can be treated with antibiotics.
Chlamydia. Chlamydia is caused by bacteria.
It’s spread through vaginal, oral, or anal sex. It can damage the reproductive
organs, such as the uterus, ovaries, and fallopian tubes. The symptoms of
chlamydia are often mild – in fact, it’s known as a “silent infection.” Because
the symptoms are mild, you can pass it to someone else without even knowing you
have it. Chlamydia can be treated with antibiotics. Infections that are not
treated, even if there are no symptoms can lead to:
* Lower
abdominal pain
* Lower
back pain
* Nausea
* Fever
* Pain
during sex
*
Bleeding between periods
Genital herpes. /genital herpes is an STI caused by
the herpes simplex viruses type 1 or type 2. It most commonly causes infections
of the mouth and lips, called “fever blisters” or “cold sores.” You can spread
oral herpes to the genitals through oral sex. Most people have few or no
symptoms from a genital herpes infection. When symptoms do occur, they usually
appear as one or more blisters on or around the genitals or rectum. The
blisters break leaving tender sores that may take up to four weeks to heal.
Another outbreak can appear weeks or months later. It is almost always less
severe and shorter than the first outbreak. Although the infection can stay in
the body forever, the outbreaks tend to become less severe and occur less often
over time. You can pass genital herpes to someone else even when you have no
symptoms. There is no cure for herpes. Drugs can be used to shorten and prevent
outbreaks or reduce the spread of the virus to others.
Human papillomavirus. HPV can
cause genital warts. If left untreated, HPV can cause abnormal changes on the
cervix that can lead to cancer. Most people don’t know they’re infected with
HPV because they don’t have symptoms. Usually the virus goes away on its own
without causing harm, but not always. Lesbians and bisexual women can transmit
HPV through direct genital skin-to-skin contact, touching, or sex toys used
with other women. This is why regular Pap tests are just as important for
lesbian and bisexual women as they are for heterosexual women. There is no
treatment for HPV, but a healthy immune system can usually fight off HPV
infection.
Trichomoniasis. Trichomoniasis is caused by a
parasite that can be spread during sex. You can also get trichomoniasis from
contact with damp, moist objects, such as towels or wet clothes. Trichomoniasis
can be treated with antibiotics. Symptoms include:
* Yellow,
green, or gray vaginal discharge with a strong odor
*
Discomfort during sex and when urinating
*
Irritation and itching of the genital area
* Lower
abdominal pain
Gonorrhea. Gonorrhea is a common STI but it is
not commonly passed during woman to woman sex. However, it could be since it
does live in vaginal fluid. It is caused by a type of bacteria that can grow in
warm, moist areas of the reproductive tract, like the cervix, uterus, and
fallopian tubes in women. It can also grow in the mouth, throat, eyes, and
anus. Even when women have symptoms, they are often mild and are sometimes
thought to be from a bladder or other vaginal infection. Gonorrhea can be
treated with antibiotics.
Hepatitis B. Hepatitis B is a liver disease
caused by a virus. It is spread through bodily fluids, including blood and
vaginal fluid. There is a vaccine that can protect you from hepatitis B. Some
women have no symptoms if they get infected with the virus. Women with symptoms
may have:
* Mild
fever
*
Headache and muscle aches
*
Tiredness
* Loss of
appetite
* Nausea
or vomiting
* Diarrhea
*
Dark-colored urine and pale bowel movements
* Stomach
pain
* Yellow
skin and whites of eyes
Syphilis. Syphilis is an STI caused by
bacteria. It is passed through direct contact with a syphilis sore during
vaginal, anal, or oral sex. Untreated syphilis can infect other parts of the
body. It is easily treated with antibiotics. Syphilis is very rare among
lesbians. But, you should talk to your doctor if you have any sores that don’t
heal.
HIV/AIDS. The human immunodeficiency virus
(HIV) is spread through body fluids, such as blood, vaginal fluid, semen, and
breast milk. It is primarily spread through sex with men or by sharing needles.
Women who have sex with women can spread HIV, but this is rare. Some women with
HIV may have no symptoms for 10 years or more. Women with HIV symptoms may
have:
* Extreme
fatigue
* Rapid
weight loss
*
Frequent low-grade fevers and night sweats
*
Frequent yeast infections (in the mouth)
* Vaginal
yeast infections
* Other
STIs
* Pelvic
inflammatory disease in the uterus, ovaries, or fallopian tubes
* Red,
brown, or purplish blotches on or under the skin or inside the mouth.
AIDS, or
acquired immunodeficiency syndrome, is the final stage of HIV infection. HIV
infection turns to AIDS when you have one or more opportunistic infections,
certain cancers, or a very low CD4 cell count.
It is
common for lesbians not to think about STIs or the consequences they can cause.
If you don’t have a doctor who knows you are a lesbian and your history or who
are not knowledgeable about the health concerns lesbians have, you run the risk
of missing them. It is important to find a doctor who is sensitive to your
needs and will help you get regular check-ups. The Gay and Lesbian Medical
Association provides online health care referrals. You can access its Provider
Directory or contact the Association at 202-600-8037.
