Lesbian and bisexual women

LESBIAN AND BISEXUAL WOMEN

SEXUAL HEALTH

Lesbian and bisexual women can catch STIs such as herpes, genital warts, chlamydia, gonorrhoea, trichomoniasis and syphilis when exchanging body fluids with other women.

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. If women are menstruating the risk is higher.

The risk of female-to-female sexual transmission HIV is extremely rare, with only a handful of reported cases. Transmission is possible through sharing of sex toys and exposure to blood during sex. Download this fact sheet with its specific HIV prevention tips and facts on HIV for Women Who Have Sex with Women http://www.avert.org/lesbians-bisexual-women-sex.htm

TIPS FOR SAFER SEX BETWEEN WOMEN

If you're using sex toys, use a new condom for each partner or between penetrations of different body openings. Sex toys should be washed with soap and water between sessions. Check out our section on using sex toys safely.

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 BISEXUAL WOMEN ON 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. Check out our section on contraception.

If you think you could be at risk of unintended pregnancy, you have the option of using emergency contraception ("morning after" pill or an IUD)

Emergency Contraception is available from:

Your GP
Out of Hours
Sexual Health clinics
C2U drop-in clinics
Emergency Departments
All pharmacies (if you are age 13 years or older)

Coils can be fitted either at Sexual Health (phone 0345 702 3687) or through some GP practices.

SYMPTOMS OF STIs IN WOMEN

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.

Antiviral tablets can help the healing process. 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 the 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.

Trichomoniasis

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

Symptoms include a frothy discharge, pain when peeing, vulval soreness, and sometimes an unpleasant vaginal odour. Some women do not have any symptoms. It is treated with antibiotics.

USING SEX TOYS SAFELY

Sex toys are safe if you use them responsibly and keep them clean – otherwise, sex toys can pass on sexually transmitted infections and infections passed on through the blood (blood-borne infections). Sex toys can also pass on bacterial vaginosis.

You can avoid STIs by:

keeping sex toys clean – wash them after each use
covering penetrative sex toys, such as vibrators, with a new condom each time they're used
not sharing sex toys
having a different set of sex toys for each partner
take care when using penetrative sex toys, particularly if there are any cuts or sores around the vagina, anus

How you clean a sex toy depends on:

what the sex toy is made of
if the sex toy uses batteries and has parts that cannot be washed

Sex toys should come with advice about how to clean and store them. Follow the manufacturer's instructions carefully.

For reusable sex toys, make sure you wash them thoroughly with warm water and soap after each use.

You should also wash them between:

using them on different parts of the body, such as the mouth, vagina and anus
one person and another

Check sex toys regularly for any scratches or breaks in the surface material where germs could be present and spread, as this can increase the risk of infection.

If you're allergic to latex, do not use sex toys that are made of, or contain, latex.

KEEPING YOUR VAGINA HEALTHY

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

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

CERVICAL SMEARS

If you have a cervix and have had any kind of sexual contact, with a man or a woman, you could get cervical cancer. This is because nearly all cervical cancers are caused by infection with high risk types of HPV.

HPV is a really common virus that 80% of us will get at one point in our lives. It can be passed on between women, even if neither of them has ever had sexual contact with a man. This is because HPV is spread by skin-to-skin contact in the genital area, which can include sexual touching, sharing sex toys, oral sex and penetrative vaginal or anal sex.

A cervical screening test involves checking the cells from the cervix (neck of the womb). The test is also known as a smear test. It aims to pick up any changes which can be easily and effectively monitored or treated.

You're still at risk of cervical cancer if:

you have had the HPV vaccine - it does not protect you from all types of HPV, so you're still at risk of cervical cancer
you have only had 1 sexual partner - you can get HPV the first time you're sexually active
you have had the same partner, or not had sex, for a long time - you can have HPV for a long time without knowing it

Sometimes people are WRONGLY told not to have a smear test due to the common misconception that LGB women can't get HPV. If you have a cervix and have been told you can't have one because of your sexual orientation then speak to your GP, practice nurse or sexual health. See the cervical screening part of our web site for more information.