Understand important health issues for lesbians — from sexually transmitted infections to depression — and get tips for taking charge of your health.
By Mayo Clinic Staff
All women have certain health risks. Women who have sex with women face an increased risk of specific health concerns, however. Although your individual risks are shaped by many factors beyond your sexual orientation and practices — including family history and age — it's important to understand common health issues for lesbians and steps you can take to stay healthy.
Certain sexually transmitted infections — such as human papillomavirus (HPV), bacterial vaginosis and trichomonas — can spread between women. Oral sex and sexual behavior involving digital-vaginal or digital-anal contact, particularly with shared penetrative sex toys, can spread infections as well. Female sexual contact is also a possible means of contracting HIV, the virus that causes AIDS.
To protect yourself from sexually transmitted infections:
- Get tested and have your partner tested. Don't have unprotected sex unless you're certain you and your partner aren't infected with HIV or other sexually transmitted infections — whether you have sex with a man or a woman. Testing is important because many people don't know they're infected, and others might not be honest about their health.
- Use a condom or other protection. During oral sex use a split-open condom, dental dam — a small piece of latex — or plastic wrap. Don't share sex toys, and keep them safe by protecting them with a condom and cleaning them before and after every use.
- Be monogamous. Another reliable way to avoid sexually transmitted infections is to stay in a long-term mutually monogamous relationship with a partner who isn't infected.
Consider the drug Truvada. In July 2012, the Food and Drug Administration (FDA) approved the use of the drug Truvada to reduce the risk of sexually transmitted HIV infection in those who are at high risk. Truvada is also used as an HIV treatment along with other medications.
When used to help prevent HIV infection, Truvada is only appropriate if your doctor is certain you don't already have an HIV or hepatitis B infection. The drug must also be taken daily, exactly as prescribed. And it should only be used along with other prevention strategies such as condom use every time you have sex.
Truvada isn't for everyone. If you're interested in Truvada, talk with your doctor about the potential risks and benefits and whether it's right for you.
- Limit the amount of alcohol you drink and don't use drugs. If you're under the influence, you're more likely to take sexual risks. If you choose to use injectable drugs, don't share needles.
- Get vaccinated. Vaccinations can protect you from HPV as well as hepatitis A and hepatitis B, serious liver infections that can spread through sexual contact.
- Remain vigilant. There's no cure for HIV/AIDS and many sexually transmitted infections, such as HPV and genital herpes. The best way to stay healthy is to protect yourself.
Lesbians and bisexual women might be at higher risk of depression and anxiety. In addition, youth who identify themselves as lesbian, gay, bisexual or transgender might have a higher risk of depression and attempted suicide. Contributing factors could include social alienation, discrimination, rejection by loved ones, abuse and violence. The problem might be more severe for lesbians who try to hide their sexual orientation and those who lack social support.
Left untreated, depression can lead to risky sexual behavior and a downward spiral of emotional, behavioral, health, and even legal and financial problems. If you think you might be depressed, talk to your doctor or seek help from a mental health provider. If you're reluctant to seek treatment, confide in a trusted friend or loved one. Sharing your feelings might be the first step toward getting treatment.
Lesbians and bisexual women might face unique risk factors for substance abuse, such as:
- Stress related to passing as a heterosexual or coming out
- Trauma due to bullying, violence, abuse or self-abuse
- Impact of sexism and discrimination
- Relying on bars or clubs for socializing and peer support
If you have a substance abuse concern, remember that help is available. Local lesbian, gay, bisexual and transgender health, mental health or community centers often provide substance abuse treatment. Organizations such as the Gay and Lesbian Medical Association also may provide referrals.
Domestic violence can affect anyone in an intimate relationship. Warning signs specific to lesbian or bisexual women might include a partner who:
- Threatens to tell friends, loved ones, colleagues or community members your sexual orientation or gender identity
- Tells you that authorities won't help a homosexual, bisexual or transgendered person
- Tells you that leaving the relationship means you're admitting that homosexual relationships are deviant
- Tells you that domestic violence can't occur in homosexual relationships or that women can't be violent
Staying in an abusive relationship might leave you depressed, anxious and hopeless. If you don't want to disclose your sexual orientation, you might be less likely to seek help after an assault. Still, the only way to break the cycle of domestic violence is to take action — the sooner the better. If you're a target of domestic violence, tell someone about the abuse, whether it's a friend, loved one, health care provider or other close contact. Consider calling a domestic violence hotline and creating a plan to leave your abuser.
Some lesbians and bisexual women struggle to find a doctor knowledgeable about lesbian health issues and with whom they feel comfortable discussing their needs and concerns. To take charge of your health, look for a doctor who puts you at ease and encourages discussion of sexual issues. Identify yourself as lesbian or bisexual, and ask about routine screenings recommended for women in your age group — such as blood pressure and cholesterol measurements and screenings for breast cancer and cervical cancer. If you're not in a long-term, mutually monogamous relationship, schedule regular screenings for sexually transmitted infections. Share any other health concerns you might have with your doctor as well. Early diagnosis and treatment help promote long-term health.
You might also take heart in a plan unveiled in June 2011 by the Department of Health and Human Services to improve the collection of data that tracks the health and experiences of people who identify themselves as lesbian, gay, bisexual or transgender. The collection of such information is expected to help address the unique health needs of the lesbian, gay, bisexual and transgender community.
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