Know important health issues for lesbians and women who have sex with women — from sexually transmitted infections to depression — and get tips for taking charge of your health.

By Mayo Clinic Staff

All women face certain health risks. However, sexual minority women, such as those who identify as lesbian or bisexual as well as women who have sex with women, have some specific health concerns.

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 sexual minority women and steps you can take to stay healthy.

Sexual minority women are at higher risk of depression and anxiety. In addition, youth who identify themselves as lesbian, gay, bisexual or transgender have a higher risk of depression and attempted suicide.

Contributing factors include social alienation, discrimination, rejection by loved ones, abuse and violence. The problem might be more severe for sexual minority women who are not "out" to others 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.

Certain sexually transmitted infections — such as human papillomavirus (HPV), bacterial vaginosis and trichomoniasis — 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. 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 practice safer sex.

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.

  • Practice safer sex. During oral sex, use a split-open condom, a small piece of latex (dental dam) 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. During digital vaginal or anal penetration, consider using a latex glove.

  • 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.
  • 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 hepatitis A and hepatitis B, serious liver infections that can spread through sexual contact. The HPV vaccine is available to women up to age 26.

Sexual minority women face unique risk factors for substance abuse, such as:

  • Stress related to coming out
  • Trauma due to bullying, violence or 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 sexual minority women might include a partner who:

  • Threatens to "out" you by telling friends, loved ones, colleagues or community members your sexual orientation
  • Tells you that authorities won't help a sexual minority
  • Tells you that leaving the relationship means you're admitting that same-sex relationships are deviant
  • Tells you that domestic violence can't occur in same-sex 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 same-sex relationship or sexual identity, 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 sexual minority women struggle to find a doctor knowledgeable about their specific health issues and with whom they feel comfortable discussing their needs and concerns. The website for the Gay and Lesbian Medical Association is one place to find referrals for doctors.

Look for a doctor who is curious, empathic and respectful of your specific needs. Share your sexual orientation with your provider, 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.

Aug. 20, 2014