We’d like to thank the Lesbian Health Action Group for providing these resources.
This website provides information about some of the most common sexually transmitted infections (STIs) experienced by Women.
Not everyone with an STI will experience the symptoms described on this site. Some people may have no obvious symptoms, others mild symptoms and some more severe.
Even without symptoms, you may still have an STI and still be able to pass it on – only testing will let you know.
All sexually active women are at risk of catching a sexually transmitted infection (STI), including women who have sex with women (WSW). Lesbians are more likely to catch certain types of infections than others; however viruses and bacteria rarely discriminate, they, like our sexual practices, only have preferences.
It is important to find a health professional that will understand your needs and that you can be open with about your medical and sexual histories.
• Try asking friends if they have or know of an understanding health practitioner they can recommend.
• Go to the QAHC Referral Directory www.qahc.org.au/ referral to find services with experience in working with LGBT clients
• Look in the LGBT press for advertisements for health services. Have regular sexual health checks and don’t be afraid to see your GP for testing. The most it will take is a swab, a bit of blood or a short exam to find out if there is anything wrong. It will save you from misery in the future and not to mention, leave more time for you and your partner to get it on! Remember to only catch the woman and only the woman, because infections are never welcome in the bedroom!
Dental dams are large sheets of latex you place over your partner’s genitals to avoid coming into contact with her vaginal fluids. Unlike condoms, you won’t find them on the shelves of your local grocery store. However, dental dams can be fashioned easily from a glove and a pair of scissors.
Follow these simple instructions:
Cut 4 fingers off the glove, leaving the thumb in place
Slit up the side opposite to the thumb Rinse talcum off the glove
Put some water-based lubricant on the side with the thumb protruding
Place the lubricated side on your partner’s vulva
Hold the glove in place with both hands, or have your partner hold it covering her labia
Use your tongue to stimulate your partner. Insert your tongue into the thumb for extra fun!
After sex, be sure to dispose of the glove safely. Turn it inside out and wash your hands.
Note that you should never share the same dam!
If you experience sensitivity to latex, find non-latex gloves from your chemist or grocery store. Lube is used for the extra sensation and that slippery feeling, reduces the risk of abrasions and cuts out the opportunity for bugs that cause infections to move into the blood system. It also reduces the risk of the latex breaking and avoids the awkwardness that comes with needing to make a new dam. Many women will choose not to use gloves or a dam for sex, however this is only recommended if you know that you and your partner are clear from STIs.
While there is indeed some truth to the point that lesbians don’t exactly need to use condoms (especially if there is no male genitalia involved), lesbians can however use them to prevent themselves from catching nasty STI’s.
When we talk of condoms, we in truth talk about latex barriers, which are one of the most effective ways of stopping STI transmission amongst women who have sex with women.
Yes, perhaps to some, eating latex is indeed not as attractive as eating pussy, but there are ways to keep it super sexy and at the same time, super safe.
Condoms can be used to protect you and your partner, as well as increase the life span of your sex toys if you use them for sexual activity. Don’t know how to roll a condom down your toy properly? Let’s use the age-old banana technique for some help.
(Insert banana photo here after every step)
Open the condom packet… gently. As simple as this sounds, if you rip the condom packet too hard (due to eagerness, sharp teeth or otherwise), you may risk damaging the condom inside as well.
Determine which direction the condom is rolled.
Place the reservoir (tip of the condom) on top of the toy and unroll it down the toy gently.
Lube up and enjoy!
Use water-based lubricant with your condoms to avoid them breaking and never use the same condom when penetrating more than one person. Change condoms when changing partners!
Note: Even though you use a condom in your sex toy use, it does not give you a reason not to wash your toys after every hot session. If your condom breaks by accident, it only takes a small tear in the latex for bacteria to travel from person to person. (Because bacteria don’t need first class, they can ride economy and still reach their destination).
The best way to avoid catching an STI is to practice safer sex using protection. By protection, we not only mean physical barriers such as dental gams or gloves, but also precautionary actions that you can take to minimise the transmission of infections during sex.
These actions include;
• Washing your hands and cutting your fingernails to minimise the risk of scratching and transmitting nasty infections to your partner during penetration.
• Having regular pap smears and sexual health checks
• Being honest with your partner about your sexual health history
• Being aware of your actions during sexual activity (e.g. be sober enough to practice safer sex!)
• Having sex when you’re the least infectious if you know you carry an STI virus and making sure you use latex barriers when doing so.
• Avoiding sex during your period or using latex barriers when if you decide to do so.
• Washing your sex toys and using a condom with them.
• Stocking your cupboard with gloves and condoms!
It’s easy to get lost in the throws of pleasure and ignore the importance of having safer sex, which can result in a partner catching something nasty and unwanted. Most infections are transmitted through bodily fluids such as blood and vaginal discharge; most of which are likely to be exchanged while having sex, especially if you do so with cuts or wounds on your fingers, genitals or mouth.
You are more susceptible to being infected if you are;
• Having sex with a woman who has an infection
• Having sex while on your period
• Having sex while having open lesions or sores that aren’t
• Sharing sex toys with a partner without using a condom
or washing the toys between each partner’s use
• Changing sexual partners.
The tricky thing about these infections is that someone can have them without knowing and so a person can be infectious, without knowing that they have become infected. The only way to find out about some STIs is to\ get a check-up, especially if you have had unprotected sex with a partner of whom you don’t know the sexual history.
Getting tested is all about prevention and means that you will be able to access appropriate treatment to reduce the risk of complications and prevent the passing on of the infection onto others.
Following is a list of STI’s potentially transmissible between women and their symptoms, however note again that several of these infections show little or no symptoms, so just because you don’t show any signs of an infection after a rough night of passion,
Caused by an imbalance of good and bad bacteria in the vagina. Transmission is not completely clear, however is common amongst women who have sex with women.
• Itching or irritation around the genitals,
• Excessive, thin or grey sticky vaginal discharge
• Characteristic fishy or musty odour.
Treatment is a round or a large dose of antibiotics.
Caused by the Herpes Simplex Virus (HSV-1 for Oral, HSV-2 for Genital), is an STI that is notorious for not showing symptoms of infection. An infected person carries the virus in most bodily fluids, making the spread of herpes incredibly easy, especially during acts of intimacy where those fluids are more likely to be exchanged. It is one of the most common infections in both men and women, largely due to how easy it is spread through sexual partners.
Although there are symptoms of infection, the virus can lay dormant within a person’s body for months (even years) without causing any physical ailments.
Symptoms of oral herpes include;
• Cold sores around the mouth
• Flu-like symptoms (Sore throat, headaches, fever, swollen neck glands)
• Sores appearing on broken skin around the body where the virus has entered
• Sores around the genitals from oral sex with a person carrying the virus. Symptoms of genital herpes include;
• Painful, ulcerating blisters or sores around the genitals
• Flu-like symptoms (Sore throat, headaches, fever, swollen neck glands)
• Small cracks in the skin with or without an itch or tingling.
• Swelling and pain in the genital area
• Painful urination.
Herpes is unfortunately incurable and an infected person will continue to carry and shed the virus during the course of their lifetime. Symptoms will flare up and subside as episodes and will be varied in their incidence. However, your GP will provide you with medication to reduce the severity of symptoms and frequency of occurrences.
Also known as yeast infections, are caused by an overgrowth of a type of yeast known as Candida.
• Itching and irritation around the genitals
• Pain while urinating
• Sticky, thick and mucouslike
white discharge. Treatment is a round or a large dose of antibiotics.
Caused by various strands of the human papillomavirus, HPV is linked to causes of genital warts and cervical cancer. It is extremely common, with 4 out of 5 people having it at some point in their lives. Not many women know that they carry the virus until it progresses to warts or cancer.
HPV can be detected with regular pap smears at your GP. For more information, please refer to our Cervical Cancer
Syphilis is a devastating disease if left untreated. There are three stages of syphilis, each with differing symptoms, however not all women will show signs of infection at each stage. It is transmitted very easily between women through all types of sexual activity and a person is infectious at almost every stage of the infection.
Primary Syphillis (1st stage)
• Characterized by a painless sore called a Chancre, usually on the area of body where the infection has been transmitted.
• Due to the sore being painless, it is often overlooked or seen as something else.
• It will disappear within a few weeks, however if untreated, the infection will progress to the second stage.
Secondary Syphilis (2nd Stage)
• Characterized by the appearance of a nonitchy rash around the body, most common around the palms of hands or soles of feet.
• Tiredness and frequent headaches
• Swollen glands
• Weight and hair loss
This stage can last for a few months and the symptoms may eventually disappear altogether and you may be symptom-free for years or even decades. However the infection is still in your body and if left untreated, there is a risk the infection will progress onto its deadliest stage.
Tertiary Syphilis (3rd Stage)
The syphilis infection can go on to cause damage to major organs such as the heart or nervous system. As it progresses, severe complications can arise depending on which part of the body the infection is affecting, resulting in any one of these symptoms;
• Loss of co-ordination
• Vision and hearing impairments
• Heart disease
• Appearance of tumours on internal and external organs.
• Late stage syphilis can eventually lead to death, so getting the infection detected and treated early is essential.
Less common in lesbians, however both can be transmitted through penetrative sex through toys and fingers if one partner carries the infection.
Symptoms are rare, however include;
• Painful sex and urination
• Increased vaginal discharge
• Spotting or bleeding when you’re not on your period.
Both Chlamydia and Gonorrhea can be treated easily with a course of antibiotics, however can only be detected through testing. It is important to get tested if you suspect you have either infection, as leaving the infection untreated can lead to more serious complications such as pelvic inflammatory disease and infertility.
Characterized by tiny insects, which live amongst pubic hair, transmitted through intimate contact through an infected partner. Lesbians are particularly susceptible to contracting lice, especially when engaging in acts such as tribadism. Symptoms include;
• Noticing the appearance of lice around your genitals or amongst your pubic hair
• Mild to severe itching.
Treatment consists of the application of medicated shampoo and the washing of bed sheets and clothing in hot water. If you suspect you have lice, make sure your partner gets
treated for it as well.
Commonly known as “trich”, is caused by a parasite and commonly infects the lower half of a woman’s genital tract. Transmission amongst women who have sex with women is
common and symptoms include;
• Foamy discharge which may be yellow or green
• An unpleasant, fishy odour
• Painful urination
It only takes a swab and a course of antibiotics to get rid of the infection, however your partners should be treated as well, because reoccurrence within 3 months of treatment is common.
Looking After Your Breasts
Breast cancer is the most common cancer amongst Australian women (excluding skin and melanoma cancers), accounting for more than a quarter of new cancers diagnosed every year.
More than 70% of all breast cancers occurs in women aged 50 years and over, however that does not mean that young women are spared from the disease, as breast cancer can develop at any age.
Risk factors for developing breast cancer include;
• Getting older (1 in 11 women will be affected by age 75 and 1 in 8 by age 85)
• Having a strong family history of breast cancer
• Having previously been diagnosed with breast cancer or DCIS (Ductal Carcinoma In Situ)
• Drinking more than 2 standard drinks a day.
• Not breast feeding
• Starting menstruation early (before 12)
• Starting menopause late (after 55)
• Taking combined Hormone Replacement Therapy (HRT) after menopause, especially for 5 years or longer.
• Gaining weight in adulthood, especially after menopause.
Mammograms are less effective for younger women (below 49 years) as breasts are denser, making it more difficult to detect signs of breast cancer.
For women under 40 years, regular screening are not recommended unless there is a family history of breast cancer, or that a previous diagnosis has already been made.
Women over 40 years are recommended to have a screening every two years
Women over 40 years can access free mammograms every two years through Queensland Health. To book an appointment, visit http://www.health.qld.gov.au/breastscreen/ or ask your local GP for more information.
You may benefit from having your breasts checked regularly
by your doctor, particularly if:
• You are not having regular mammograms
• You are unsure about what is ‘normal’ for your breasts
• You are not confident in giving yourself breast examinations
Remember that support for your breasts don’t only come in the form of a bra! Make sure you remain vigilant in conducting regular self-examinations and mammograms if they apply to you.
Ask your GP for any advice and don’t hesitate if you think that there is something wrong with them, because for your health, it is always better safe than sorry.
Lifestyle factors and the effect that sexuality has on addressing health needs and the access of services, all play
a role in the difference in health outcomes for lesbians as compared to heterosexual women.
Lesbians are 2-3 times more likely to develop breast cancer than their heterosexual counterparts, linked to the higher prevalence of risk factors related to breast cancer.
Risk factors especially relevant to lesbians include;
• Not having children or giving birth to your first child after the age of 30.
• Not breast feeding
• High rates of alcohol use.
All these risk factors can be seen to correlate with the general risk factors for women, making lesbians more likely to be at risk of developing breast cancer.
Lesbians also access health services less frequently than members of the general community. They are less likely to go for mammograms and perform self-examinations than heterosexual women, which may be reflective of the increased incidence of breast cancer in lesbians, due to low rates of preventative screening or later presentation of symptoms.
You can protect yourself from breast cancer by lowering or eradicating those risk factors by keeping yourself healthy and making adjustments to your current lifestyle.
Lowering your chances of breast cancer can be as simple as;
• Cutting alcohol consumption to two drinks or less a day
• Exercising regularly
• Increase your consumption of fresh fruit and vegetables, avoiding or reducing your intake of food high in saturated and animal fat.
• Maintaining a healthy body weight.
There is no need to be embarrassed about checking your breasts. The process of self-examination takes less than five minutes and may potentially save your life.
When conducting a self-exam, make sure you check for changes in;
• Size and shape of your breast or nipple
• Unusual thickening in your breasts
• Lumps that are painful or tender
• Skin over your breasts, such as redness or dimpling
• Unusual discharge from your nipples
Note that most lumps are not cancers. However any new lump that does not go away after 3-4 weeks should be examined by your GP. You should also report any persistent pain, especially if it is in one breast.
Hint: Who says you have check on your breasts yourself? Breast checking can be sexy if done with a partner, but be careful not to get sidetracked! For the duration of the exam, keep your hands above her waist!
So you can recognize the normal size and shape of your breasts, stand in front of a mirror and look at your breasts with:
• Your arms at your side
• Your arms raised behind your head
• Your arms on your hips and your chest muscles flexed Afterwards, lie down with a pillow under your left shoulder:
• Put your left hand behind your head and feel your left breast with the pads of the 3 middle fingers on your right hand
• Start at the outer edge and work around your breast in circles, getting closer to your nipple with each circle
• After you have checked your breast, squeeze your nipple gently and look for fluid coming out of the nipple
• Be sure to include the area up to your collarbone and out to your armpit
Remember to do the same to your right breast with the pillow under your right shoulder
Currently, there is no way of preventing breast cancer. You can however, reduce the likelihood of developing breast cancer and increase the chances of recovery, especially if the cancer is detected early.
To screen your breasts, you will need to go in for a mammogram, which are essentially x-rays of the breasts. They will be used to look for signs of breast cancer and investigate changes in the breasts, as well as detect smaller tumors that cannot be felt by self-examination.
• If you have had any form of breast cancer you will need regular follow-up screenings to ensure that if the cancer reoccurs, it can be detected and treated promptly.
• Your regular follow-up will include regular mammograms and/or ultrasound and a physical examination of your breasts by the doctor
• If you are at higher risk of breast cancer due to a family history of breast cancer, you might also need an individual program of regular tests
Looking After Your Cervix
One of the ways to get more comfortable with the pelvic exam is to know what is going to happen before you even get to your appointment. The point of the Pap Smear is merely to check for abnormal cervical cells.
You will be asked to undress and get on the table. You will need to bend your knees, with your feet together and let your legs go floppy. BREATHE.
The practitioner will check out your vulva and the surrounding areas for colouring, discharge, and anything that does not seem normal for you.
This is where the speculum is introduced. While many women may believe that a speculum is a type of torture device, it is actually a tool used to hold the vaginal canal open so the practitioner can see your cervix. Then they will lube you up and slowly insert the speculum into your vagina. BREATHE
Once the speculum is inserted (don’t worry, only the thin beak-like section is inserted), the practitioner, slowly uses the handle to push it open just enough for them to get a clear view of your cervix. They take a couple swabs of the cervical cells, place the cells on a lens to send to the lab, and slowly take out the speculum. BREATHE.
The register keeps a confidential history of your Pap smear results and sends you a reminder if you are overdue for your next smear. Results of your smear are automatically sent to the register. If you do not wish to have your details forwarded to the register you can tell your health professional at the time of the smear.
For further information contact: 1800 777 790
For more information about STIs apart from HPV and practicing safer sex, please visit www.qahc.org.au/lesbian.
The cause of almost all cancer of the cervix is long term infection caused by some types of human papillomavirus (HPV). There are over 100 types of HPV affecting various parts of the body but only a few are linked to cancer of the cervix. Most women with HPV will not develop cancer of the cervix. In most cases the body’s immune system will clear the virus in one to two years. Increasing age, smoking and lowered immunity are also linked with a greater risk of developing cancer of the cervix.
Exposure to HPV can be considered a normal part of being a sexually active person. Most women only become aware of the fact that they have HPV when they have an abnormal Pap smear result or if genital warts appear. In a small number of women HPV stays in the cells of the cervix. If HPV is not cleared there is an increased risk of cancer of the cervix developing. This usually takes a long time – often more than 10 years.
• Age: about half of the new cases of cervical cancer diagnosed each year are in women over 50 years of age.
• Smoking: women who smoke are known to be at greater risk of developing cervical cancer than non-smokers.
• Persistent HPV infection
• Not having a Pap smear every two years!
You do not have to have anyone in the room that you do not want there. This means that if you want a female doctor, you cannot be forced to see a man, and vice versa. You also do not have to agree to have a specific person assisting the doctor or clinician. You can refuse to have any particular person in the room for any reason.
None of the clinic staff should be present while you are undressing or while you’re putting your clothes back on.
You may watch what is happening through a mirror, if you want to, and you are not required to keep a sheet over your legs so that you cannot see what is happening.
Anyone who touches your genitals must wear gloves. If you are allergic to latex, you need to inform the clinician so that they can use latex-free gloves.
You may ask the clinician to tell you exactly what he or she is doing throughout the exam.
If it is your first visit, the clinician must do this.
You are free to ask questions at any time.
The staff must do any tests on you that you ask for, as long as they are capable of performing these tests.
You may bring a family member, partner, or friend to support you during the exam.
You do not have to do anything you don’t want to do.
You deserve to be listened to, and are free to tell the staff what would make you most comfortable. (i.e. you can ask that they take more time, go more slowly, stop to allow you to relax, etc.)
You can stop the exam at any time.
If at any time the staff does anything that makes you uncomfortable, you can leave.
If it is your first exam, tell your doctor or nurse practitioner beforehand. They may go more slowly and explain more about what they are doing
Another way to become more comfortable with the exam is to ask a friend, family member or partner if you may accompany them to their next exam so that you can see someone else go through it first.
The vagina is one big muscle so the more you breathe and relax, the easier it will be for you and the practitioner. It should not hurt so if you find it really uncomfortable, take some deep breaths and relax your muscles. Talking also relaxes the pelvic muscles , so chat to your provider while having the smear.
The last part of the exam is the bimanual exam. All that means is that the practitioner uses their hands to examine you. With gloved hands, they will insert two fingers from one hand into your vagina until they are touching your cervix. Gently, they will jiggle your cervix a little so that, with their other hand on your belly, they can feel your uterus. They are checking for size, tenderness, and anything else that does not feel normal for you. This allows them to feel for your ovaries as well.
After the bimanual exam, any last discussions will happen and then the practitioner will leave you to get dressed. The whole exam takes about five minutes. Congratulations, you are done!
The HPV vaccine is given as a series of 3 injections into the upper arm muscle. It should be given within a 6 month period, for example:
• First dose – chosen date
• Second dose – 2 months after the first dose
• Third dose within 4 months of the second dose
The vaccine is most effective when all 3 doses have been given. Missed doses should be given as soon as possible.
See your local GP for more information Once you have had vaccination however, it does not mean you need to avoid Pelvic exams!