Sexual health for women who sleep with women

Monday 6th June, 2016


The topic of sexual health practices for women who have sex with women is often overlooked. But like other sexual encounters, there are risks - and ways to avoid them.

“Does anyone in this classroom know how to use a dental dam?”

Young people in London tend to be comparatively well informed about straight sexual health (boy meets girl).

Who doesn't fondly recall the teacher leaving a roomful of teenagers with a stack of condoms and a banana for 'practice'?

Gay sex ed (boy meets boy) is also starting to take off, particularly following discussion in popular TV programs and celebrity campaigns.

(Click to magnify) Image: Flickr, David Yu Photography

The general sex ed message is clear: use a condom. No glove, no love, and no buns in the oven.

But not all sexual partnerships involve a pregnancy risk - or a penis.

What about girl-on-girl?

Lesbians, bisexuals, women who have sex with women (WSWs)...are people sufficiently aware of the risks?

In a Reuters Health survey of more than 500 lesbians, bisexual women and WSWs, 26% reported having been diagnosed with an STI.

Additionally, a 2014 survey by Stonewall showed that half of the lesbian/bisexual women they screened had an STI.

Because anything that involves an exchange of fluids, or genital / mouth contact, can run similar risks to male-female sex.

Nicole*, who self-identifies as pansexual, was 17 or 18 when she first heard of a dental dam. "One of my older pansexual friends told me about it. I had to research it because I didn’t know what it was."

Miranda, who had sex with a woman once but otherwise identifies as straight, didn’t know she had to even use protection.

"I’ve never heard of a dental dam. I didn’t know there was any need."

Miranda did get an STI check up after two weeks, but she wasn't aware she needed another check six months later for HPV (Human papilloma virus), herpes or HIV.

Although it sounds like some brutal orthodontic procedure, a dental dam is actually just a thin, latex square that goes over your lady garden and prevents any direct contact between lips and labia.

You can now buy them in most major chemists and pharmacies, but in a pinch you can easily DIY.

You simply need a condom, preferably non-lubricated. Snip off both the tip and the base then cut down the condom lengthways. You open it and voila - a perfect, rectangular dental dam.

Alternatively, you can use finger cots (also known as gloves or finger condoms), as a latex covering to protect against bacteria or dirt transfer. You can also just cut a finger off some surgical gloves - but not your Marigolds.

To combat the lack of awareness, here are all the STIs that can be passed between ladies.

HPV (Human Papilloma Virus) - Some strains need only skin-to-skin contact to be transmitted, and it's not always detectable without a test.

The vast majority of cervical cancer cases are caused by HPV, so make sure you’re getting your smear tests regularly (once a year after the age of 25). If you’re under 25, you could look into the Gardasil vaccine.

Genital herpes - The key fact here is that some women might not have any symptoms at all, or the virus might be lying dormant and not manifesting itself in blisters and ulcers. Just keep practising safe sex and going for regular check ups.

Gonorrhoea and chlamydia - These can be passed between women via fluids, toys, hands or just genital contact. They are more often than not symptomless for women.

However, they can lead to serious consequences like an infection in the fallopian tubes or infertility. Luckily, these are easily treatable with antibiotics.

HIV – It’s highly unlikely and very rare, but HIV can be transmitted between women through sexual activity. The risk is even higher when either woman is on her period, and if soft tissues in the mouth or vagina come into contact with the blood.

Not much research has been done into whether dental dams can prevent this, so your best course of action is just to keep up with regular blood tests.

[Not technically STIs, but lady-specific risks]:

Bacterial vaginosis - WSWs are at a significantly increased risk of passing this around, and because the symptoms are fairly mild (a change in discharge, for example), you might mistake it for a bout of thrush. However, this does require a trip to your GP for a course of antibiotics.

Trichomoniasis – A fairly unknown (and unpronounceable) infection, but not uncommon. This can be transmitted via anything involving vaginal fluid, even just fingers.

Again, some women don’t have any symptoms, but if you notice any changes in discharge (e.g. change in smell, colour or consistency), then it’s important to get antibiotics. Like BV, this rarely clears up by itself.

Thrush - Although the risk is unlikely, you can accidentally pass on stress-related thrush via a less stressful activity, like touching and sharing sex toys. Natural yoghurt is the traditional cure (yes, applied straight onto the area), but there are also creams, pessaries, tablets and medicines to combat the hellish itching.

*All names changed for anonymity purposes.