Health issues for lesbians and other women who have sex with women

All women face certain health risks. But there are some specific health concerns that lesbians and other women who have sex with women need to be aware of.

Individual health risks are shaped by many factors beyond sexual orientation and sexual behavior, including family history and age. But it’s important for lesbians and other women who have sex with women to understand the following health issues and take steps to stay healthy.

Women who have sex with women may be at a higher risk of depression and anxiety than are other women. This might be due to discrimination, rejection by loved ones, weak social connections, abuse or violence. The problem might be more severe for those who haven’t told others about their sexual orientation or for those who don’t have support from friends or family.

If you’re concerned about your mental health, talk to your health care provider or to a mental health provider. If you’re hesitant to seek treatment, consider talking with a trusted friend or loved one. Sharing your feelings could be the first step toward getting help.

Certain sexually transmitted infections can spread between women. Examples of those infections include human papillomavirus (HPV), bacterial vaginosis and trichomoniasis. Oral sex and other sexual behavior, especially with sex toys, may lead to infections. Female sexual contact may spread HIV, the virus that causes AIDS. There’s no cure for HIV/AIDS and some other sexually transmitted infections, such as genital herpes. But treatment is available.

Take these steps to protect against sexually transmitted infections:

• Get tested and have your partner tested. Testing for sexually transmitted infections is important because many people don’t know they’re infected. Others might not be honest about their health.
• Have safer sex. During oral sex, use a small piece of latex, called a dental dam, or a latex barrier. Wash sex toys with hot soapy water between uses. Or cover them with a new condom for each use. During vaginal or anal sex that involves the fingers, consider wearing a latex glove.
• Have only one sexual partner. Another reliable way to avoid sexually transmitted infections is to stay in a long-term relationship with only one partner who isn’t infected.
• Limit alcohol, and don’t use drugs. If you’re drunk or high, 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. These are serious liver infections that can spread through sex. The HPV vaccine is available to women up to age 26. Some women between the ages of 27 and 45 also may benefit from the HPV vaccine. An HPV infection raises the risk of cervical cancer. Other cancers, including cancers of the vulva, vagina, anus and throat, also can be caused by HPV.
• Consider pre-exposure prophylaxis (PrEP). Some women who have sex with women, especially if a partner has HIV, may be at higher risk of HIV infection. They may benefit from taking PrEP. PrEP is a way for people who don’t have HIV to prevent HIV infection by taking medicine. PrEP can reduce the risk of HIV infection in those who are at high risk. Talk to your health care provider about whether PrEP is right for you.

Lesbians and other women who have sex with women are more likely to have alcohol use disorder and use illegal drugs than are other people. If you have concerns about alcohol or drug use, help is available. Talk to your health care provider. Many health care and mental health organizations focused on the lesbian, gay, bisexual and transgender community also offer substance use treatment or may be able to provide information about local resources.

If you smoke cigarettes or use other tobacco products, quitting will greatly lower your risk of health problems. Talk to your health care provider about resources available to help you quit.

Violence can affect anyone in an intimate relationship. And research has shown that lesbians and other women who have sex with women experience intimate partner violence at a higher rate than do other people. But they might be less likely to report this kind of violence due to:

• Threats from an abuser to tell others about an individual’s sexual orientation or sexual behaviors.
• Fear of discrimination from health care providers or law enforcement.

In addition to the physical risks, staying in an abusive relationship can lead to depression, anxiety and feelings of hopelessness. If you don’t want to tell others about your sexual orientation or same-sex relationship, it may be hard to ask for help. But the only way to break the cycle of violence is to take action.

If you’re the target of intimate partner violence, tell someone about the abuse, whether it’s a friend, a loved one, a health care provider or another close contact. Or consider contacting a domestic violence hotline for help.

Concern about homophobia and the stigma sometimes associated with homosexuality may prevent some lesbians from getting routine health care. But it’s important that you get the care you need.

Look for a health care provider who understands your concerns and puts you at ease. For you to get high-quality health care, it’s important that your provider knows and understands your sexual orientation and sexual behavior. So it’s crucial that you feel comfortable talking honestly with your health care provider.

Also, ask your health care provider about routine screenings recommended for people in your age group. Those may include blood pressure and cholesterol measurements, as well as screenings for breast, cervical and ovarian cancers. If you’re not in a long-term relationship with one sexual partner, schedule regular screenings for sexually transmitted infections.

Talk with your health care provider about any other health concerns you might have. Open communication can help promote long-term good health.