Sexual health for lesbian and bisexual women

Women who have sex with other women can pass on or get STIs. Know how to protect yourself.

Lesbians and bisexual women are not immune from sexually transmitted infections (STIs), yet can be complacent about getting tested for them, according to Ruth Hunt at the charity Stonewall. 

Sometimes, lesbian and bisexual women are told they don't need to be tested for STIs. This is not the case.

A survey of lesbian and bisexual women by Stonewall revealed that half of those who have been screened had an STI. And of those women who had an STI, one in four had only had sex with women in the previous five years.

"Women can catch STIs such as herpes, genital warts and chlamydia when exchanging bodily fluids," says Hunt.

"Any one-on-one contact, such as oral sex or using the same hand when touching yourself and then your partner, can put you at risk. Two women that are both menstruating are at a higher risk, too.

Tips for safer sex between women

  • If you're using sex toys, use a new condom for each partner or between penetration of different orifices. Sex toys should be washed with soap and water between sessions. Find out more about cleaning sex toys.
  • Avoid oral sex if either of you has any cuts or sores in the mouth or on the lips, or use a dental dam. A dental dam is a latex or polyurethane (very thin, soft plastic) square, of about 15cm by 15cm, which you can use to cover the anus or female genitals during oral sex. It acts as a barrier to help prevent sexually transmitted infections passing from one person to another.
  • Some infections can be transmitted by hands, fingers and mutual vulval rubbing. Wash your hands before and after sex.
  • Wear latex gloves and use plenty of water-based lubricant for vaginal and anal fisting.

Tips for safer sex with men

If you have vaginal, anal or oral sex with a man, use a condom. When used correctly, condoms protect against unintended pregnancy and STIs. In addition to using condoms, find out about the form of contraception that suits you best.

If you think you may be at risk of unintended pregnancy, emergency contraception (the 'morning after' pill or an IUD) is available from pharmacies, your GP, hospital, family planning clinics and some sexual health clinics.

Vaginal health

The vagina is self-cleansing, so there's no need to wash inside it (douching). Vaginal soreness and vulval irritation can be caused by over use of perfumed soaps, bubble baths and shower gels.

Read how to keep your vagina clean.

After going to the toilet, always wipe from front to back (from vagina to anus).

Read more about vagina health.

Symptoms of STIs

Thrush

Thrush is caused by an overgrowth of yeast called candida. Symptoms may include vulval and vaginal itching, pain and soreness on penetration, burning when passing urine and a thick, white discharge.

It's possible for women to transmit thrush during sex through touching and sharing sex toys. Thrush can be treated with medicated cream, pessaries and tablets, which can be bought from a chemist. Go to your GP if your symptoms persist. Read more about thrush.

Genital herpes

This is caused by a virus, which can spread if you have vaginal, anal or oral sex, or share sex toys. It can also cause cold sores on the mouth and nose.

Symptoms include painful blisters and ulcers around the genital area, although some women may have no symptoms.

Anti-viral tablets can help the healing process and shorten the length of the episode. Read more about genital herpes.

Genital warts

These are fleshy growths in the vulval and anal region. They may be itchy but are usually painless.

They are caused by certain strains of human papilloma virus (HPV), which are usually sexually acquired through skin contact, such as rubbing vulvas together.

Women with genital warts do not need more regular smear tests than those without them. There are a variety of treatment options, including freezing and medicated creams. Read more about genital warts.

Trichomonas vaginalis (TV)

TV can be passed between women during any sexual activity that involves the exchange of vaginal fluid.

Symptoms include a frothy discharge, discomfort when passing urine, vulval soreness, and sometimes an unpleasant vaginal odour. Some women don’t have any symptoms. TV is treated with antibiotics.

Read more about trichomonas.

Chlamydia and gonorrhoea

These STIs are caused by bacteria, which can infect the cervix, rectum, throat and urethra. There may be a discharge but usually there are no symptoms.

If the conditions are not treated, the bacteria may lead to an infection in the fallopian tubes and infertility.

Chlamydia and gonorrhoea can be passed between women through shared sex toys, hands and by rubbing vulvas together. Treatment is with antibiotics.

Read more about chlamydia and gonorrhoea.

Syphilis

Syphilis is a bacterial infection that causes a painless ulcer, usually in the genital area. It will disappear on its own but other symptoms may appear. These can include a rash on the body and swollen glands.

If it is not treated, syphilis can cause serious nerve and body organ damage later in life.

In its early stages, syphilis is extremely infectious and can be passed on by close skin contact during sex. Treatment is with antibiotic injections or tablets.

Read more about syphilis.

When to see a doctor

If you have any of the symptoms above or are worried you may have an STI, speak to your GP or visit an STI clinic. Getting tested regularly is a good idea to ensure you have a healthy sex life. NHS services are free.

Find your local sexual health services.

Read more about STIs.

Page last reviewed: 09/06/2012

Next review due: 09/06/2014

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The 10 comments posted are personal views. Any information they give has not been checked and may not be accurate.

User702309 said on 05 August 2012

Lesbeeproud, kezaroo, if you both had actually read the article, you would have realised that the reason there is a section for 'sex with with men' on this page is because this is actually an article for lesbians and bisexual women, not just solely for lesbians. Bisexual women obviously will have sex with men too, hence the need to inform them of how to have safe sex with both genders [and seeing as they're not straight, they might not choose to go to the straight sections of the site because they need to know about safe sex with women too!]

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kezaroo said on 15 May 2012

I agree with 'lesbeeproud's comment. I too was shocked by the 'how to have safe sex with a man' section on this page. I was looking at this page out of curiosity so i could start to take better care of my sexual health. Comments and sections like those above are why society isnt yet all about equality for us gays!

I also find it disgusting that getting hold of any dental dams is so difficult. Never in any sexual relationship has a partner mentioned a dental dam. The only reason i knew what one was was because i was given one at a gay night when i lived down south.

Obviously not enough people are aware of them or comfortable to buy or use them. This needs to change. Why not give them away like the LGF do with 'free gay mens safer sex packs'. Start as you mean to go on NHS, and dont be so ignorant.

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lesbeeproud said on 07 May 2012

why is there nothing on here about sexual enjoyment for non-straight people? if you look on the 'straight' section for sex, there are a million and one pointers for them to enjoy sex, get around any sexual problems, and have an active, healthy sex life. Why is there nothing for us? Just articles about sti's.. so we are basically told that we have diseases, but nothing about how we should enjoy our sex lives, have healthy sexual relationships, or even have safe sex? someone had to correct this article via a comment so people would know what a dental dam actually is!

And this is Lesbian sexual health!

if by definiton a lesbian is someone who only has sex with women, why is there 'health advice' on having sex with men? I am considering reporting this content as it has been written so poorly, with lack of knowledge, insight to the sexuality written about, and has offended me ridiculously when I was looking for tips on keeping safe, but also help with my sexual relationships, and I have had nothing but an embarrasing 'article' and feel asthough the homophobia so present in GP surgeries is also on the internet.

I cannot believe that this was published. I pity the poor teenage girls struggling for advice who come on this site.

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Amadeus26 said on 12 November 2011

Good video but it's a shame we have to go online to get this information. We live in an increasingly equal society so I think it's about time the NHS had leaflets about safe LGBT sex in their clinics, hospitals etc. It would be so much more comforting and easier to pick up a leaflet from a surgery instead of searching online. Online advice is flawed in the fact that many website aren't validated by medical health professionals so you never know what is good advice or not.

I also have a point about washing sex toys - washing them with just soap and water isn't actually 100% effective. It helps but it's best to use antibacterial soap as sex toys can have lots of shapes and forms and it's easy for virus to get trapped. Use antibacterial soap, ladies :)

Also agree with with dental dams being unavailable in Boots. I've had the confused look a few times! Also tired of the same old 'are you on the pill' question from my lady doctor! Look in my patient files and put that I'm a lesbian - it's not a dirty word.

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kale65 said on 22 June 2011

Hi, dental dams are available online check out pasante who make them or ask at your local G U clinic and if they don't stock them ask. condoms are freely available and can be made into a dam but not easily, but alas until Lesbians/women who have sex with women start asking for stuff and start acknowledging safer sex practices, nothing will change.

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Kathryn at NHS Choices said on 22 March 2011

Hi adelais,

Thank you for pointing out the error. The content has now been amended.

Best wishes,

Kathryn, Live Well Editor

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adelais said on 15 March 2011

Describing a dental dam as something that "fits in your mouth" is misleading as that's not where you place it and the person who wrote that is not appropriately informed. It's called a dental dam because they are also used during dental procedures as a barrier. During woman to woman sex they are stretched across the genitals to prevent exchange of body fluids between the woman and their partner's mouth or genitals which would otherwise be in direct contact. They take practice to use but that's not necessarily a problem! This page should be edited by someone who knows what they are talking about.

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jetboy said on 16 February 2009

The above information is in a leaflet and can be accessed and downloaded at : http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Sexualhealth/DH_4001942

Scroll down to section titled - Safer Sex and Sexual Health Advice

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Lesley Hedges said on 30 January 2009

this is very interesting clear and useful but is it available as a leaflet ?

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User63278 said on 12 November 2008

Thanks for the info but I have never been able to buy a dental dam in a shop in this country. If I go to Boots etc and ask for a dental dam the assistants looks at me with a completely blank expression on their face.

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