Lesbians – Sexual Health And Pap Smears

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It is important to look after your sexual health and well-being. This brochure dispels some of the myths around lesbians' sexual health and discusses the importance of having regular Pap smears.

Lesbians and sexually transmitted infections (STIs)

It is a myth that lesbians are not at risk of STIs.

There are cases of women transmitting Human Immunodeficiency Virus (HIV), human papillomavirus (HPV), herpes and syphilis to other women. In theory, women could also transmit chlamydia and gonorrhoea to other women. The vaginal infection bacterial vaginosis (BV) is more common among lesbian women. It is still not certain if BV is transmitted through sex.

If left undetected, STIs can lead to serious complications such as pelvic inflammatory disease, ectopic pregnancy and infertility.

Other infections that can be sexually transmitted include hepatitis A, B and rarely C. The risk of transmission of various infections is dependent on specific sexual practices and other behaviours such as sharing sex toys or injecting equipment. Therefore, it is important to find a health professional with whom you feel comfortable talking to about your risks and whether you should consider having tests for STIs.

Safer sex practices

When you enter a new sexual relationship talk to your partner about who they have had sex with in the past. This can help you find out if you may be at risk of contracting a STI. Talking honestly can also give you the chance to discuss what sexual practices you prefer.

You can reduce your risk of contracting an STI by:

Using dams during oral/vaginal and oral/anal sex
Using latex gloves and water based lubricant when touching/penetrating the vagina/anus
Using condoms and water based lubricant when sharing vibrators, dildos and other sex aids
Having a sexual health check when starting a new relationship
Asking a new partner to have a sexual health check.

You can have a sexual health check at your doctor's surgery, sexual health clinic or family planning clinic.

What are dams?

Dams are thin latex sheets that go over the vaginal or anal area to act as a barrier during oral/vaginal or oral/anal sex.

Using dams:

Do not reuse or share dams
Use one side of a dam
Use a new dam if switching between oral/vaginal and oral/anal sex
Use a water-based lubricant on the underside of the dam to increase sensitivity
Store dams in a cool, dry place away from direct sunlight.

Dams come in a variety of colours and flavours and can be obtained from chemists and sexual health and family planning clinics. If dams are unavailable an unlubricated condom can be cut up and used.

Cervical cancer

Approximately 340 women die of cervical cancer in Australia every year. The cervix is the entrance to the uterus or womb. Up to 90% of cervical cancer cases could be prevented if women had a Pap smear every two years.

There are a number of risk factors for cervical cancer:

Human Papillomavirus (HPV): HPV is the virus responsible for warts. Some strains of HPV are sexually transmitted and can infect the genital area. The virus is very common but most people never develop visible warts. The vast majority of women who develop cervical cancer have been exposed to particular strains of genital HPV. Genital HPV is transmitted through skin to skin contact of the genital area.
Age: A woman's risk increases with age.
Smoking: Smoking significantly increases a woman's risk (up to four times that of non-smokers).
Not having regular Pap smears: Three our of four women who develop cervical cancer have never had a Pap smear or do not have regular two yearly Pap smears.

What is a Pap smear?

A Pap smear is a screening test that detects early changes in cells of the cervix. Cervical cancer can usually be prevented if these changes are found and successfully treated. A Pap smear is conducted by a health professional (usually a doctor or nurse). It involves:

Placing an instrument called a speculum into the vagina so the cervix can be clearly seen
Cells are wiped from the cervix using a small spatula and/or brush
Cells are smeared on a slide and sent to a laboratory for testing.

What is the Pap smear register?

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.

Lesbians and Pap smears

Lesbians are less likely to have had regular Pap smears. This may be due to:

A personal belief that there is no risk of STIs and cervical cancer
Not being able to afford it
Being told by health professionals that lesbians don't need Pap smears.
Not routinely visiting a health professional for other reasons (eg. for contraception)
Difficulties finding a suitable health professional
Previous experience of homophobia or fear of homophobia

Early changes in the cervix that can progress into cervical cancer have been found in lesbians. Current national recommendations are that all women aged between 18 and 70 who have ever had sex need to have a Pap smear every two years. Whilst the risk of cervical cancer for women who have only ever had sex with women is uncertain, it is advisable to discuss with a health professional knowledgeable in the area of sexual health whether you are at risk of cervical cancer and should consider having a Pap smear.

If you experience symptoms like bleeding between periods, after menopause or following sexual activity or abnormal discharge you should see a health professional, even if your previous Pap smear result was normal.

Finding a health professional

A health professional who understands your health issues as a lesbian is important. To find someone suitable you can:

Ask friends
Look for advertisements in the gay and lesbian press
Contact the organisations listed on the back of this brochure.

If you have had a negative experience with a health professional you can make a complaint to the Health Rights Commission. The Anti-Discrimination Commission Queensland can also be contacted for discrimination issues.

For more information:

Women's Health Queensland Wide – Health Information Line
(07) 3839 9988
1800 017 676 (toll free outside Brisbane)
www.womhealth.org.au

Family Planning Queensland
(07) 3250 0240
www.fpq.com.au

Queensland Health – Sexual Healthline
07 3240 5881
www.health.qld.gov.au/sexhealth/

Gay and Lesbian Welfare Association
Counselling and referral, 7pm-10pm - (07) 3252 2997
1800 184 527 (toll free outside Brisbane)
www.glwa.org.au

Open Doors (supports lesbian, gay, bisexual and transgender young people and their families)
(07) 3257 7660
www.opendoors.net.au

Health Rights Commission
(07) 3234 0272
1800 077 308 (toll free outside Brisbane)
www.hrc.qld.gov.au

Anti-Discrimination Commission Queensland
1300 130 670
www.adcq.qld.gov.au

Queensland Health Pap Smear Register
1800 777 790

This brochure was jointly developed by:

Women's Health Queensland Wide
165 Gregory Terrace, Spring Hill
PO Box 665 Spring Hill Q 4004
Telephone: (07) 3839 9962
Email: whcb@womhealth.org.au
Web: www.womhealth.org.au

Family Planning Queensland
100 Alfred Street
PO Box 215 Fortitude Valley Q 4006
Telephone: (07) 3250 0240
Email: info@fpq.com.au
Web: www.fpq.com.au

We would like to thank Queensland Health for funding the development and printing of this brochure.

Women's Health Queensland Wide Inc. and Family Planning Queensland have made every effort to ensure this information is accurate. However, they accept no responsibility for any errors, omissions or inaccuracies in respect of the information contained in the material provided by Women's Health Queensland Wide Inc. and Family Planning Queensland nor is the provision of the material by Women's Health Queensland Wide Inc. and Family Planning Queensland to be construed as any representation that there are no other materials or information available in relation to the information provided. Further, Women's Health Queensland Wide Inc. and Family Planning Queensland accept no responsibility to persons who may rely upon this information for whatever purpose.