Sexually transmitted infections: a guide for lesbian and bisexual women

To get the bad news over with, sexually transmitted infections (STIs) can be spread through woman-to-woman sex. You are less likely to catch some of them than are gay men or heterosexuals, but others are less fussy and some seem to prefer hot lesbian action. The good news is that there is a person who can protect you from these nasties—you. With a bit of self-awareness and common sense, you can significantly reduce your chances of catching one of these annoying wee beasties.

The one golden rule for safer sex is to avoid exchanging body fluids of any kind. A dental dam can be used as protection during oral sex and rimming (oral-anal contact)—a little bit of lube on the recipient’s side will prevent chafing. If you can’t get hold of dams, it’s possible to cut open a condom as an emergency option. It’s tricky, messy, and they’re not a good shape, but if there’s nothing else, it’ll do. Using a dam is particularly important if you want to go down on someone during their period.

If you want to share toys, put a condom over them. Remove the condom and replace it with a fresh one before using the toy on another person.

A finger cot or gloves provide protection in case of chafing or sores on the hands and fingers. Keep your nails well trimmed to reduce the odds of damaging the latex or vinyl.

Basic personal hygiene can prevent many ills—a bath or shower is a wonderful prelude to sex but don’t brush your teeth immediately beforehand as it can encourage bleeding. Check that any mouthwashes are free of salicyates (aspirin) which can also make your gums bleed.

Alcohol and other intoxicants can be fun, and help you pick up the courage to talk to the gorgeous babe in the corner, but they can also cloud your judgement and people are less likely to practise safer sex when under the influence. Like most good things, they’re most fun if indulged in moderately. Libra is an Edinburgh-based voluntary organisation helping women concerned about their drinking regain balance in their lives. See resources below for more information.

See your GP or visit a GUM clinic for tests if you have any suspicious symptoms. Such symptoms include: any change in your vaginal discharge; pain during sex or while pissing; sores around your genitals or mouth; bleeding (‘spotting’) at unusual times of the month or between your periods.

And last but by no means least, partners need to be honest with each other. You don’t need to give each other the third degree about each other’s sexual past, but if you think you’ve been exposed to a sexually transmitted infection, or have exposed your partner to an STI, then you owe it to that other person to communicate that, so the appropriate medical treatment can be obtained, and to abstain from sexual activity until the condition has been cleared up.

The upshot of all this is that it’s easier to prevent an STI from happening than it is to treat it once it does. So play safe, be happy, and stay healthy!

The Bugs

Allergic Vaginitis

Because the symptoms of this are both inside the vagina and around the vulva, it is often mistaken for something else, usually a yeast infection or even herpes. It is caused by an allergic reaction to something, such as latex, lubes, nonoxynol-9 (a spermicide), sex toys or toiletries. Symptoms include red, irritated skin, vaginal itching and increased discharge. The best way to deal with it is to find out what’s causing the problem and find an alternative.

Bacterial Vaginosis (BV)

This happens when the bacteria which naturally occur in the vagina (usually beneficial) get out of balance. Symptoms are a yellow/grey discharge, sometimes accompanied by a fishy smell, and vaginal irritation. One definite cause is douching, and it is regarded as a condition peculiar to lesbians, although no-one can explain why. It’s treated with antibiotics and oral medication.


This is the most common sexually transmitted infection, but is rare in lesbians. It is mostly passed on through penetrative sex, so it can be transmitted via toys, fingers and hands. Most women have no symptoms whatsoever, and it hangs around for years. Can include pain during sex or while peeing; increased vaginal discharge; irregular bleeding. Can cause infertility through pelvic inflammation (see Pelvic Inflammatory Disease). It can be treated with antibiotics.


Like Chlamydia, this is spread via penetrative sex, including the use of fingers and toys. It can also be transmitted via oral sex and affect the throat and urethra. A rare means of transmission is through sharing flannels, as the bacterium thrives in warm moist places. Sometimes there are no symptoms, but vaginal discharge (which can be yellow or yellow-green) and a burning pain on peeing are common. It’s treated with antibiotics.


An inflammation of the liver with various causes, and symptoms including yellow skin and eyes, nausea, loss of appetite, tiredness and stomach pain. There are three main hepatitis viruses. Hepatitis A is found in faecal matter, such as contaminated food and oral-anal contact. Transmission between women has been known.

Hepatitis B is spread by an exchange of blood and other body fluids. This includes touching an open cut if you have broken skin and sharing toothbrushes, nail clippers or razors. It takes very little blood or fluid to transmit, but cannot be contracted through food, drink or casual contact. Lesbians are invisible as far as Hepatitis B research is concerned, but vaccines for both Hepatitis A and Hepatitis B are available.

Hepatitis C is spread mainly through contact with infected blood, and sexual transmission is relatively rare. Again, there has been no research into whether this can be spread via woman-to-woman sex.

Herpes (genital)

Very common, the main symptoms are painful sores around the mouth (‘cold sores’), arsehole and genitals (‘genital warts’). It can be passed on easily through any contact with a sore, so you should avoid going down on someone if you have a cold sore. They go away of their own accord, but are incurable and can recur.


HIV is spread through direct contact with blood, vaginal fluids and semen, during sex, childbirth or through sharing needles. Reports of transmission via breast milk seem to have been exaggerated by a certain ethically-challenged baby milk company (see Free Formula: A Danger of Disastrous Proportions, for example). The problem seems to be related to chafing of the nipples causing them to bleed, rather than the milk itself. HIV attacks white blood cells, causing them to lose their ability to fight infections and usually leading to AIDS.

While still rare among lesbians, there have been cases of woman-to-woman transmission and the leading suspects are menstrual blood, vaginal discharge (when there is also vaginitis) and certain sex practices which can cause bleeding, whether by accident or deliberately.

Human Papillomavirus (HPV, Genital Warts)

There are many different viruses which can produce genital warts, including herpes, which are painless lumps around your genitals and anus. They’re all spread by touch. They are treated by freezing them off, or using a paint-on solution. One of the wart viruses has been linked to cervical cancer, and because an exchange of body fluids is not required to spread it, you should insist on having regular smear tests, even if you have never had sex with a man.

Pelvic Inflammatory Disease (PID)

Caused by several bacteria, including chlamydia and gonorrhoea, infection usually starts within a few days of sex with an infected person, but it can take up to few months. It can also occur after childbirth, surgery and abortion. Symptoms include abdominal and back pain, nausea, spotting, vaginal discharge and fever, but some women show no symptoms whatsoever. Scar tissue from PID can block the fallopian tubes, leading to infertility. There have been cases of woman-to-woman transmission, but, as usual, no specific studies.

Pubic Lice (Crabs)

Lice need human contact to spread, and cannot hop or fly. Spread by any close contact with an affected person, their bed linen or their clothes, symptoms include seeing the lice themselves, and itching. Transmission between female sexual partners is common, and treatment involves special lotions and shampoos (available at pharmacies, but cheaper on prescription), and washing clothing and bed linen in hot water.


This is an infestation of tiny mites which burrow into the skin and give off a chemical which causes itching. Any close (and not-so-close) contact can spread the mites, and they can live in fabric for a couple of days. The first time someone gets scabies, the itching will take 2-6 weeks to start; later infestations show up more quickly as people become sensitised. The main symptom is itching—really evil, nasty itching that keeps you awake at night and causes you to scratch until you bleed. Treatment involves thoroughly putting lotion over your entire body below the neck, including under nails. Partners and friends should also be treated as a precaution, and a second treatment might be required.


A serious and devastating (if untreated) disease which is transmitted via contact with the sores and rashes associated with it. It can also be passed on by a pregnant woman to the foetus. The first sign is a single sore or spot, hard at the edges, which is usually painless and easily mistaken for something else. This appears between 10 days and three months after contact, lasts for 2-6 weeks and is highly contagious. 6-8 weeks after it disappears, around 30% of sufferers will go on to the second stage which lasts from 2 weeks to 6 months. Symptoms at this stage include swollen lymph nodes, rashes and flu-type symptoms. Another kind of highly infections sore sometimes appears—flat greyish warts. Beyond this, if still untreated, the infection will cause serious damage to the brain, heart, nervous system, kidneys, and eyes. The signs of syphilis on the skeleton are quite dramatic, and the bones can look like molten wax. Fortunately, it need not get this far as it is susceptible to penicillin, and partners will also need to be treated.


Only found in the vagina, this can lead to an itchy, frothy and smelly discharge. Symptoms start around 2-20 days after exposure. Woman-to-woman transmission is well-documented and it can also be spread through sharing flannels and has been known to have been caught by women sharing a jacuzzi. Easily treated with antibiotics, and no long-term effects, but partners should be treated too.

Yeast Infections (Candidiasis)

This happens when a usually benign yeast living in the vagina gets out of control. It is not considered to be a sexually transmitted infection, but can be a symptom of something more serious and should be checked out. Symptoms include a thick white vaginal discharge with a yeasty odour and the appearance of cottage cheese, and itching.


The most pernicious of all infections, you can have it for years without realising it, and the majority have it to some degree. It’s spread by letting someone else tell you what’s good for you, especially religious organisations and politicians. Symptoms include low self-esteem, feeling bad after a good time, and judgemental behaviour towards others. If left untreated, it can lead to an inability to enjoy yourself, large counselling bills, irresponsible behaviour leading to epidemics of sexually transmitted infections and, in rare cases, death through suicide. It can be treated by learning to love and respect yourself and your own values, and having a good laugh.



Thanks to Father Mort L. Sinn of the Russian River Sisters of Perpetual Indulgence for help and support.

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Bless you and play safe.

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