Home' LOTL : September 2004 Contents HEALTH
SEXUALLY TRANSMITTED INFECTIONS
At a recent course in sexually transmitted infections (STIs)
I asked why we weren't learning about women who
have sex with women (WSW). I was stunned when the (very
experienced) lecturer said, "Lesbians don't have a problem
Such statements seem to stem from an abject ignorance of
female sexuality on the part of the medical profession and a
reluctance by WSW to discuss their orientation and practices
when presenting for health care. It's not that the problem isn't
there, it's that the data's lacking.
The risk of women catching an STI varies depending on
the STI. Herpes, wart vir us, and bacterial vaginosis pass fairly
easily between women during sex. HIV, hepatitis B,
gonorrhea, and chlamydia are much less likely to be
transmitted, but it is still possible.
Ignoring an STI may have serious consequences. They can
cause cer vical cancer, damaged reproductive organs, pregnancy
complications, transmission of infections to foetus or newborn.
Many STIs are silent in women and have similar symptoms of
abnormal vaginal discharge and irritation so are easily
overlooked or inappropriately self-treated.
More partners equals more risk. So if you and your girl
have been monogamous for life, you don't need to read much
further. If either of you have ever had sex with a man, though,
a Pap smear every two years is essential. Since the majority of
lesbian and bisexual women have had sex with men, it is
possible to have become infected years ago and still carry the
infection. Herpes and wart virus are examples of infections
which can lie dormant for years.
Monogamous or not, bacterial vaginosis (BV) is the one
infection even my course tutors agreed was common among
lesbians. In one study over half the lesbians had BV, even in the
absence of sex with a man in the previous year. There was also
a high likelihood if one partner in a monogamous lesbian
couple had BV her partner would too.
No one knows exactly what causes BV, (formerly
Gardnerella vaginitis after the bacteria commonly associated
with it), but it's basically a disturbance of the normal vaginal
bacteria and acid balance. Douching, excessive genital washing
and any activity where vaginal fluids are exchanged are all risk
factors for BV.
BV causes a grayish, watery discharge, with a strong fishy
odour and occasional vaginal irritation. Diagnosis is made by
testing the discharge. BV is often mistaken for a yeast infection
and many women try to self-treat with the wrong medication.
Correct diagnosis is important because untreated BV is associated
with complications during pregnancy and pelvic inflammatory
disease (PID). Treatment is not always necessary unless you are
pregnant or about to undergo an invasive procedure. BV is
treated orally or vaginally with metronidazole or clindamycin.
Partners don't need to be treated unless also infected.
Another common infection is Trichomoniasis. It's a tiny
protozoa which can present like BV but it is definitely an STD.
Transmission between women is well documented and
probably underestimated. It is not passed via toilet seats or
sharing towels, only by sex. It lives in the moist areas of the
genitals of infected people and causes a yellowish, foamy
discharge with foul odor. There may be painful urination,
itching or irritation but symptoms are often absent. Treatment
is simple with oral metronidazole in a single dose. Partners must
also also be treated and you should avoid sex until treated.
Taylor Square Private Clinic is pleased
to announce that Dr Terri Foran, former
Medical Director of Family Planning NSW, is
now available for consultations in Women's
Health Medicine including Colposcopy clinics.
Dr Foran's prominence in the field of Women's
Health, Medical Journalism and Teaching
will be a valued addition to our clinic's
provision of comprehensive health. She joins a
team of experienced sexual health and
393 Bourke Street Darlinghurst
By Appointment 9331 6151
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