F REQUENTLY A SKED Q UESTIONS
The more risk factors (or things that
increase risk) a woman has, the
greater the chance that she will
develop heart disease. There are
some factors that you can’t control
Lesbian Health
WomensHealth.gov
Q: What challenges do lesbian
such as getting older, family health
1-800-994-9662
women face in the health care
history, and race. But you can do
TDD: 1-888-220-5446
system?
something about some of the
A:
Lesbians face unique challenges within
the health care system that can cause
poorer mental and physical health.
Many doctors, nurses, and other health
care providers have not had sufficient
biggest risk factors for heart and
cardiovascular disease—smoking,
high blood pressure, lack of exercise,
diabetes, and high blood cholesterol.
●
Exercise. Studies have shown
training to understand the specific
that physical inactivity adds to a
health experiences of lesbians, or that
person’s risk for getting heart and
women who are lesbians, like
cardiovascular disease, as well as
heterosexual women, can be healthy
some cancers. People who are not
normal females. There can be barriers
active are twice as likely to develop
to optimal health for lesbians, such as:
heart and cardiovascular disease
●
Fear of negative reactions from their
doctors if they disclose their sexual
orientation.
compared to those who are more
active. The more overweight you
are, the higher your risk for heart
●
Doctors’ lack of understanding of
lesbians’ disease risks, and issues that
may be important to lesbians.
disease. More research with lesbians
in this area is needed.
●
Obesity. Being obese can make you
●
Lack of health insurance because of
more likely to get heart disease, and
no domestic partner benefits.
cancers of the uterus, ovary, breast,
and colon. Many studies have found
●
Low perceived risk of getting
that lesbians have a higher body
sexually transmitted diseases and
mass than heterosexual women.
some types of cancer.
For the above reasons, lesbians often
avoid routine health exams and even
delay seeking medical care when health
problems occur.
Studies suggest that lesbians may
store fat more in the abdomen and
have a greater waist circumference,
which places them at higher risk for
heart disease and other obesity-
related issues such as premature
Q: What are important health
death. Additionally, some suggest
issues for lesbians to discuss
that lesbians are less concerned
with their doctors or nurses?
about weight issues than
heterosexual women.
A:
●
Heart disease. Heart disease is the
#1 killer of all women. Factors that
raise women’s risk for heart
disease—such as obesity, smoking,
At this time, more research is
needed in these areas: physical
activity in lesbians; possible dietary
page 1
and stress—are high among lesbians.
differences between lesbians and
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F REQUENTL Y A SKED Q UESTIONS
heterosexual women; if a higher
BMI is a ref lection of lean tissue and
not excess fat; and if there’s a
different cultural norm among
lesbians about thinness. In addition,
compared to the general population.
Smoking as a teen increases the risk
of becoming an adult smoker. We
know that about 90 percent of adult
smokers started smoking as teens.
other important factors for
●
Depression and Anxiety. Many
researchers to consider are
factors cause depression and anxiety
race/ethnic background, age, health
status, education, cohabitation with
a female relationship partner, and
having a disability. Studies have
among all women. Studies show that
lesbian and bisexual women report
higher rates of depression and
anxiety than heterosexual women
reported that among lesbian and
do. This may result from the fact
bisexual women, African American
that lesbian women may also face:
or Latina ethnicity, older age, poorer
health status, lower educational
> Social stigma
attainment, lower exercise
> Rejection by family members
frequency, and cohabiting with a
female relationship partner increases
> Abuse and violence
a lesbian woman’s likelihood of
> Being treated unfairly in the legal
having a higher BMI.
system
●
Nutrition. Research supports that
lesbian and bisexual women are less
likely to eat fruits and vegetables
every day. More research on food
consumption and dietary differences
in relation to health and lesbians and
bisexuals is needed.
> Hiding some or all aspects of
one’s life
> Lacking health insurance
Lesbians often feel they have to conceal
their lesbian status to family, friends,
and employers. Lesbians can also be
recipients of hate crimes and violence.
●
Smoking. Smoking can lead to
heart disease and multiple cancers,
including cancers of the lung,
Despite strides in our larger society,
discrimination against lesbians does
exist, and discrimination for any reason
throat, stomach, colon, and cervix.
Lesbians are more likely to smoke,
compared to heterosexual women.
Researchers think that high rates of
smoking in this population are a
consequence several things, like
may lead to depression and anxiety.
●
Alcohol and drug abuse.
Substance abuse is as serious a public
health problem for the lesbians, gay
men, bisexuals, and transgendered
social factors, such as low self-
esteem, stress resulting from
discrimination, concealing one’s
people (LGBT) as it is for the
general U.S. population. Overall,
recent data suggest that substance
sexual orientation, and tobacco
advertising targeted towards gays
and lesbians. Studies have also found
that smoking rates are higher among
gay and lesbian adolescents
use among lesbians—particularly
alcohol use—has declined over the
past two decades. Reasons for this
decline may include greater
awareness and concern about health;
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more moderate drinking among
women in the general population;
some lessening of the social stigma
and oppression of lesbians; and
changing norms associated with
drinking in some lesbian
communities. However, both heavy
drinking and use of drugs other than
alcohol appear to be prevalent
among young lesbians and among
some older groups of lesbians.
●
Cancers. Lesbian women may be at
a higher risk for uterine, breast,
cervical, endometrial, and ovarian
cancers because of the health
profiles listed above. However, more
research is needed. In addition, these
reasons may contribute to this risk:
> Lesbians have traditionally been
less likely to bear children.
Hormones released during
pregnancy and breastfeeding are
believed to protect women
against breast, endometrial, and
ovarian cancers.
> Lesbians have higher rates of
alcohol use, poor nutrition, and
obesity. These factors may
increase the risk of breast,
endometrial, and ovarian cancers,
and other cancers.
> Lesbians are less likely to visit a
doctor or nurse for routine
screenings, such as a Pap, which
can prevent or detect cervical
cancer. The viruses that cause
most cervical cancer can be
sexually transmitted between
women. Lesbians have similar
rates of mammography testing
(for breast cancer) as heterosexual
women.
●
Domestic Violence. Also called
intimate partner violence, this is
when one person purposely causes
either physical or mental harm to
another. Domestic violence can
occur in lesbian relationships as it
does in heterosexual relationships,
though there is some evidence that
it occurs less often. But for many
reasons, lesbian victims are more
likely to stay silent about the
violence. Some reasons include
fewer services available to help
them; fear of discrimination; threats
from the batterer to “out” the
victim; or fear of losing custody of
children.
●
Polycystic Ovarian Syndrome.
PCOS is the most common
hormonal reproductive problem in
women of childbearing age. PCOS
is a health problem that can affect a
woman’s menstrual cycle, fertility,
hormones, insulin production,
heart, blood vessels, and appearance.
Women with PCOS have these
characteristics:
> high levels of male hormones,
also called androgens
> an irregular or no menstrual cycle
> may or may not have many small
cysts in their ovaries. Cysts are
f luid-filled sacs.
An estimated five to 10 percent of
women of childbearing age have
PCOS (ages 20-40). There is
evidence that lesbians may have a
higher rate of PCOS than
heterosexual women.
●
Osteoporosis. Millions of women
already have or are at risk for
page 3
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F REQUENTL Y A SKED Q UESTIONS
osteoporosis. Osteoporosis means
that your bones get weak, and
you’re more likely to break a bone.
Osteoporosis in lesbian women has
not yet been well studied.
the cervix that can lead to cancer,
if it is not treated. Most people
with HPV or genital warts don’t
know they are infected until they
have had a Pap test because they
●
Sexual Health. Lesbian women are
may not have symptoms, but the
at risk for many of the same STDs as
virus can still be spread by
contact. Lesbians can transmit
heterosexual women. Lesbian
women can transmit STDs to each
other through skin-to-skin contact,
mucosa contact, vaginal f luids, and
menstrual blood. Sharing sex toys is
another method of transmitting
HPV through direct genital skin-
to-skin contact or by the virus
traveling on hands or sex toys.
Some women and their doctors
wrongly assume that lesbian
STDs. These are common STDs
women do not need a regular Pap
that can be passed between women:
test. However, the virus can be
spread by lesbian sexual activity,
> Bacterial vaginosis (BV).
and many lesbians have been
Although we don’t know for sure
sexual with men so it is
that BV is caused by a sexually
transmitted agent, BV occurs
more commonly among women
who have recently acquired other
STD’s, or who have recently had
recommended that lesbian
women have a Pap test. This
simple test is an effective method
of detecting abnormal cells on
unprotected sex. For reasons that
are unclear, BV is more common
in lesbian and bisexual women
than heterosexual women, and
frequently occurs in both
the cervix that can lead to cancer.
Begin getting Pap tests no later
than age 21 or sooner if you’re
sexually active. These
recommendations apply equally
to lesbians who’ve never had sex
members of lesbian couples. BV
happens when the normal
bacteria in the vagina get out of
balance. Sometimes, BV causes
with men, as cervical cancer
caused by HPV has been seen in
this group of women.
no symptoms, but over half of
> Trichomoniasis “Trich”. It is
affected women have a vaginal
caused by a parasite that can be
discharge with a fishy odor or
passed from one person to
vaginal itching. If left untreated,
another during sexual contact. It
BV can increase a woman’s
chances of getting other STDs
such as HIV, chlamydia,
gonorrhea, and pelvic
inf lammatory disease.
> Human papillomavirus
(HPV). HPV can cause genital
warts and abnormal changes on
can also be picked up from
contact with damp, moist objects
such as towels or wet clothing.
Trich is spread through sexual
contact with an infected person.
Signs include yellow, green, or
gray vaginal discharge (often
foamy) with a strong odor;
discomfort during sex and when
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urinating; irritation and itching
HSV-1 is another herpes virus
of the genital area; and lower
that usually infects the mouth
abdominal pain in rare cases. To
and causes oral cold sores, but
tell if you have trich, your doctor
can also be transmitted to the
or nurse will do a pelvic exam
genital area through oral sex.
and lab test. A pelvic exam can
Lesbians can transmit this virus
show small red sores, or
to each other if they have
ulcerations, on the wall of the
intimate contact with someone
vagina or on the cervix. Trich is
with a lesion or touching infected
treated with antibiotics.
skin even when an outbreak is
> Herpes. Herpes is a virus that
not visible.
can produce sores (also called
> Syphilis. Syphilis is an STD
lesions) in and around the vaginal
caused by bacteria. Syphilis is
area, on the penis, around the
passed through direct contact
anal opening, and on the
with a syphilis sore during
buttocks or thighs. Occasionally,
vaginal, anal, or oral sex. If
sores also appear on other parts of
untreated, syphilis can infect
the body where the virus has
other parts of the body. Syphilis
entered through broken skin.
remains uncommon in the
Most people get genital herpes by
general population, but has been
having sex with someone who is
increasing in men who have sex
shedding the herpes virus during
with men. It is extremely rare
periods when an outbreak is not
among lesbians. However,
visible. The most common cause
lesbians should talk to their
of recurrent genital herpes is
doctor if they have any non-
HSV-2, which is transmitted
healing ulcers.
through direct genital contact.
Q:
STD
Symptoms
●
abnormal vaginal discharge
●
burning when urinating
●
●
●
●
nausea
●
●
pain during sex
●
What other STDs can lesbian women get?
Chlamydia
Most women have no symptoms.Women with symptoms may have:
bleeding between menstrual periods
Infections that are not treated, even if there are no symptoms, can lead to:
lower abdominal pain
low back pain
fever
bleeding between periods
page 5
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WomensHealth.gov
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TDD: 1-888-220-5446
STD
Hepatitis B
HIV/AIDS
Pubic Lice
Symptoms
●
pain or burning when urinating
●
●
●
●
●
●
●
●
●
●
stomach pain
●
●
●
●
●
●
●
●
menstrual cycle changes
●
●
itching
●
finding lice
Gonorrhea
Symptoms are often mild, but most women have no symptoms. Even
when women have symptoms, they can sometimes be mistaken for a
bladder or other vaginal infection. Symptoms are:
yellowish and sometimes bloody vaginal discharge
bleeding between menstrual periods
Some women have no symptoms.Women with symptoms may have:
mild fever
headache and muscle aches
tiredness
loss of appetite
nausea or vomiting
diarrhea
dark-colored urine and pale bowel movements
skin and whites of eyes turning yellow
Some women may have no symptoms for 10 years or more.Women with
symptoms may have:
extreme fatigue
rapid weight loss
frequent low-grade fevers and night sweats
frequent yeast infections (in the mouth)
vaginal yeast infections and other STDs
pelvic inflammatory disease (PID)
red, brown, or purplish blotches on or under the skin or inside the
mouth, nose, or eyelids
Q: What can lesbian women do to
You can access their database of
protect their health?
members at www.glma.org/
A:
●
Find a doctor who is sensitive to
programs/prp/index.shtml or
your needs to help you get
contact them at (415) 255-4547.
regular check ups. The Gay and
●
Get a Pap test. The Pap test finds
Lesbian Medical Association
changes in your cervix early, so you
provides online health care referrals.
can be treated before the problem
page 6
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F REQUENTL Y A SKED Q UESTIONS
becomes serious. Begin getting Pap
tests no later than age 21 or within
three years of first having sexual
intercourse. After two to three
yearly Pap tests have been normal,
talk to your doctor or nurse about
getting a Pap test at least once every
Read more about having a healthy
diet at http://www.4woman.gov/
faq/diet.htm.
●
Drink moderately. If you drink
alcohol, don’t have more than one
drink per day. Too much alcohol
raises blood pressure and can raise
three years.
your risk for stroke, heart disease,
●
Talk to your doctor or nurse osteoporosis, many cancers, and
about an HPV test if your Pap other problems.
test is abnormal. In combination
●
Get moving. An active lifestyle can
with a Pap test, an HPV test helps
prevent cervical cancer. It can detect
the types of HPV that cause cervical
help every woman. Thirty minutes
of moderate physical activity on
most days of the week can greatly
cancer. The Food and Drug
improve your health and decrease
Administration (FDA) has approved
your risk of heart disease and some
an HPV DNA test for women for
cancers!
the following uses:
●
Don’t smoke. If you do smoke, try
> as a follow-up to a Pap test with
to quit. Avoid second hand smoke as
results that are abnormal
> in combination with a Pap test in
women aged 30 and older
much as you can. Read more about
quitting at http://www.4woman.gov/
QuitSmoking.
●
Practice safer sex. Get tested for
STD’s like chlamydia or herpes
before beginning a relationship. If
you’re unsure about a partner’s
status, practice methods to reduce
the likelihood of sharing vaginal
f luid or blood, including condoms
on sex toys.
●
Try different strategies to deal
with your stress. Stress from
discrimination is a tough challenge
in the life of every lesbian. Relax
using deep breathing, yoga,
meditation, and massage therapy.
You can also take a few minutes to
sit and listen to soothing music, or
●
Have a balanced, healthy diet. Eat
read a book. Talk to your friends or
a variety of whole grains, fruits, and
get help from a professional if you
need it.
vegetables. These foods give you
energy, plus vitamins, minerals, and
fiber. Besides, they taste good! Try
foods like brown rice or whole-wheat
bread. Bananas, strawberries, and
melons are some great tasting fruits.
Try vegetables raw, on a sandwich, or
in a salad. Be sure to pick a variety of
colors and kinds of fruits and
vegetables. You can vary the form—
try fresh, frozen, canned, or dried.
●
Talk to your doctor or nurse
about screening tests you may
need. Regular preventive screenings
are critical to staying healthy. All the
tests that heterosexual women need,
lesbian women need too. See these
online charts for screening
guidelines for different age groups:
www.4woman.gov/screeningcharts.
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page 8
●
Get help for domestic violence.
Call the police or leave if you or
your children are in danger! Call a
crisis hotline or the National
Domestic Violence Hotline at 800-
799-SAFE or TDD 800-787-3224,
which is available 24 hours a day,
doctor or nurse about taking
medicines to prevent or treat bone
loss.
●
Know the Signs of a Heart
Attack. Women are less likely than
men to believe they are having a
heart attack and more likely to delay
365 days a year, in English, Spanish,
and other languages. The Helpline
can give you the phone numbers of
in seeking treatment. For women,
chest pain may not be the first sign
your heart is in trouble. Before a
local hotlines and other resources.
heart attack, women have said that
●
Build strong bones. Exercise. Get a
bone density test. Learn more about
that at: http://www.4woman.gov/
faq/osteopor.htm. Make sure you get
enough calcium and vitamin D each
day. Reduce your chances of falling
by making your home safer. For
example, use a rubber bathmat in the
shower or tub. Keep your f loors free
from clutter. Lastly, talk to your
they have unusual tiredness,
trouble sleeping, problems
breathing, indigestion, and
anxiety. These symptoms can
happen a month or so before the
heart attack. During a heart attack,
women often have these symptoms:
> Pain or discomfort in the center
of the chest.
Signs of a Heart Attack
Dash line indicates
that organ is behind
other main organs.
Brain
anxiety, dizziness, trouble sleeping
Chest
Arms, Back, Jaw,
chest pain, chest pressure, fullness
or squeezing (lasts more than a few
pain
Shoulders, Neck
minutes or comes and goes)
Skin
cold sweat
Lungs
trouble breathing
Stomach
upset stomach, urge to throw up
Body
feel tired and weak
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> Pain or discomfort in other areas
of the upper body, including the
arms, back, neck, jaw, or
stomach.
> Other symptoms, such as
and are different from the signs of a
heart attack. Signs you should look
for are weakness or numbness on
one side of your body, dizziness, loss
of balance, confusion, trouble
shortness of breath, breaking out
talking or understanding speech,
in a cold sweat, nausea, or light-
headache, nausea, or trouble walking
or seeing. Remember: Even if you
headedness.
have a “mini-stroke,” you may have
●
Know the Signs of a Stroke. The
some of these signs. ■
signs of a stroke happen suddenly
Signs of a Stroke
Dash line indicates
that organ is behind
other main organs.
Face, Arm, or Leg
numbness or
weakness (mainly on
one side of the body)
Brain
confusion, trouble talking or
understanding speech, dizziness,
loss of balance, bad headache
Eyes
trouble seeing in one or both eyes
Stomach
throwing up (or urge to)
Body
feel tired
Legs
trouble walking
page 9
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WomensHealth.gov
1-800-994-9662
TDD: 1-888-220-5446
The lesbian health FAQ has been reviewed by the University of Washington, University of
California, Los Angeles, and Gynecological Health Associates.
January 2005
Phone: (800) 799-7233
Gay and Lesbian Medical Association
(GLMA)
Phone: (202) 332-5536
For more information
For more information on lesbian health issues, contact the National Women’s Health
Information Center at 1-800-994-9662 or the following organizations:
Centers for Disease Control and
Prevention (CDC)
Internet Address: www.cdc.gov
Off ice on Violence Against Women,
OJP, DOJ
Internet Address:
http://www.ojp.usdoj.gov/vawo
Phone: (415) 255-4547
Internet Address: http://www.glma.org
Lesbian Health Research Center,
Institute for Health and Aging, UCSF
Phone: (415) 502-5209
Internet Address:
http://www.lesbianhealthinfo.org
Lesbian STD Web Site, University of
Washington
Internet Address:
http://depts.washington.edu/wswstd/
National Center for Lesbian Rights
Phone: (415) 392-6257
Internet Address: http://www.nclrights.org
The Mautner Project
Internet Address:
http://www.mautnerproject.org
page 10
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