Breast Cancer Among Lesbians

 

a. Testing & Check Ups

After skin cancer, breast cancer is the second most commonly diagnosed cancer among women, affecting one in eight women who live to the age of 80. The disease forms when breast cells mutate and multiply uncontrollably, forming a tumour. If untreated, cancerous cells may spread to other parts of the body.

Women who have a family history of breast cancer, who are obese, who have a sedentary lifestyle, who drink heavily, or who have dense breasts have a higher risk of the disease.

A lump, mass and change in the feel or position of the breast are among the most common symptoms of breast cancer. Other symptoms include:

• Swelling, redness or inflammation
• Changes in the nipple
• Nipple discharge
• Pain in the breast
• Itchy or irritated breasts
• Changes in colour
• Peeling or flaky skin

Tools and tests used to diagnose breast cancer include:

• Lab tests, including advanced genomic testing
• Biopsy
• Imaging tests, including ultrasound and mammography

Common treatments for breast cancer include surgery, chemotherapy, hormone therapy, radiation therapy, and targeted therapy.

At the Queer Wellness Centre, we recommend a yearly health check which also encompasses a breast exam by your doctor. In addition, we encourage you to examine your breasts every month to look for sign of anything wrong.

b. Referral and treatment

QWC will be able to refer you to a specialist should the results come back as positive. We are also able to provide psychological support and any other supportive medical needs.

Sexual Health

a. Oral safe sex-supplies for lesbians

Even though two women don’t have to worry about getting pregnant when they have sex with each other, they still have to think about how to protect themselves from sexually transmitted infections. STIs can be transmitted through fingering, oral sex and sharing sex toys. Here are a few ways to reduce your risk of STIs and other infections:

• Dental dams. Use these if you’re performing oral sex, either on the vagina or the anus. Unprotected oral sex puts you at risk for chlamydia, gonorrhoea, herpes, HPV, syphilis, and hepatitis. There is also a small chance of transmitting HIV, but this is quite rare, and would require the person giving oral sex to have cuts or open sores in or around their mouth.
• You can use these for sex-toys. Sex toys can transfer infections from one person to another, so clean sex toys thoroughly in between use.
• Gloves or finger cots. These can protect you during manual-genital stimulation, such as fingering, and clitoral stimulation. They may feel more comfortable when used with lube. Manual sex (fingering) has a fairly low STI risk, but you can still potentially get chlamydia, syphilis, herpes, HPV or genital warts.

Regular STI testing: Everyone who is sexually active should get regularly tested for STIs. Talk to your partner about when they were last tested, and what for. Talk to your doctor about how often you should get tested.

b. Vaginismus

Vaginismus is a condition involving muscle spasms in the pelvic floor muscles. For some women, the vaginal muscles involuntarily or persistently contract when they attempt vaginal penetration. Vaginismus can make it very painful, difficult, or impossible to have sexual intercourse, to insert a tampon, or to undergo a gynaecological exam. When you try to insert an object such as a tampon, penis/vibrator or speculum into the vagina, it tightens up because of involuntary contractions of the pelvic floor muscles. This leads to generalised muscle spasm, pain and temporary cessation of breathing. If you have vaginismus, you can’t control or stop the contractions of your vaginal muscles.

Symptoms can include:

• Painful intercourse with tightness and pain that may be burning or stinging
• Penetration being difficult or impossible
• Long-term sexual pain with or without a known cause
• Pain during tampon insertion
• Pain during a gynaecological examination
• Generalised muscle spasm or breathing cessation during attempted intercourse

Vaginismus is classified into two types:

• Primary vaginismus: when vaginal penetration has never been achieved
• Secondary vaginismus: when vaginal penetration was once achieved, but is no longer possible, potentially due to factors such as gynaecologic surgery or trauma

Vaginismus does not prevent people from becoming sexually aroused, but they may become anxious about sexual intercourse, so that they try to avoid sex or vaginal penetration

Treatment is possible however and usually includes education, sex therapy and counselling, and exercises

c. Vaginal Thrush

Vaginal thrush is a common yeast infection that affects most women at some point. It is an infection of the vagina and/or vulva with a yeast germ called candida. Some women are prone to recurring episodes of thrush. Certain factors can make thrush more likely to develop, including:

• When you are pregnant due to hormone changes
• Medical conditions such as diabetes or HIV
• Taking antibiotic medication
• Depleted immune system
• Friction during sex can cause minor damage where Candida are more likely to thrive – make sure your vagina is well lubricated
• Some cancers and their treatment

Itch of the skin folds outside the vagina is the most common symptom of thrush. It may be itchy inside the vagina also. There may also be soreness of the vulva. Sometimes it may be painful to pass urine and/or painful to have sex. There may also be a discharge from the vagina which is usually creamy white and quite thick. It can add to the itch, redness, discomfort, or pain around the vulva, and may cause cracking in the skin. The discharge from thrush does not usually smell. Other conditions, such as genital herpes or urinary tract infection may have similar symptoms, so it is important to have the diagnosis confirmed.

 There are a few different options for treating thrush. Some treatments are applied directly to the vagina and/or vulva; others are medicines which are swallowed orally.

Topical thrush treatments are pessaries and creams which you insert into the vagina with an applicator. They contain anti-yeast medicines. They can be administered as a large single dose, or a lower dose over a few days. You may also want to rub some anti-thrush cream on to the skin around the vagina a few days, especially if it is itchy.

Diflucan is a single dose tablet that is taken to treat thrush, and is only available via a prescription from your doctor. You may also want to rub some anti-yeast cream on to the skin around the vagina for a few days, especially if it is itchy.

 Preventing vaginal thrush

If you get thrush frequently, you can:

• Avoid wearing tight-fitting underwear, tights or jeans – the aim is to prevent the vaginal area from being constantly warm, moist and airless.
• Use water and an emollient (moisturiser) soap substitute to clean the vulva (skin around your vagina), but avoid cleaning this area more than once a day
• Apply a greasier moisturiser to the skin around your vagina several times a day to protect it
• Avoid potential irritants in perfumed soaps, shower gels, vaginal deodorants, wipes and douches
• Ensure your blood sugar level is kept under control, if you have diabetes
• Eat probiotic yoghurt or take probiotic supplements

STI’s

a. Common vaginal STIs among lesbians

 1. Chlamydia

Chlamydia is one of the most common sexually transmitted infections you can get. It is caused by bacteria called Chlamydia trachomatis and it can infect both men and women in equal measure across all age groups. Women can get chlamydia in the cervix, rectum, or throat. Men can get chlamydia in the urethra (inside the penis), rectum, or throat. You may not know you have chlamydia because many people never develop any signs or symptoms, but chlamydia isn’t difficult to treat once you know you have it. If left untreated, however, it can lead to more-serious health problems, including infertility in both men and women, pelvic inflammatory disease, and ectopic pregnancy. Untreated chlamydia may also increase your chances of getting or giving HIV/AIDS.

 Symptoms of chlamydia

Early-stage Chlamydia infections rarely cause any symptoms. When signs do start to occur, it is usually a few weeks after exposure to the infection. Signs and symptoms of a chlamydia infection can include:

Women:

• Painful urination
• Vaginal discharge
• Lower abdominal pain
• A burning sensation when urinating
• Pain during intercourse
• Bleeding between periods and after sex in women
• Swelling in the vagina or around the anus
• Nausea or fever

 Chlamydia can also infect the rectum causing rectal pain, discharge or bleeding.

It’s also possible to acquire chlamydial eye infections (conjunctivitis) through contact with infected secretions.

Both men and women can also develop reactive arthritis because of a chlamydia infection – this is a type of arthritis that happens as a “reaction” to an infection in the body.

 How do you get chlamydia?

Chlamydia is most commonly spread during oral, vaginal, or anal sex with someone who has the infection. It’s also possible for a mother to spread chlamydia to her child during delivery, causing pneumonia or a serious eye infection in her new-born. Chlamydia can also cause premature birth.

If you’ve had chlamydia and were treated in the past, you can get re-infected if you have unprotected sex with someone who has it.

 Risk factors

Chlamydia is more common in young people. You are more likely to get it if you don’t consistently use a condom, or if you have multiple partners.

Factors that increase your risk of a chlamydia infection include:

• Being sexually active before age 25
• Multiple sex partners within a short period of time
• Not using a condom consistently
• History of prior sexually transmitted infection
• Men who have sex with men

 How is chlamydia diagnosed?

Lab tests are used to diagnose chlamydia. Your doctor may ask you to provide a urine sample. For women doctors may use a cotton swab to get a sample from your vagina to test for chlamydia.

 Who should be tested for chlamydia?

You should go to your doctor for a test if you have symptoms of chlamydia, or if you have a partner who has a sexually transmitted disease. Those at higher risk should get checked for chlamydia every year.

 Treatment of chlamydia

Treatment of chlamydia is very important as it can lead to serious long-term health consequences. Antibiotics are effective in treating chlamydia and will cure the infection. You may get a one-time dose of antibiotics, or you may need to take medicine every day for 7 days. Antibiotics however cannot repair any permanent damage that the disease has caused.

To prevent spreading chlamydia, you should not have sex until the infection has cleared up.

Repeat infections are common, so you should get tested again approximately three months after treatment.

Depending on the test used to diagnose chlamydia, a person may also be treated for gonorrhoea because these two bacteria often occur together

 2. Herpes

Genital herpes is a sexually transmitted infection which causes infected sores, blisters, ulcers and cuts in both men and women. It is caused by the herpes simplex virus (HSV) which can be passed on even if the person does not have any symptoms. Sexual contact is the primary way that the virus spreads.

After the initial infection, the virus will lie dormant in your body and can reoccur many times a year, for many years.

Genital herpes can cause pain, itching and sores/ulcers in your genital area until the infection clears. During an initial outbreak of genital herpes, you may experience flu-like symptoms such as swollen lymph nodes in your groin, headache, muscle aches, and fever. You can spread the infection on yourself by touching an infected sore and then touching another area of your body. Sores can develop on the buttocks and thighs, urethra, anus and mouth. Women can also develop sores in or on the vaginal area, external genitals, and cervix. Men can also develop sores in on the penis or scrotum.

Genital herpes is caused by HSV-2. The virus spreads through skin-to-skin contact. It is very common and highly contagious, whether or not you have an open sore.

There’s no cure for genital herpes, but medication can help to relieve symptoms, and reduce the risk of infecting others. Condoms also can help prevent the spread of a genital herpes infection.

 3. Gonorrhoea

Gonorrhoea is a very common sexually transmitted infection caused by bacteria that can infect both men and women, and was commonly known as ‘the clap’. It can cause infections in the genitals, rectum, and throat. In females, gonorrhoea can also infect the cervix. You can get gonorrhoea by having vaginal, anal, or oral sex with someone who has gonorrhoea.

Abstaining from sex or always using a condom when you have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections such as gonorrhoea.

Symptoms of Gonorrhoea

Both men and women with gonorrhoea often have no symptoms at all, or symptoms might be mistaken for a bladder infection.

Symptoms in men can include:

• A burning sensation when urinating
• A white, yellow, or green discharge from the penis
• Painful or swollen testicles

Symptoms in women can include:

• Painful or burning sensation when urinating
• Increased vaginal discharge
• Vaginal bleeding between periods

Rectal infections can involve discharge, anal itching, soreness, bleeding, and painful bowel movements.

You should be examined by your doctor if you notice any of these symptoms.

Risk Factors for Gonorrhoea

Any sexually active person can get gonorrhoea through unprotected vaginal, anal, or oral sex. Other factors that can increase your risk include:

• Having a new sex partner, a sex partner who has other partners, or by having multiple sex partners
• Sharing sex toys without washing them and covering with a new condom each time they are used
• Having had gonorrhoea or another sexually transmitted infection

If you are a sexually active man who is gay, bisexual, or who has sex with men, you should be tested for gonorrhoea every year.

Annual screening is recommended for sexually active women younger than 25, or older women with risk factors such as new or multiple sex partners, a sex partner with other partners, or a sex partner who has a sexually transmitted infection.

Having gonorrhoea makes you more susceptible to infection with HIV, and subsequently AIDS. If you have HIV and also have gonorrhoea, your viral load will increase, making you more likely to pass on HIV if you have sex without a condom, even if you are taking antiretrovirals.

Prevention of Gonorrhoea

To prevent gonorrhoea you should:

• Use a condom if you have sex, including anal sex, oral sex or vaginal sex.
• Use male and female condoms, dental dams and latex gloves.
• Stay in a monogamous relationship in which neither partner has sex with anyone else.
• Before you have sex, you and your partner should get tested and share your results with each other.
• Don’t have sex with someone who appears to have a sexually transmitted infection e.g. burning during urination or a genital rash or sore.

How is Gonorrhoea diagnosed?

A simple urine test or a swab taken by your doctor will show whether or not you have gonorrhoea.

If you have had oral or anal sex, swabs may be used to collect samples from your throat or rectum. In some cases, a swab may be used to collect a sample from a man’s urethra (urine canal) or a woman’s cervix.

Treatment of Gonorrhoea

Gonorrhoea can be cured with the right treatment, but though medication will stop the infection, it will not undo any permanent damage caused by the disease. You should always wait seven days after finishing all medications before having sex. If you’ve had gonorrhoea in the past, you can still get infected again if you have unprotected sex with a person who has gonorrhoea.

Untreated gonorrhoea can cause serious and permanent health problems in both men and women and can lead to permanent infertility in both. In rare cases, untreated gonorrhoea can spread to your blood or joints – this condition can be life-threatening.

b. Treatment of STIs

If you have an untreated STI it can cause a range of mild to severe health complications and create other health conditions.

STIs caused by bacteria are easier to treat than viral infections, which can be managed but not necessarily cured. Treatment for STIs usually consists of one of the following:

• Antibiotics are used to cure many sexually transmitted bacteria and parasitic infections including gonorrhoea, syphilis, chlamydia and trichomoniasis. Typically, you’ll be treated for gonorrhoea and chlamydia at the same time because the two infections often appear together.

Once you start a course of antibiotics it is important to complete the course. It’s also important to abstain from sex until seven days after you’ve completed antibiotic treatment and any sores have healed.

• Antiviral drugs. If you have herpes or HIV, you’ll be prescribed an antiviral drug. Antiviral drugs will reduce the number of herpes recurrences if you take daily suppressive therapy, but you will still be contagious.

Antiviral drugs can keep HIV infection in check for many years and even reduce your virus count so low that it can hardly be detected, but you will still have the virus and can still transmit it.

Vaginal Health

Certain STIs, such as human papillomavirus (HPV), bacterial vaginosis, and trichomoniasis – can spread between women. Oral sex and sexual behaviour involving digital-vaginal contact, particularly with shared penetrative sex toys, can spread infections between partners as well.

 Female sexual contact is also a possible means of contracting HIV, the virus that causes AIDS. There’s no cure for HIV/AIDS and many sexually transmitted infections, such as HPV and genital herpes. The best way to stay healthy is to practice safe sex.

Pap smears

 A Pap smear is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on your cervix. A pap smear is not usually used to detect herpes, syphilis, chlamydia, gonorrhoea or other common STDs and STIs. During the routine procedure, cells from your cervix (the opening to the top of your uterus) are gently scraped away and examined for abnormal growth. The procedure is done at our offices.

The test should not be performed during your menstrual period, since the presence of blood may interfere with the results. The best time to schedule a Pap smear is two weeks after the start of your last menstrual period.

HPV is a virus that causes warts and increases the chance of cervical cancer. If you have HPV, you may be at an increased risk of developing cervical cancer and will need regular pap smears done.

Annual check-ups

Some lesbian women struggle to find a doctor knowledgeable about their specific health issues and with whom they feel comfortable discussing their needs and concerns. The Queer Wellness Centre is one place to find a doctor capable of meeting your needs.

We highly recommend building a relationship with your doctor and attending the clinic annually for a check-up and routine screening.

If you are having sex with multiple partners, you should schedule regular screenings for sexually transmitted infections. Also share any other health concerns you might have with your doctor. Early diagnosis and treatment help promote long-term health.