Hormones and Their Role in Gender Transitioning

Every person’s transition journey is different and personal to them. The first step for many is taking hormones. Whether it’s oestrogen or testosterone assisting you on your journey of transitioning, it plays a vital role not only in your appearance, but in the way you feel and behave. It’s perfectly normal.

There may be ups and downs in mood and libido (Trust us the highs are high and the lows can be low!), but overall, your brain and your body will eventually align. Over time, you may even experience gender euphoria! (The dream).

If you’re just getting started on your journey, it’s important to note that taking hormones causes some changes which are irreversible. It’s also important to bear in mind that HRT is not a magical cure-all that will change your body overnight. It takes time, sometimes a lot of time, for effects to become visible, in some more so than in others. So try to be patient with your body! There are four key areas where you can expect changes to occur as your hormone therapy progresses: physical, emotional, sexual, and reproductive.

Here are some of the major changes you can expect from hormone therapy:

Transgender women

• Softer skin, less oily
• Softening/feminising soft tissue of the face
• Development of breast tissue
• Slower hair growth
• Feminisation of body shape – fat redistribution
• Likelihood of reduced libido
• Estrogen may reduce fertility and consultation with a reproductive specialist is recommended

Transgender Men

• Voice deepens
• Increase in abdominal fat and muscle mass
• Growth of facial and body hair
  Oily, coarse skin, possibly acne
  Clitoral growth
  Increased libido
  Increased appetite
  Testosterone therapy may reduce fertility and consultation with a reproductive specialist is recommended

A second puberty?

Hormone therapy can almost be considered a second puberty. Remember the confusing roller coaster of emotions, the uncontrolled outbursts, the bad skin associated with your teen years? Yep, that is exactly what you can expect.
It’s however important to remember that the extent of, and rate at which your changes take place, depend on many factors including your genetics, age, and your overall state of health.
It’s also important to note that taking higher doses of hormones will not necessarily bring about faster changes. It’s like trying to bake a cake at a higher temperature for shorter? It almost always flops! Remember, patience is a virtue! Taking higher doses also poses a serious medical threat. Avoid comparing with what you may have read online or with your friends. Everyone is different, which means your medicines and dosages will vary widely to others.

No one-size-fits-all

There’s no one-size-fits all approach to transitioning. Every body is different! Taking HRT can be a fast process or achingly slow, it just depends on who you speak to and their own personal experience. The bottom line is, if HRT makes you able to smile in pictures again, look at yourself in the mirror with confidence, and put on clothes and go out into the world and rock it, you know you’re definitely on the right track!

Vocal Health: helping the transgender community find their voice.

Literally.

One of the primary ways people express their gender is through their voice. Which is why it can be incredibly frustrating when you’ve transitioned but your voice hasn’t caught up. And while estrogen-based hormones don’t have an impact on your vocal chords, working with a vocal coach can feminize the tone and timbre of your voice.

We know that ‘trying on’ and ‘testing out’ a new voice will initially feel a bit strange (probably a lot like acting). But over time, your new voice will become second nature.

Voice plays a vital role

Voice features such as pitch, voice quality and inflection can signal a person’s gender to others. Which is why for so many transgender women, voice is one of the most crucial and often unguided aspects of transition, especially because oestrogen therapy cannot feminise the voice in trans women.

If you Google Male to Female Voice training, your search results will be flooded with “How To’s” and YouTube tutorials.

While these instruction videos might work for one person, there’s no guarantee they’ll work for another. In addition, medical experts warn that the voice is a muscle, and it can get injured or strained if not used properly. There’s also a risk that you pinch your voice without realizing because no one is there to guide and correct you.

Recent advances in voice therapy is making significant strides in helping to empower transgender women through their voice. Feminine-sounding voices are generally perceived as higher pitched, slightly breathier and with more varied inflection than masculine-sounding voices.

Voice therapy retrains the voice by retraining the brain and focuses on five parts of speech: pitch, intonation, volume, articulation and resonance.

The training also focuses on helping to feminize body language, facial expressions, and mannerisms.

The bottom line

Some people want to change how their speaking voice sounds as part of their gender expression. Others do not. It is your choice. For many, finding their voice is about so much more than just the way they sound and are perceived by others, it forms a vital piece of their identity. But, for those undergoing vocal training, it is critical to take your time and not push yourself too hard.

Remember you’re using muscles in a new way, which means they’re bound to get sore. Just as you can’t run a marathon on your first day of practice, you won’t be able to learn and perfect a female voice overnight. The most important thing is to look after yourself and your vocal chords!

Drink plenty of water, avoid overexertion, avoid raising your voice, rest your voice when tired, and allow adequate time to warmup and warm-down your voice.

Remember, patience is a virtue! “Rivers know this: there is no hurry. We shall get there some day.” ― A.A. Milne, Winnie-the-Pooh.

November is Trans Awareness month on our QWC sexual health calendar. In this series of articles we will aim to assist you in better undertanding the issues facing the Trans community.

Essential tips for tucking, strapping & packing

Whether it’s tucking, strapping or packing, we all have our own philosophies when it comes to our bodies that help us not only create our desired body shape but contribute to making us feel whole.  And with so many new products coming onto the market, it’s becoming even easier to express ourselves in a painless, comfortable, safe, and in many cases, a fashion-forward way.

The most important thing is to learn to love your body and embrace being your unique self. As Oscar Wilde famously put it – “Be yourself; everyone else is already taken”.  For many of us tucking, binding and packing is a huge part of our daily realities. But, like with everything in life, there are risks involved if not done properly. We outline key tips to keep in mind to ensure you stay safe (and away from the ER) when tucking, strapping and packing.

1. Chest Binding

Binding for so many is an absolute non-negotiable.  But, while chest binding can significantly improve mental health and anxiety, it can cause negative side effects. A 2016 study that examined 2 outcomes among people who bind found only 2.8% of individuals out of 1800 had rare and severe outcomes like rib fractures. This reinforces the fact that binding is not inherently harmful if the right precautions are taken.

Safe ways to bind include:

• Take a break every couple hours. Prolonged binding could cause adverse side effects including breast, back and chest pain, skin irritation, or fungal infections. The golden rule is to try to give yourself a break every 8 to 12 hours. Make sure you also avoid exercising and sleeping in your binder.
• Find the right fit. Wearing binders that are too tight will not only restrict your breathing but can cause tissue and muscle damage. Bodies change over time, especially if you’re on hormones. Make sure you wear a binder that fits your body comfortably and correctly and change the size when you need to. Trust us, you don’t want to be out somewhere and not be able to breathe!!
• Bind properly. Commercial binders, sports bras, strategic layering, and bandages, are the safest ways to bind. Do NOT bind your chest with duct tape or plastic wrap as this can damage your skin.
• Be careful how you wash it. Hand wash and air dry your binder regularly (Every few days). Make sure you don’t put your binder in the tumble drier as there’s a very high chance it’ll shrink.

2. Tucking

As with binding, tucking (no matter how you choose to tuck) needs to be done safely and comfortably to ensure no adverse and damaging side effects. Risks associated with improper tucking include skin irritation and discomfort, UTIs, dehydration, infections, and bladder and kidney damage.

Safe ways to tuck include:

• Don’t tuck for too long. Tucking for too long can lead to testicular discomfort and pain. As with chest binding, we recommend taking regular breaks from tucking.
• Be mindful of the tape you choose. Not all tape is skin safe to use, especially when it comes to sensitive skin. It’s therefore super important to choose the right adhesive to avoid chafing and skin irritation. We recommend testing a small area before full application. It’s also a good idea to shave the area where the tape will be used, so there’s no irritation or pain when the tape is removed.
• Keep it clean. The increased moisture caused by tucking can cause skin irritation, rashes, and infections. Make sure you keep the area dry and clean. Consider applying anti-fungal powder or creams to prevent odours and infections.

3. Packing

While packing comes with far fewer health risks than binding and tucking, a small percentage of people do report some negative side-effects from wearing certain prosthetics.

Safe ways to pack include:

• Be careful if you have allergies. If you’re allergic, be extra careful to check ingredients carefully when purchasing a prosthesis. We recommend purchasing silicone because it is non-allergenic and non-porous. Silicone is also much easier to clean.
• Store your packer carefully. You obviously want your packer to retain its shape which means storing it carefully as opposed to throwing it into a cupboard or into the bottom of your bedside drawer.
• Watch out for the adhesive. Be careful of the ingredients contained in the adhesives used to hold the packer in place. This is directly applied to the skin and can cause significant skin irritation, especially if you’re allergic.

The bottom line

Binding, tucking and packing are vital for so many for a variety of reasons.  Just make sure you do it as safely as possible to mitigate any potential health risks and side effects. So, what are you waiting for? Get outside and rock the look that makes you feel whole and happy. With a little tuck here or a little packing there, you do YOU! Above all, feel comfortable, be safe and take care.

General Health

a. Anal care

Transgender women – if you still have a penis – need to stay on top of your health and protect yourself throughout your life. There are a number of precautions you can take to prevent contracting a sexually transmitted infection, and if you are concerned you can easily take tests to find out your status.

All transgender women should be tested regularly for STDs, including HIV, Syphilis, Hepatitis B, Hepatitis C, Chlamydia, and Gonorrhoea.

If you have had sex with someone you don’t know well, or have casual sex with multiple partners, you should be screened more often for STDs and may benefit from getting tested for HIV more frequently.

It is important to have an open conversation with your doctor about getting vaccinations for Hepatitis A and B, and HPV – there are a number of vaccines that can help to protect your health.

 You can do many things to protect your sexual health. For example, you can learn about how STIs are spread and how you can reduce your chances of getting an STI. Have open and honest conversations with your partners about your risk of being infected with an STI. You can also talk to your doctor about PrEP, which may be appropriate if you have many partners.  

b. Vaginal care

Transgender men – if you still have a cervix, and unless you have had a complete hysterectomy, are still at risk of cervical cancer and ovarian cancer. Your risk of cervical cancer, or HPV, relates to your past and current sexual practices, but even people who have never had a penis in contact with their vagina may still contract an HPV infection. The HPV vaccine, can greatly reduce your risk of cervical cancer, and you may want to discuss this with your doctor. Pap smears are used to detect cervical cancer or pre-cancer conditions such as an HPV infection. Your doctor will make a recommendation as to how often you should have a pap smear.

Transgender Community Health Section

Medical centres where transgender people are made to feel welcome are scarce in South Africa. The Queer Wellness Centre (QWC) aims to address this gap by offering holistic services to transgender people that are supportive and understanding of their unique needs. We help transgender, gender nonconforming, and non-binary adults access to the highest quality gender affirming medical care.

QWC offers experienced doctors as well as referrals to specialists such as plastic surgeons, psychiatrists, psychologists, endocrinologists in support of our transgender patients. We hope that our clinic will help to quicken the pace of what can be a very long and bureaucratic journey.

1. Hormone Therapy

a. Getting started on transition Hormone therapy In Johannesburg

Transgender hormone therapy is when sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals to assist them with more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is to become a transgender woman or a transgender man: 

• The impact of your gender identity at work, school, home and social environments, including issues related to discrimination, relationship abuse and minority stress
• Mood or other mental health concerns
• Sexual health concerns
• Risk-taking behaviors, including substance use and use of nonmedical-grade silicone injections or unapproved hormone therapy or supplements
• Protective factors such as social support from family, friends and peers
• Your goals, risks and expectations of treatment and your future plans for your care

b. Hormone level checks

Before starting hormone therapy, your doctor will evaluate your health to rule out any medical conditions that might affect or contraindicate treatment. This evaluation might include:

• A review of your personal and family medical history
• A physical exam, including an assessment of your external reproductive organs
• Lab tests measuring your lipids, blood sugar, blood count, liver enzymes, electrolytes and the hormone prolactin
• A review of your immunizations
• Age- and sex-appropriate screenings
• Identification and management of tobacco use, drug abuse, alcohol abuse, HIV and other sexually transmitted infections
• Discussion about sperm freezing or egg freezing

You might also need a mental health evaluation by a provider with expertise in transgender health. The evaluation might assess:

• Your gender identity and dysphoria
• The impact of your gender identity at work, school, home and social environments, including issues related to discrimination, relationship abuse and minority stress
• Mood or other mental health concerns
• Sexual health concerns
• Risk-taking behaviors, including substance use and use of nonmedical-grade silicone injections or unapproved hormone therapy or supplements
• Protective factors such as social support from family, friends and peers
• Your goals, risks and expectations of treatment and your future plans for your care

 c. Hormone Injection Assistance at QWC

Hate needles? We’re good at handling pricks. Bring your hormones.
If you have an aversion to needles we are more than happy to administer your injections for you

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.

HIV

Testing

Human immunodeficiency virus (HIV) testing determines whether you are infected with HIV. HIV is a virus that weakens your immune system and can lead to acquired immunodeficiency syndrome (AIDS).

HIV tests can check for antibodies that your immune system produces in reaction to the HIV infection. AN HIV antibody test is only accurate three months after exposure, because this is how long it takes your body to produce enough antibodies for it to show up in a test. Other HIV tests look for evidence of the virus in the body. Recently developed tests can produce results in minutes.

HIV testing is the only way to know for sure if you have HIV, and knowing your status means you can keep yourself and your sexual partners healthy. In addition, being diagnosed early gives you a better chance of living a long and healthy life, while allowing you to take control of your health.

 You should have an HIV test if you:

• have had unprotected sex
• have had multiple sex partners
• have recently been diagnosed with another STI
• have shared needles or other injecting equipment
• are worried about HIV and want to put your mind at ease

 If you are sexually active, it’s good to get into the habit of regularly testing for HIV.

 HIV Positive Medical Support

If your result is positive or ‘reactive’, you will need to give a blood sample to have your results confirmed.

For most people, receiving a positive diagnosis can be a shocking and emotional experience – this is completely normal. Your doctor is there to support you and to answer any questions that you have.

If you do have HIV, being diagnosed at an early stage will allow you access to treatment, allowing you to live a longer and healthier life. You can start taking antiretroviral drugs immediately, which will reduce the amount of HIV in your body and protect your immune system from damage. And with the correct treatment and care, those living with HIV can expect to live as long as the average person. Reducing the levels of HIV in your body also make it less likely that you will pass HIV in to your partner. In fact some people will find that the virus becomes undetectable in their system with treatment – this means that the HIV does not show up in normal blood tests.

Although there is no cure for HIV/AIDS, treatments have come a long way and provide an improved and extended quality of life for most, meaning a near normal life expectancy. Remember that HIV is now a manageable illness – the earlier you begin treatment, the healthier you can stay, while also preventing the onset of AIDS.

 How to get your Pep Prescription

 Post-exposure prophylaxis, or PEP, is an emergency treatment for HIV, to be taken after possible exposure to HIV to prevent infection. It’s a short four-week course of antiretroviral drugs that can stop HIV infection if taken properly. PEP is most effective at preventing HIV infection if you take it within 24 hours of exposure. The most important thing is to make sure you take PEP within the 72-hour window. It’s important to get tested after using PEP, to make sure the treatment was successful. You should test 3 months after potential exposure, and again 6 months after.

PEP is not taken if you already have HIV, or as a regular form of HIV prevention. If you face a prolonged risk of HIV, for example if your partner is living with HIV or if you regularly have sex without a condom with multiple partners, PrEP is a better choice for you.

PEP is only is available from doctors or the emergency department of a hospital. The Queer Wellness Centre will be able to prescribe Pep should you require it.