12:44 am - 01/02/2012

Lesbian Sexual Health

Hello!

So a bunch of discussions over in contact_vp has made me feel a bit more empowered/safe to ask a question that's been on my mind, and another comment over there made me curious about something also related to the topic of lesbian sexual health.

Background Information: I'm a cisgender woman and, for all intents and purposes, I'm a lesbian ("all intents and purposes" meaning that I recognize the diversity of gender and the impact that has on the traditional definition of "lesbian"/my identity as a lesbian). I came out as lesbian a year ago this month; I had come out as pansexual about two years prior. I've never had penis-in-vagina sex, I've never performed oral sex on any gender, and I've never had oral sex performed on me. I was fingered once by an ex-boyfriend when I was 19. I do use a vibrator on occasion to masturbate but I rarely insert it into my vagina.

In short -- I am a "virgin" by heterosexual terms, and essentially, I've never been any farther than heavy petting over clothes below the belt, and under the clothes above the belt.

I am not sexually active with anyone right now, nor am I involved with anyone romantically.

1. AKA, the question I've been having.
As I said, I'm not sexually active right now but this question has been on my mind and I wanted to know for future reference.

A few years ago one of my friends told me about the "30 minute rule" with regards to PIV sex -- meaning that within 30 minutes of having PIV sex, the female should use the bathroom in order to avoid UTIs and the like.

--Does this apply to lesbian sexual activities (i.e., oral sex, fingering, scissoring, etc.)? If so, which ones?
--Does this apply if either myself or my partner were to use a strap-on, dildo, vibrator, or any other sex toys inserted into a vagina? Which objects, when inserted into a vagina, would garner the need for the "30 minute rule" (if any objects do garner the need for it)?


2. Pap Smears

What does one mean by "sexually active" with regards to becoming "sexually active" and needing a pap smear? Does it mean heterosexually active, or just sexually active overall? There was a comment in contact_vp regarding the legitimacy/need for pap smears, and I'm planning on making a gynecologist appointment soon and was wondering how to approach this in my appointment. I'm 22, so by the age standard I should get one, but by the "sexually active" standard, I'm not sure if I will ever qualify for that. :|


These are questions obviously not covered in porn and pop culture, so thanks in advance :D
gunshotbeauty 2nd-Jan-2012 07:14 am (UTC)
2-it does seem to be a misconception that lesbians or non hetrosex don't need regular pap smears but it still is important. i went to a sexual health conference and saw a fascinating lecture on the misconceptions about lesbian sex and how there isn't enough emphasis on pap smears still being needed even if no piv sex is involved. whether you get one based on your age is up to you but if you have been sexually active with anyone i would count it as you being "eligible". there really needs to be much more queer friendly and queer specific sex ed info imo
ennifer_jay 2nd-Jan-2012 08:44 am (UTC)
there really needs to be much more queer friendly and queer specific sex ed info imo

agreed!!! I didn't want to say it in my post but it always makes me seethe with anger when people mention the sexually active standard with regards to pap smears. I just sit there and grumble, "well what if you're gay grumblegrumblegrumble"
gunshotbeauty 2nd-Jan-2012 08:48 am (UTC)
yeah i know it irritates me too because i want to specialize in queer health issues with teens. the lectures i went to in regards to lesbian health was fascinating and they talked about how they were trying to encourage the lesbian community where the woman was from to support each other and encourage regular check ups, std testing pap smears etc. they also had an interesting research study on bv and lesbians. anyway it really does irritate me and i hope things change and i can be a part of it because teens these days seem to be far more open minded sexually so we need to emphasis sex ed for all types of sexual orientations. back in high school (ten years ago) i don't think we covered ANYTHING queer so hopefully things are a little different now and if they aren't then i will have my work cut out for me!
ennifer_jay 2nd-Jan-2012 08:57 am (UTC)
I just went to the Gay & Lesbian Medical Health Association to do a search for a gyno nearby. I did a 50 mile radius with the selections "self-pay" and "self-pay/sliding scale."

Nothing showed up. :| *And* I'm less than 10 miles outside Philadelphia. How did the Mazzoni Center not show up there? :| Oops. You're from Australia. The Mazzoni Center is a pretty well-known LGBT health clinic based in Philadelphia.

I just did it out of curiosity. I haven't had any problems with Planned Parenthood in my experience, so I'm planning on going there for an appointment again. Granted, the PP by my university is probably more liberal than the one by my home though. :/

Sigh.

Edited at 2012-01-02 09:03 am (UTC)
sweetchild92 2nd-Jan-2012 09:13 am (UTC)
I know on the PP website it will show what centers have LGBT services (not entirely sure what those are, but it's there!)
gunshotbeauty 2nd-Jan-2012 11:24 am (UTC)
hmm how odd it wasn't listed but that is awesome there is a lgbt clinic! i definitely would love to work in one.

things are still tricky here sometimes but the awful stories i hear from america just break my heart so bad. health care is so important and i just sigh and cringe on a daily basis of how bad things can be in some areas there. i hope to live long enough to see things be different for future generations.
knittinggoddess 2nd-Jan-2012 02:34 pm (UTC)
A lot of the pap and other sexual health advice still stands for lesbians--especially after reading those autostraddle articles!--but I agree we should remember to use inclusive phrasing.
atalanta0jess 2nd-Jan-2012 04:15 pm (UTC)
Urg, I just deleted my whole comment. :/

Sexually active is an ambiguous term though, I think. I mean, making out and touching over clothes is sexual activity, but probably doesn't count as something that means you need a pap.

Would it be accurate to say that sexually active (when we're talking about it as a criteria for getting a pap) means "have had genital to genital contact with another person, or have had indirect contact with another person's genitals through shared toys or hands that touch both without being washed"?
frolicnaked 2nd-Jan-2012 05:18 pm (UTC)
My NP uses the phrase "partnered genital contact" to describe how she defines "sexually active" for Pap purposes. Basically, if there are two people together, and there is genital touching going on, that "counts" in terms of whether or not one should consider getting a Pap.

That said, the term might be too cautious with respect to sexual activity. For instance, I could very much see situations where two partners had genital stimulation but where there was no direct/indirect genital contact (for instance, if each partner had their own toy and/or touched only their own genitals with their partner present). But my NP is a little cautious about these things anyway, and "partnered genital contact" is a fairly easy phrase to remember and picture, at least for me.
gryphonwing 2nd-Jan-2012 06:24 pm (UTC)
That's not a bad way to put it, I think... I would prefer it if we could talk about actual risky behaviors (i.e. HPV is an opportunistic little virus and travels easily, etc.) but if we need shorthand I think I like that one.
atalanta0jess 2nd-Jan-2012 06:46 pm (UTC)
Oooh, I like that...clear, concise, and inclusive. Sounds like your NP is a winner!
chasing_breezes 2nd-Jan-2012 07:24 am (UTC)
I've never heard of the "30 Minute rule", but I *am* exceptionally pronel to UTIs. My doctor always told me after sexual activity is advised, but never suggested a time limit. Contact between a hand/mouth/toy can irritate the urethra and introduce bacteria. Peeing after that contact flushes it and reduces the likelihood of UTI occurring.

As far as part two, lesbians are also able to pass on HVP, so need pap smears just as much as straight women. There's an article here: http://www.autostraddle.com/why-are-gay-ladies-so-afraid-of-the-gynecologist/2/ that discusses some of the studies and stats etc.

:)
knittinggoddess 2nd-Jan-2012 07:29 am (UTC)
I hadn't heard the 30 minute rule either. I've always heard within 10 minutes, or, more accurately, ASAP.

Oooh, good link.
chasing_breezes 2nd-Jan-2012 07:43 am (UTC)
Yeah, when I say 'never been told a time limit' I mean, 'I've never been told to pause at a certain point'. ASAP afterwards is definitely my standard operating procedure, thanks to UTIs love of me.

Autostraddle is particularly good lesbian sexual health resources, I highly recommend the following as well (not directed at you specifically, OP, but since we're on the subject):

http://www.autostraddle.com/safe-sex-for-lesbians-45382/
ennifer_jay 2nd-Jan-2012 08:42 am (UTC)
Mods, can we put this link into the "useful external sites" on the sidebar, or under one of the headings to our left?
rockstarbob Mod Note2nd-Jan-2012 03:57 pm (UTC)
Just letting you know we've seen this and are evaluating. :)

Further discussion is welcome in CVP.
ennifer_jay 2nd-Jan-2012 08:41 am (UTC)
Thank you for your encouragement in CVP to post here, and for your links. Autostraddle is great, I love that website! :D Do you have an account there?
chasing_breezes 2nd-Jan-2012 08:58 am (UTC)
No worries, glad I could be of assistance.

And, yes, I do! My user name is Cat (which is also really my name), my icon is the same :)
knittinggoddess 2nd-Jan-2012 07:28 am (UTC)
Yay, I'm so glad you're feeling brave enough to post! I hope we won't let you down.

Post-sex timing: The point is that any grinding in the vulva area has a potential to move bacteria from the anus to the urethra. Yes, PIV is better at this than, say, hands on the clit and nowhere else. But I'd imagine scissoring and fingering would be pretty efficient at moving bacteria. Depending on how sensitive you are, you may wish to pee every single time, no matter what!

Pap smears: Before ACOG changed their guidelines, a doc told me (at the time not having PIV) to please get paps every three years, if not yearly. If your partner has HPV, you can consider yourself exposed. Yes, STI transmission rates are lower for lesbians than they are for those in hetero relationships, but unfortunately "lower" doesn't mean "zero". Plus, keep in mind that not all queer vulva-bearers* are gold stars. (Yup, I'm one of those gold star-less queers. Sorry.)
altorogue 2nd-Jan-2012 08:26 am (UTC)
I have nothing extra to add to what's already been said, but I have to say I LOVE your icon! Genius. And I LOVED Ronna. :D
ennifer_jay 2nd-Jan-2012 08:38 am (UTC)
haha *blushes at goldstar status* and no hatred towards the goldstar-less queer folk! ♥ :D don't be sorry!

Just asking out of curiosity sake -- what if I have my HPV vaccine (which I do)? Obviously I'll still get a pap smear done but I'm just curious.

Edited at 2012-01-02 08:40 am (UTC)
chasing_breezes 2nd-Jan-2012 11:49 am (UTC)
My understanding of the vaccine is that it guards against the most common, but not all, strains of the virus. I was definitely informed all three times that I will still need paps in the future.
archangelbeth 2nd-Jan-2012 07:30 pm (UTC)
*nod* The vaccine is for the two strains of HPV most often found causing complications with cervical cells, and, if Gardasil, also the two strains most often found causing warts. (So Gardasil protects against 4 strains of HPV, total. I believe there is another vaccine that only protects vs. the two Cervical Cell Affecting strains.)
aylaelphaba 2nd-Jan-2012 11:49 am (UTC)
Hi! I'm just curious, what does "gold star" mean in this context? I've never heard that term before.
chasing_breezes 2nd-Jan-2012 12:02 pm (UTC)
Ugh, it's a term for lesbians who have never been involved with men. Problematic for a bunch of reasons but mostly used for shorthand these days.
gryphonwing 2nd-Jan-2012 06:25 pm (UTC)
Yeah, just shorthand now - I think it's mostly used ironically anyway. :)
knittinggoddess 3rd-Jan-2012 12:14 am (UTC)
That's certainly how I use it! At one point, it helped feed anxiety about dropping my lesbian label, but it has lost most meaning and weight with me.
Does it predate the L Word, or did that show bring it into popularity?

And I'm totally derailing this thread now, sorry.
gryphonwing 3rd-Jan-2012 01:25 am (UTC)
It's older than that - at least, I've been aware of it for a long time. The L Word did bring it up and maybe brought it back to popularity?

Now if only some of the other slang and signifiers of the 80s would come back. I want a labrys tattoo but I don't want to have to explain why I have an axe on my shoulder! :)

At least it's a pleasant derail...
aylaelphaba 2nd-Jan-2012 06:40 pm (UTC)
Ahh, yes, I see how that could be a problematic term, depending on the context/connotation/etc.
misspaigeb 2nd-Jan-2012 07:41 am (UTC)
As for your first question I would assume it would basically depend how prone you are to getting UTIs. Personally I've never had one... Knock on wood... Even when I didn't pee after PIV. My understanding is that fingers/hands/mouths/genitals sometimes introduce bacteria to that area that can get up into the urethra and cause an infection and peeing can help flush those things out. Granted some people might get a UTI anyway, it really depends on the person. To be safe I'd probably pee soonish after any kind of sex but especially oral. You could probably avoid similar problems if your partner were to wash their hands before manual sex or making sure toys are cleaned properly. If you find wearing tight clothes causes UTIs or you're otherwise just prone to them you might make a habit of it. But all in all it's a very personal thing and you might not know if you need to make a habit of it until you try not doing it and end up with a UTI (or dont.) Hopefully that makes sense. Just in reading VP I've noticed how likely people are to getting UTIs really varies. I'm hetero but i have engaged in all of the activities you listed except scissoring, generally not peed and been fine.

As for the second question I don't have as much info but HPV is spread by genital to genital contact. If I were you and all I'd done so far was heavy petting over clothes below belt I'd tell my doctor I was not sexually active. Personally I don't really think you need a Pap at this point.

Hopefully that was helpful even though I'm hetero. I'm sure others will chime in with more info!
elfbert 2nd-Jan-2012 10:40 am (UTC)
I'd never even heard of the 'pee after sex' rule until I found this comm.!

But I've been sexually active for 15 years, and never had a UTI or, indeed, anything else (hope they don't turn out to be famous last words!) and whilst I sometimes pee after PIV/oral sex, usually I just snuggle up to my partner and fall asleep.

So I guess it just depends how prone you are to such things.
knittinggoddess 2nd-Jan-2012 02:38 pm (UTC)
I thought it meant a 30 min window after sex in which to pee.

Though sometimes I get worried about my urethra and have the urge to clear my urethra before we're even done..
nickelshoe 2nd-Jan-2012 02:46 pm (UTC)
Seriously, I wonder about this. What's the difference between waiting twenty minutes to pee after a quickie and peeing immediately after a longer session?
atalanta0jess 2nd-Jan-2012 04:20 pm (UTC)
Yeah, but you can get cavities even if you brush and don't eat many sweets. That's, IMO, a more accurate analogy for going to the gyno even if you've had a very low number of partners. Your oral health can degrade even in the presence of good habits, and its not at all uncommon for that to occur. Cervical dysplasia rarely if ever occurs in the absence of HPV exposure.

Obviously it is an individual decision when to get a pap smear. I just wanted to point out that it's not exactly a good analogy...someone who doesn't eat sweets and hasn't been to the dentist in 10 years is not analogous to someone who has never had sex and hasn't been for a pap in 10 years.
nickelshoe 2nd-Jan-2012 02:44 pm (UTC)
1) I can't speak to lesbian sex specifically, but I can say that I think I got my only urinary tract infection due to not peeing after fingering. That or improper hygiene with my menstrual cup. Anything that has the potential to irritate your urethra or push bacteria in it is something you should probably pee after. I try to pee after baths as well, since some people have problems with them. So I don't think it matters whether it's a penis, fingers, or toys that are being inserted into the vagina. It's more about whether they're bothering your urethra at the same time, which would depend somewhat on how the activity was performed and how close your urethra is to your vagina.

2) If a person hadn't had vaginal penetrative sex, then I doubt they could have HPV on their cervix. But I don't know how well fingering or sharing toys would really transfer it either. I haven't looked to see if anyone has published studies, but my guess is that you are at very low but not quite zero risk from a single episode of fingering.
jennifer0246 2nd-Jan-2012 04:03 pm (UTC)
With regard to urinating after sexual activity, I would recommend attempting to void after any sexual contact (even self-stimulation), to allow the body to expel any germs/foreign bacteria that have entered the urethra during direct stimulation of the vulva. The female urethra is short, which can allow bacteria to make the trip from vulva to bladder quickly, and that is no bueno.

I'm not familiar with a '30 minute rule', and not sure I would support that. The recommendation I'm most familiar with, and the one I tend to share with others, is to void either immediately or very soon after sexual activity of any flavor.

Pap smears are screening for cervical cancer and abnormalities that can lead to precancers. These abnormalities, and cervical cancer itself are caused by HPV, which is a very contagious virus that is contained in skin cells and passed via sexual contact. Given that information, my extrapolation is that anyone who has skin-to-skin sexual contact (that is, contact of sexual skin to sexual skin, not manual or oral stimulation) is at risk for HPV transmission, and should be screened for cervical anomalies via pap smears, per recommendations of those who know more about such things than I do. Currently the ACS and ACOG recommend that people with a cervix begin getting pap smears at age 21, and do so every other year until age 30, unless abnormalities present themselves.

As you're describing your situation, I don't believe you're in need of a pap smear currently. Whether to pursue one would be your decision, hopefully made after discussion with a health care provider of your own to help answer any questions and so you can make an informed decision.
atalanta0jess 2nd-Jan-2012 04:24 pm (UTC)
As others have said, the pee after sex rule is pretty dependent on what works for your body. The most cautious route would be to pee after anyone touches your crotch with anything ever.

I tend to pee after activities that rub my urethra a lot, which in practice is activities that involve anything thrusting in my vagina (whether that means fingers, penis, or toy). I don't tend to go pee after clitoral stimulation or even use of a toy that is small and doesn't involve lots of thrusting or whatever. This routine has worked pretty well for me, but maybe wouldn't for someone who is very UTI prone.

And now I'm starting to feel a little shy. :0)
rubyscarlett 2nd-Jan-2012 05:08 pm (UTC)
1. I'd never heard of the '30 minute rule' you mention. I've never had PIV sex that lasted that long, to be honest I'd get bore/sore if it lasted that long. I think any sexual activity puts both partners at risk of contracting UTIs if no barriers are involved, however long the activity is. I don't believe peeing afterwards reduces much of anything but if it does I would still be highly suspicious of something I can't be entirely sure of, after all it's not as if you could see the UTIs just flowing out of you when peeing.
Better be more careful than not enough so, I think.

Thanks for posting!
luvherbones 2nd-Jan-2012 05:20 pm (UTC)
1) i pee after sex involving any kind of penetration - fingers, toy, tongue. i don't watch the clock, but i'd say i probably do it within about 30 minutes. fwiw, my gf doesn't ever pee afterwards & has never had a uti. also, washing hands & toys first is another great habit!

2) yes, you do need to get a pap smear. i'm not clear on the age & frequency guidelines, but i know others here are. another frequently misunderstood aspect of lesbian sexual health is std tests - when you become sexually active please get yourself tested! you are at risk, even if you don't engage with men.
gryphonwing 2nd-Jan-2012 06:31 pm (UTC)
I'm not prone to UTIs - as far as I know I've only had one and I only found out about it by accident as it was asymptomatic. But I still pee after sex, usually as soon as possible. I generally feel like I need to - all those muscle contractions!

Anything introducing bacteria to the area of your urethra is potentially problematic. This means hands and mouths and other genitals are the major players here. Washing hands before sex can help a lot - nothing fancy, just a quick wash, and rinse off the soap well! Whether you're likely to get a UTI from toy play has a lot more to do with your toy hygiene than anything else, although you can transfer your own bacteria to your urethra. If you've just sanitized a toy it's not likely to be adding anything to the mix.

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