American Medical Association Family Medical Guide - American Medical Association [241]
Lesbians also are at risk of acquiring STDs during sexual activity. Herpes (see page 482), HPV, and bacterial vaginosis (see page 879) are especially easy to transmit, while HIV, gonorrhea, and chlamydia are more difficult to transmit. Additionally, some lesbians have sex with men, from whom they can contract an STD and then transmit it to a female partner. An HPV infection can lead to cancer of the cervix (see page 875), although women can also develop another type of cervical cancer that is unrelated to sexual intercourse or HPV exposure. For this reason, lesbians need to have regular Pap smears (see page 140) to detect precancerous changes in the cells of the cervix at an early stage, when they are easiest to treat.
Staying Healthy
If you are gay, you can take positive steps to protect yourself from sexually transmitted diseases and more serious medical conditions such as HIV infection and cancer by following these guidelines:
• Practice safer sex. Use a latex condom every time you have any type of sex, and make sure you know how to use it correctly (see page 478).
• Get vaccinated. Ask your doctor about getting vaccinated against hepatitis A and B.
• Drink alcohol only in moderation, and don’t use other drugs. Unprotected or irresponsible sexual activity is more likely to occur when you are under the influence of alcohol or other drugs.
• Get tested. Ask your doctor to test you for STDs if you have had unprotected intercourse so you can be treated right away.
Contraception
Awide range of reliable contraceptives is available, and each contraceptive has advantages and disadvantages. Some contraceptives require a prescription, while others are available over the counter. Be sure to talk with your doctor about the risks and benefits of each method of birth control before choosing one. Consider reliability, side effects, and protection against sexually transmitted diseases (STDs; see page 477) when making your decision. Remember that hormonal and barrier methods of birth control do not protect against STDs. Doctors strongly recommend that women who use these birth-control methods and are not in a mutually monogamous relationship also use condoms during sexual intercourse to protect themselves from STDs.
Oral Contraceptives
The contraceptive pill (birth-control pill) is currently the most effective method of reversible birth control. The most frequently prescribed birth-control pills are called combined pills because they blend synthetic versions of estrogen and progesterone (progestin). Estrogen and progesterone are the major hormones that control the female reproductive cycle.
Birth-control pills work primarily by preventing ovulation, the monthly release of an egg by the ovaries. The pills also make it difficult for sperm to enter the uterus by making the mucus produced by the cervix thicker and harder to penetrate. Birth-control pills regulate a woman’s menstrual cycle by providing a controlled dose of hormones daily. Most women notice changes in their menstrual cycle when they take birth-control pills—their periods occur precisely every 28 days and usually are shorter and lighter. Many women take birth-control pills specifically to regulate their cycle and reduce menstrual flow, not just for contraception.
In addition to preventing pregnancy, birth-control pills have other beneficial effects. A woman who takes birth-control pills is much less likely to have ovarian cysts (see page 864), breast lumps (see page 856), iron deficiency anemia (see page 610), rheumatoid arthritis (see page 918), or pelvic inflammatory disease (PID; see page 871) than a woman who does not take birth-control pills. Birth-control pills also protect against cancer of the ovary, uterus, and colon. The combined pill, because it contains estrogen, helps maintain bone density in women who are at risk for osteoporosis (see page 989) and can prevent ectopic pregnancies (see page 523).
Birth-control pills are packaged in 21-day or 28-day packs. The pills