Women's sexual health

Women are much more likely to access health care and health services than men, and many are more used to intiating conversations about their sexual health needs. However, that's not true for every woman and we still need to be sensitive to the possibility of hidden problems - perhaps they are consulting for something else such as feeling tired all the time (TATT), hoping you will divine what's really wrong!  And the environment, confidentiality and good communication skills remain important for everyone - as with gay men, lesbian women may not be confident about disclosing their sexuality and could find some questions difficult to answer, for example: "What contraception do you use?"

Screening is an important issue, and depending on their age, all women will be invited to attend for screening related to sexual health. View the video of 'Gail's story' and think about how you might handle this situation if you were the member of nursing staff involved. To read a transcript of the audio in this video, select the link Gail's story (Word 15KB).

How you can help

It is difficult to provide correct information to people who exhibit aggressive behaviour but it is important that Gail is aware of the facts. The more certain you are of these essential facts, the more confidence you will have to draw on all your communication skills to provide this key information for Gail.

Cervical cancer screening

All women from the age of 25 to 64 years are invited for a smear test every three to five years to check for cell changes (triggered by a human papilloma virus - HPV) that could lead to cancer of the cervix. Gail's story presents an interesting case study on attending for a smear test. Some women in same sex relationships, and even some health professionals mistakenly assume that lesbians do not need screening. However, it is still possible that they may have been exposed to HPV either through a previous sexual relationship with a man, or from sex with a woman whose previous partner(s) may have had sex with a man. Gail needs to be given this information and encouraged to make an appointment for screening. She may find it easier if she and her partner attend for their smear test together.

Chlamydia testing

You learned earlier that chlamydia is the most common STI in the UK and is often silent (no obvious signs or symptoms of its presence). Testing aims to control and prevent chlamydia for the highest risk group - people under the age of 25 who are sexually active. In England the National Chlamydia Screening Porgramme opportunistically offers testing (via a urine sample) free through GP practices, sexual health services and lots of non-health settings too. In other UK countries testing is also available but not as a national screening programme.