Comparison of gynecologic health care problems between lesbians and bisexual women. A survey of 2,345 women.

A survey of reproductive system problems was conducted in a large group of lesbians (n = 1,921) and bisexual women (n = 424) in a nonclinical setting. Demographically the groups were similar: the majority of respondents were white, urban and well educated. A history of heterosexual coitus was common in both groups (bisexuals, 95%; lesbians, 77%). Bisexuals were more likely than lesbians to report an abnormal Papanicolaou smear, cystitis, genital herpes, gonorrhea and vaginal infections. When sexual orientation was controlled for, most, but not all, of these differences were associated with a difference in reported frequency of (prior) coitus. Despite the lower risk of certain problems, however, the lesbians who reported no previous coitus did report the occurrence of vaginitis, abnormal Papanicolaou smears and genital herpes. There were no differences in past oral contraceptive use, endometriosis, menstrual dysfunction or breast disease. The lesbian group reported a greater percentage of hysterectomies. These data suggest that, overall, the sexual behaviors of lesbians are associated with a lower risk of most sexually transmitted diseases.