Unless you’ve been living under a rock, you’ll know that we’re in the middle of a global pandemic caused by COVID-19, a strain of coronavirus.
As the UK government and NHS are currently handling for the outbreak, what will this mean for those who need to access sexual and reproductive health services?
The NHS has announced that all elective and non-urgent surgeries will be cancelled for the next 3 months to relieve pressure on medical staff amid the Coronavirus outbreak. Hospitals have also been asked to send home as many patients as possible, in order to free up as many beds as possible to prepare for those suffering with COVID-19.
On top of that, the government has also issued new guidelines for individuals to reduce the transmission of the virus. The public has been advised to stay at home unless absolutely necessary. All of the above means that accessing sexual and reproductive health services is trickier.
GP surgeries and hospitals are overwhelmed, supermarkets are emptied amid a stockpiling hysteria, NHS 111 is receiving an overwhelming amount of calls, and many sexual health clinics have closed or drastically limiting the amount of patients they can accomodate. Admittedly, it’s a scary situation! What happens if you suddenly get thrush during the lockdown? Or what do you do if your pill prescription is running low?
The following is based on a combination of available evidence, good practice guidelines from the government and NHS, and expert advice from both sexual health services and regulating bodies. Please keep in mind that this is an evolving situation (and a weird, confusing one at that), so these tips may be updated if or when new information becomes available.
Treating vaginal infections
Having a vaginal infection or UTI can be distressing, but please consider whether you need to be seen urgently, or whether your visit could be postponed.
This would prevent the number of people sharing waiting areas in clinics, following the government’s guidance to stay home as much as possible. If your healthcare provider feels like further examination is required, an in-person appointment may be arranged.
If you know you’re prone to recurrent thrush or BV, it’s a good idea to buy some over the counter treatment just in case. But please don’t hoard them! Others may need access to them as well. You can also buy prescription treatment online and have it delivered to you through online pharmacies like The Health Counter.
A good way to prevent vaginal infections such as thrush and BV is to take probiotics. Daye's ProViotics contain 2.5 billion live cells of Lactobacillus plantarum GLP3 and our clinical trials show they are 99.8% effective against Candida, the fungus that causes yeast infections.
If you need urgent medical care and your GP practice has closed, call 111 and inform them of any possible COVID-19 symptoms, or whether you’ve been in contact with a confirmed case of COVID-19. If possible, use the NHS 111 online service.
The Faculty of Sexual and Reproductive Health (FSRH) published guidance on contraception during the COVOD-19 lockdown. The guidelines state people on the combined pill no longer need a blood pressure reading for a 6-month repeat supply of pills, whilst new pill users can provide a blood pressure reading to doctor or nurse over the phone. The length of time an IUD and and contraceptive implant can be left in place have also been extended by one year.
Bear in mind that FSRH have also highlighted that "it may not be possible to start your chosen contraceptive method at this time, but you will be provided with an effective temporary method in the meantime."
If you are in need of a contraception injection top-up, contact your service provider ASAP as it's important not to leave a gap of more than 14 weeks between injections.
If you use Sayana Press and do the injections yourself at home, you should be able to request a top-up and have it delivered to you. If you take the Depo-Provera and a face-to-face appointment injection isn't possible, you may be offered the progestogen-only pill in the short term.
It’s also a good idea to buy some condoms, should you run out of your contraception and need an alternative (naturally this only applies to those who have sex with people with a penis). Call your GP or prescribing pharmacy to arrange some form of delivery or pick-up.
Don’t delay emergency contraception. If you have had unprotected sex or think you need emergency contraception, don’t put this off. The FSRH has stated that the morning after pill can be delivered to you, and clinics are doing their best to maintain the fitting of IUDs when oral emergency contraception is not a viable option.
Call your nearest sexual health service for advice on how to access emergency contraception. Many online pharmacies also deliver emergency contraception (but at a cost).
If you have had unprotected sex, or are symptoms of an STI (keep in mind that most STIs are asymptomatic), call your local sexual health clinic first. Many sexual health clinics are temporarily closing their walk-in services or telling patients not to come in for booked appointments.
Whether or not you are self-isolating or showing symptoms of COVID-19, as a precaution you should call your local clinic and follow their advice.
Young people’s sexual health charity Brook is operating telephone consultations for anyone under 25, with face-to-face appointments protected for those who need them urgently. You can find your local service here.
Testing for STIs can also be performed using a home test kit, ordered online (most of the time it’s free). The availability of at-home STI kits depends on where you live, so we recommend looking online for which provider caters to your area.
The Royal College of Obstetrics and Gynaecology (RCOG) has recently published a report with guidance and information for healthcare professionals on how to handle COVID-19 in pregnant patients.
The guidance reassures that pregnant women don’t appear to be more susceptible to the consequences of infection with COVID-19 than the general population.
The report states: “Data are limited but special consideration should be given to pregnant women with concomitant medical illnesses who could be infected with COVID-19 until the evidence base provides clearer information. There are no reported deaths in pregnant women at the moment.”
There is also no evidence to suggest that COVID-19 will affect the health of the baby during pregnancy, nor that it will increase the risk of miscarriage. Labour shouldn’t be affected either, and the way you deliver your baby is unlikely to change unless you start showing COVID-19 symptoms, or symptoms start to worsen.
Routine appointments may be delayed until the period of self-isolation ends, but if your appointment can’t wait, contact your midwife or antenatal clinic to arrange. It’s not advised to go present to A&E or a clinic, so if you need urgent care please call 111. If it’s an emergency, call 999. In both cases, inform the operator of any possible exposure to COVID-19.
The government has announced that temporary measures have been approved in England to ensure continued access to early medical abortion services.
Anyone seeking an abortion will be able to take both abortion pills at home (as opposed to in clinic), and doctors will be allowed to prescribe abortion pills from their homes. You will also be able to self-refer directly to your local abortion clinic, and consultations will be carried out over the phone.
But most of all… don’t panic!
We understand that desperate times call for desperate measures, but please don’t try at-home remedies you read about online.
Access to standard services and treatments will likely be harder, especially for those who can’t turn to private healthcare. If you have a routine appointment with the NHS, you should receive a text message to either confirm the appointment or to say if it's cancelled. If it is still going ahead, only attend if you are not required to be self-isolating. Reply via text to cancel the appointment if you are unwell or are self-isolating.
The Royal College of General Practitioners (RCGP) is also advising GPs to conduct telephone or video consultations as much as possible, so you will likely still be able to speak to your doctor even if you’re self-isolating.
There are also many private services available that allow you to speak to a doctor via video call, so this may be an option for some people (should your GP not be able to). Apps like Livi allow you to see a GP by video and fill out prescriptions if needed.
Visit the NHS website for more information on COVID-19, and what to do if you’re experiencing symptoms.