While you might have had to get used to working from home, cooking all your meals, and spending a lot more time with your flatmates than you thought you’d ever have to during lockdown, other aspects of life are more difficult to adapt. For many people on hormonal contraception this has been a pretty scary time, with doctors appointments have been cancelled and guidelines around leaving the house issued. So, here’s all the questions you might have about contraception and COVID-19 answered. Whether you need to get a repeat prescription for your pill or have your coil changed it’s worrying not being able to see your GP as normal. But there are things you can do to maintain some normalcy.
Can I Get A GP Appointment?
Right now sexual health clinics are running on minimum staff or have been closed all together as resources have been channelled into other parts of hospitals. People have been strongly advised to stay away from their GPs and most consultations are going on over video call.
Dr Simran Deo works for UK-based online doctor Zava UK explains “as we’re all being encouraged to stay in our homes as much as possible to prevent the spread of coronavirus, getting access to pharmacy and GP services may be more tricky than usual.” Instead you can consider using an online doctor, such as Zava UK for a consultation or to access medication. Many online doctors, such as Zava UK cost money and extra charges for medication may apply. To have a consultation with one of their doctors all you need to do is fill out a medical questionnaire and they’ll be in touch with you.
What If I Need More Contraceptive Pills?
The pill is the most commonly prescribed contraceptive in the UK. No matter how organised you are, no one could have predicted the lockdown, and you may now need a prescription renewal. Tracey Forsyth, lead contraceptive nurse at British Pregnancy Advisory Service, told The Independent, “GPs are saying ‘use condoms’ to women when they ring up and ask for a repeat prescription of contraceptive pills.”
Guidelines from the Faculty of Sexual and Reproductive Healthcare state that if you’re already taking a specific contraceptive pill, be that the combined pill or progesterone only pill, then you should continue taking it and access a six to 12 month prescription to cover you for the entirety of lockdown. You can get this with a prescription online or from your pharmacy. If you’re concerned about your blood pressure or not being checked by a clinician in this time then you can arrange a video consultation with your GP or online doctor and order a blood pressure monitor online to do a reading via webcam.
Pharmacies have been deemed an essential service and if you’ve had a consultation with your GP they can often offer prescription services and contraceptive support, including the pill, and emergency contraception.
You can also get your prescription from an online doctor at this time. Through the Zava UK website you can get access to different contraceptive pills, the morning after pill, cystitis treatments, menopause and hormone therapies, thrush treatment, STI tests and treatments. You still need a prescription for your pill which you can get through an online consultation. However, you don’t need to be prescribed emergency contraception and can pick this up from your local pharmacy or websites like EllaOne or Zava UK.
Should I Stop Taking The Pill?
If you have the ability to come off the contraceptive pill during lockdown then that may seem like the best solution. However, for many people the side effects of changing hormonal contraception can be too significant for this to be an option.
“For those who are forced to come off the pill or change to a different type due to shortages, they may experience symptoms such as mood swings or changes to their skin or weight as the body adjusts to new hormone levels, as well as increased risk of unplanned pregnancy,” says Dr Deo, “women can be prescribed the contraceptive pill for a number of health conditions including irregular, heavy or painful periods, polycystic ovary syndrome (PCOS), acne, or even endometriosis. Taking a sudden or unexpected break from the pill may see symptoms of these conditions return.”
Can I Leave My Coil Or Implant In For Longer?
When you had your implant fitted you should have been told that it’d be effective for three years. If you have a coil or IUD, it's effective for five or ten years depending on the type you have. These aren’t contraceptives you can remove yourself and not having access to your doctor or clinic can be concerning, if you're in need of a replacement.
“Understandably, it might be more difficult to get your coil removed while social distancing measures are in place in the UK. If your coil reaches the end of its lifespan and you can’t get an appointment to have it removed, you may want to start using an additional form of contraception, such as condoms, as some types may lose their effectiveness,” says Dr Deo.
The Faculty of Sexual and Reproductive Healthcare has released guidance that states that some forms of long-lasting contraception, like the coil or implant could be effective for longer than the recommended time.
The Banded copper IUDs are said to likely be effective for 12 years, not ten. Mirena and Levosert coils are fitted for five years but can likely be effective for six. Similarly contraceptive implants are licensed for three years but are likely to be effective for four.
The FSRH added that while studies suggest these contraceptive methods are still extremely effective for this additional time more studies need to be conducted to be sure that they’re as effective as the time they’re licensed for. Dr Deo suggests, “if you’re worried, try to speak to your GP or nurse over the phone, who can provide specific advice related to the exact type of coil you are using. Do not try to remove your device yourself.”
What Should I Do If I'm Having Problems With My Coil Or Implant?
If you’ve just had the coil or implant fitted you may experience side effects for a few weeks or months afterwards. These can include headaches, nausea, breast tenderness, mood swings, and your periods may become heavier, longer or more painful, per the NHS.
However, if you’re worried that something may be wrong Dr Deo says, “side effects normally disappear within the first three to six months, but if you’re worried, arrange a call with your GP.” You know your body so if you’re worried it’s better to speak to a clinician.
Are Walk-In Centres Still Open?
Walk-in centres provide a range of care, from STI testing to maternal services. They’re a key service in sexual and reproductive health. However, many have closed due to resources being channeled to elsewhere within the NHS. “During coronavirus, some walk in centres are operating differently to normal. Some are being used to triage coronavirus patients while others are asking people to call in first for a phone assessment, so it’s important to research what’s happening in your local area before setting out,” says Dr Deo, “If you think you need to see a doctor in an emergency, A&E departments are still open, and doctors are urging people not to avoid seeking help in an emergency due to coronavirus fears.”
How Can I Access Emergency Contraception?
If you’re in need of emergency contraception during lockdown you can access it online, as previously mentioned, from online doctors such as Zava UK or ellaOne. You won’t need a prescription but can have a video consultation with a doctor should you want one. Similarly, accessing emergency contraception would fall under an essential trip out to your pharmacy and you can pick a morning after pill up over the counter.
What If I Need Access To An Abortion?
The Independent reported on March 24 that they anticipated it’s 44,000 women across England and Wales would need access to an early medical abortion over the following 13 weeks. It’s looking like lockdown is going to last longer than that period of time and it’s vital that access to abortion remains open for people who need it. The Department of Health has confirmed that people needed early medical abortions will be able to take both pills at home, rather than travelling to a clinic to take the second pill. Those who need to do so should speak to their doctor to arrange access.
Alternatively Dr Deo says, “for pregnancies that are further along, an abortion provider will be able to discuss your options with you. You can contact them directly, without being referred by your GP.”