Contraception during the COVID-19 pandemic

posted by: Jonathan Shaw

Updated 06.04.20

Due to the impact of the COVID-19 pandemic we have had to significantly reduce the provision of routine contraception across our service.  This includes the suspension of all routine provision of Long Acting Reversible Contraceptives (LARCs). LARCs are methods including all hormonal and non-hormonal coils, implants and contraceptive injections.

We however are ensuring that contraception should be available to those that need it. We have now implemented a telephone triage system for all contraception needs. Please call your local clinic to access this triage system. We are still providing LARCs to a small number of patients who are assessed as high risk.

At present we are offering telephone triage to assess for and provide:

• Emergency contraception
• Supply of contraceptive pills (for collection from the service)
• Complications arising from LARCs – eg. significant coil pain, implant pain, missing LARCs
• Advice and referral for abortion care

Helpful advice has been supplied to clinics like ours from the Faculty of Sexual and Reproductive Health (FSRH – here). This includes reassuring information for people who already have a LARC inserted that is due to, or has, expired. There is good evidence that extended use of:

• Nexplanon implants for 4 years
• 10 year lifespan copper IUDs for 12 years
• IUS (Mirena coil only) for 6 years

with arrangements made for removal/replacement after the COVID-19 crisis is over. Women can leave the LARC in place and add a progestogen-only pill (POP) on top if they are worried, but the risk of pregnancy is likely to be small.

Finally please remember that condoms remain an effective and widely available form of barrier contraception.

A note on moon cups:

We are aware that the use of moon cups and other menstrual cups is increasing due to concerns about the environment. With COVID-related travel restrictions in place they also offer a convenient way of managing periods when access to other sanitary products might be difficult.

We are seeing an increase in numbers of coils becoming dislodged or even removed by the use of such menstrual cups. We wish to advise caution, particularly during the COVID-19 pandemic which means access to our service is limited.

Please follow the recommendations below when using a menstrual cup if you have a coil:

The manufacturer of the Moon Cup® recommends waiting for 6 weeks following the insertion of IUC before using the menstrual cup. They also state that the Moon Cup should be placed low in the vagina with an adequate seal, which should be broken before the cup is removed. The manufacturer also recommends checking for IUC threads after each menses. If the threads cannot be located, or if a woman thinks her Cu-IUD has moved or if a woman experiences pain, the manufacturer recommends using additional contraception and consulting with an appropriate health care professional. (FSRH guidance on Intrauterine contraception)

Please note that due to COVID-19 we will not be able to refit a coil that has become dislodged or removed but we will be able to remove a dislodged coil to ensure you are safe and pain free.

If you do have concerns about your coil please phone your local clinic for advice.