Greater Glasgow and Clyde Medicines

Provision of contraception during COVID-19: Update Jan 2022

Key points:

  • The Faculty of Sexual & Reproductive Healthcare (FSRH) Clinical Effectiveness Unit has published advice to support provision of effective contraception during the COVID-19 pandemic. Sandyford have adopted this advice for their own services with some variances, as described below.
  • This information is included for the attention of NHSGGC Primary Care services as this may be used as reference to inform their own practice.
  • Telephone consultation and remote prescribing should be carried out whenever possible to reduce face to face review whilst supporting ongoing provision of contraception.
  • If accepting patient own self reporting of weight and use of BP home kit, note that this may not be accurate and should not form the basis of a treatment plan.
  • Ensure past medical history and medication review is undertaken to ensure all risk factors are identified (including teratogenic risk) and appropriate contraceptive protection is prescribed.

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Advice/variance to FSRH Covid-19 guidance

 Notes

Patients currently on CHC or POP:

If stable, provide a further 12 month prescription

Current supplies are being monitored by pharmacy.

If no satisfactory BP has been done within the preceding year then POP should be considered rather than CHC.

 

Patients currently on Depo-Provera®:

  • Move to Sayana Press® with self-administration of 12 month supply  
  • If patient does not wish to self inject consider switch to oral contraception. 

Ask patient to refer to self-injecting technique on website: https://www.sayanaanswers.co.uk/

 

Advice on extended use of LARC for contraception as outlined by FSRH:

Previous extended use recommendations have been discontinued as of November 2021. Usual license limits apply.

Patients should make their own coil or implant appointment online via Sandyford website. SCI referrals will still be accepted for extremely vulnerable patients or those requiring an interpreter.

Mirena® IUS as progestogenic component of HRT beyond 5 years:

Mirena® currently has a four year licence for this indication; however FRSH guidance says that 5 year use is acceptable.


Whilst awaiting an appointment for IUS change, women will need to be prescribed additional progestogen for endometrial protection.


If perimenopausal:
Cyclical – add in medroxyprogesterone acetate 10mg daily (for 12 consecutive days in every cycle) or switch to cyclical HRT e.g. Femoston® 1/10mg, 2/10mg, Evorel Sequi® 


If known or likely post-menopausal:

Add in medroxyprogesterone acetate 5mg daily or switch to a continuous combined HRT e.g. Femoston-conti® (1mg/5mg), Elleste Duet Conti®, Kliovance®, Evorel Conti® 

 

Patients should make their own coil appointment online via Sandyford website.

 

 

For further professional support:

Email query service: ggc.sandyfordprofessionalsupport@nhs.scot 

Menopause advice: ggc.menopausesupport@nhs.scot 

Sandyford will provide a limited service during the Covid-19 pandemic until further notice:

  • Appointments for long-acting reversible contraception should be made by patients online via Sandyford website.
  • Sandyford, along with pharmacies, is continuing to provide an emergency contraception service. Contact for this service is on 0141 211 8130.

Abortion service continues as normal with home medication delivered to patients. 0141 211 8620

 

Abbreviations:

CHC: combined hormonal contraception

POP: progestogen only pill

LARC: long-acting reversible contraception

IUS: intra-uterine system

 

Published 19/01/2022. Medicines Update blogs are correct at the time of publication