How Can I Access Sexual and Reproductive Healthcare in the UK?

Dr. Sarah Borg
A primer on accessing sexual and reproductive healthcare in the United Kingdom.

ALL sexual and reproductive healthcare in the UK is free through the NHS.

The best ways to access sexual and reproductive health services are through a GUM (genitourinary medicine)/sexual health/family planning clinic or through your GP. You do not need an NHS number to attend a GUM clinic — these services are available to everyone. To find out which services are available near you, you can check out the Sexwise website.

A great thing about going to a GUM clinic is that you can get a comprehensive sexual health check up with a doctor or nurse who works in sexual health. It can be your one-stop shop for contraception, sexually transmitted infection (STI) screening and management of STI symptoms, pre-exposure prophylaxis (PrEP) for HIV and more.

If you need contraception

ALL contraception in the UK is free, including emergency contraception. There are many different methods of contraception available so you should be able to find something that suits you. These include contraceptive pills, the contraceptive patch, the vaginal ring, injectable contraceptives, implants, and intrauterine devices (IUDs). You can have a read about all the methods available in the UK on the Sexwise and Contraception Choices websites, or a range of contraceptive methods here at Scarleteen, so that you can come to your appointment with some information and any questions about the methods you’re interested in.

Emergency contraception comes in two forms – an intrauterine device or emergency contraceptive pills. Both forms of emergency contraception are available for free at GUM clinics, some GP clinics and some A&Es. Emergency contraceptive pills can also be bought over the counter at some pharmacies.

If you want to get tested for STIs 

Free at-home STI testing kits are available to many people in the UK (depending on where you live) and can be ordered online. These kits are for if you want to test for STIs and also have no symptoms. If you do have symptoms, you should see a nurse or doctor at your GP clinic or a GUM clinic instead.

The free STI testing kits are sent to your house in an unmarked confidential package. The tests usually involve collecting a urine sample for those with a penis and a vaginal swab for those with a vagina; these usually test for chlamydia and gonorrhea. Taking a vaginal swab is similar to inserting a (very tiny, very thin) tampon. There is also a blood test, usually for syphilis and HIV; this involves pricking your finger and squeezing out blood into a small tube. You can then post the samples back to the lab for processing for free – just pop the kit in any post box.

If you’ve got STI symptoms

If you have any symptoms, like unusual discharge from your vagina or penis, pain passing urine, pain in your pelvis or lower tummy, pain with sex, unusual vaginal bleeding (like during or after sex, or between periods), or rashes, lumps, bumps, or sores on or around your genitals, then you should be assessed by a healthcare professional at a GP clinic or GUM clinic.

If you need a cervical smear

A cervical (or Pap) smear is a test to help detect pre-cancerous changes in the cervix . All cisgender women or other people with a cervix aged 25 to 64 should be invited by letter. You should have a cervical smear every 3 years from age 25 to 49. After this, the test becomes less frequent. Even if you have had HPV vaccinations, you still should have regular cervical smears.

If you have not already, register with a GP in the UK. You will get a letter in the post just before you turn 25 inviting you to book an appointment at your GP clinic for a cervical smear. If you do not receive a letter, or you think you need a cervical smear and haven’t received a letter, contact your GP.

If you need an abortion 

Abortions are available for free through the NHS. You can either ask a GUM clinic or GP to refer you, or you can contact one of the following abortion providers directly:

Check out the NHS website for more information.

If you have been sexually assaulted

The UK has sexual assault referral centres which are 24-hour one-stop specialist services where you can receive medical care and counselling. Find your closest centre on the NHS website. You can also go to a GUM clinic, an accident and emergency department, or your GP clinic.

Check out the Sexwise and NHS websites for more information on finding those services.

The last thing you may feel like doing after being sexually assaulted is going to the doctor. However, you should ideally do this as soon as possible because you may be at risk of pregnancy or STIs. You can be given medications to reduce your risk of pregnancy and STIs after assault. You don’t have to report the assault to the police if you don’t want to: reporting isn’t required to get emergency contraception, medications to help prevent STIs or other kinds of care.

I’m a man who has sex with men. Where should I go?

You can visit your local GUM or GP clinic to discuss regular STI screening, relevant vaccinations that may be available to you for free (e.g. the HPV vaccine, hepatitis vaccines etc), pre-exposure prophylaxis for HIV, and more.

What to expect at your appointment

If you have symptoms, are having a cervical smear, or are having an IUD inserted your nurse or doctor will likely need to examine you. Please don’t worry about pubic hair: your healthcare provider couldn’t care in the slightest if you have or haven’t shaved or waxed. It also doesn’t matter if you are currently menstruating. If you are feeling anxious, remember that the doctor or nurse you are seeing examines many people every day and this is as mundane for them as brushing your teeth is for you.

What about during the coronavirus pandemic?

The NHS is still open. Don’t avoid seeking healthcare you usually would during this time. Call your local GUM or GP clinic and they will advise you on what you can do during this time. They may try and manage your needs remotely, like by posting you medications you may require.

During the lockdown is also a great time to order an STI testing kit to your home.

While routine services may running at reduced capacity right now, all emergency services are functioning. If you have been assaulted, if you need emergency contraception, if you are feeling unwell, or if you need an abortion, you will still be able to receive these services and more. For example, some clinics are now posting medical abortion pills to patients, and you can still get help from a sexual assault referral centre (SARC) during the coronavirus outbreak. You can contact your GP clinic, GUM clinic, or go to A&E if you need any sexual and reproductive healthcare.

 

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