This section has useful links to other agencies and organisations that support your work in sexual health and contraception. (Please note that 4YP no longer exists in Bristol.)
This page also contains some FAQs which have been generated from an ongoing audit of clinical queries that we receive.
If you cannot find what you are looking for, or require additional information or help, please contact us on 0117 342 6913.
Useful websites
Please see the website links below for helpful national information and guidance.
British Association for Sexual Health and HIV (BASSH)
British HIV Association (BHIVA)
British Pregnancy Advisory Service (BPAS)
Faculty of Sexual and Reproductive Healthcare (FSRH)
Family Planning Association (FPA)
Society of Sexual Health Advisers
Local policies and guidance
Safeguarding in South Glos – policies and plans
Safeguarding in South Glos – learning from practice
Helpful resources for assessment
Please see the links below for helpful tools that may be used to help with your patient assessment.
UK Medical Eligibility Criteria tables for contraception use (UKMEC)
Spotting the Signs proforma (for child sexual exploitation)
Brook Sexual Behaviour Traffic Light Tool
National Osteoporosis Society – Are you at risk of osteoporosis?
Alcohol Use Disorders Identification Test (AUDIT)
How to calculate the latest time in the cycle and that an emergency IUD may be fitted – please see document
Frequently Asked Questions
Contraception
- A patient has come in for a coil removal and I cannot see the threads
Consider the need for emergency contraception.
Advise other means of contraception.
Organise an ultrasound to confirm the position of the coil.Refer to Complex Coil Removal clinic, please see Clinical services and How to Refer
- A patient has come for a coil removal. I could see the threads and tried to remove it and was unable to
Refer to Complex Coil Removal clinic, please see Clinical services and How to refer
Please consider whether the attempted removal may have dislodged the intra-uterine contraceptive device and offer bridging contraception if necessary.
- I have a patient with lost threads; an USS was organised which shows the coil is embedded, what should I do?
The patient should be referred to Gynaecology rather than Unity sexual health in this instance for removal with hysteroscopy.
Advise other means of contraception.
- My patient is on the depo and is asking whether she can take this away with her on holiday as it will be due when she is away?
At present, this service is not available; she will need to consider alternative contraception.
- My patient has presented today for a coil removal, she has had unprotected sex in the last seven days, can I still do it?
In both cases whether it is an IUD or an IUS, the coil should not be removed if there has been any unprotected sex in the last 7 days due to risk of pregnancy from any remaining viable sperm.
- A patient has come for an implant removal but I cannot feel the implant
Consider the need for emergency contraception. Advise interim contraception.
Refer to the Deep Implant clinic, please see Clinical services and How to refer
- My patient came for implant removal, I tried to but was unable to remove it
Refer to the Deep Implant clinic, please see Clinical services and How to refer
- My patient has already had oral emergency contraception this cycle, can I give it again?
Yes you can. The FSRH guidance recommends giving oral emergency contraception for every episode of unprotected sex in a cycle.
For further guidance:
- My patient has a Mirena coil and has just been prescribed carbamazepine, do I need to do anything?
No.
Enzyme inducers, like carbamazepine, can affect all progesterone containing contraception, with the exception of Depot medroxyprogesterone acetate and the Intra-uterine system.
For further guidance:
- I have a transgender patient- what are their contraceptive needs?
From FSRH CEU statement
The medical help required by transgender and non-binary patients is highly individualised. People’s goals, from hormone therapy and surgery vary enormously, therefore so will the appropriateness and acceptability of different methods of contraception. Sensitive communication, with a clear attempt to avoid any stigmatising language, is therefore the key issue.
The Faculty of sexual and reproductive healthcare have produced a statement on Contraceptive Choices and Sexual Health for Transgender and Non-Binary People (October 2017).
STIs
- I have a pregnant woman with herpes, what do I do?
Aciclovir is safe to use at any point during pregnancy. Normal dosing regimen applies.
If she is more than 28 weeks, and if this is a primary episode, she will need to be referred for consultant led antenatal care and may require caesarean delivery.
For further guidance:
- My patient’s results have come back positive for gonorrhoea
We advise that patients are seen by our service so they can receive the correct treatment and discuss partner notification and test of cure.
If you are happy to do this is in surgery then they do not need to be seen by us.
Please refer to our local guidelines for recommended treatment regimens.
For further guidance:
- I have a patient that has been treated for epidydmo-orchitis, do I need to treat their partner?
Yes.
We recommend partner notification and treatment for recent sexual partners.
All partners should be treated empirically with Doxycycline 100mg BD for 7days. Advise no sex until both partners finished treatment.
- I have a patient that has been treated for PID, do I need to treat their partner?
Yes.
We recommend partner notification and treatment for recent sexual partners.
All partners should be treated empirically with Doxycycline 100mg BD for 7days. Advise no sex until both partners finished treatment.
- I have a patient who has tested positive for Trichomonas vaginalis (TV) with a IUC in situ, does this need to come out?
No, treat the patient as per guidelines for TV but the coil does not need to be removed.
- I have a patient I have a high suspicion for PID with a IUC in situ, does the coil need to come out?
No, treat the patient for PID but the coil does not need to be removed.
- I’m unsure of diagnosis of a genital lump, how do I refer the patient to you for second opinion?
You can advise the patient of our clinics and opening times and to come to the next available walk in slot.
If you feel they need to be seen urgently, please ring us on 0117 342 6900
Non-Clinical
- What's changing with the 4YP brand?
As of April 2018 the 4YP brand will no longer exist in Bristol.
Unity Sexual Health from this date will take over the sexual health related training that was previously provided by 4YP. We’re currently reviewing the training programme.