Sexual & Reproductive Health
The departments of Sexual & Reproductive Health (formerly known as Family Planning) and Genitourinary Medicine merged in 2008 and are now known as the department of Sexual Health.
The administrative base is at Glenalmond House, Coathill Hospital, Coatbridge ML5 4DN and there are clinics every day across Lanarkshire. Most clinics are combined clinics and patients can be see and managed in a single clinic with both Genitourinary Medicine and contraceptive consultations.
There are still a few traditional Family Planning/Sexual & Reproductive Health clinics dealing with contraception mainly.
There is a dedicated appointment line which patients or GPs can refer into: 0845 618 7191.
This is open 9am – 4.45pm Monday to Friday.
There is a sexual health link on FirstPort under clinical service. This has links to protocols etc. Link to come
There is also a public website, Lanarkshire Sexual Health, which has up to date information on all clinics and on contraception and sexual transmitted infections.
Notes
Symptoms suggestive of an acute sexually transmitted infection (STI) (urgent)
We aim to offer an appointment within 48 hours to all clients who have symptoms suggestive of an acute STI eg genital ulcers, new onset vaginal discharge, urethral discharge, pelvic pain, testicular pain. However, we may not be able to offer them an appointment in their local clinic within this time frame.
It may be quicker for the patient to call the appointment line themselves: 0845 618 7191
For treatment if already diagnosed with acute STI: (urgent)
The following link takes you to a list of the recommended treatments (assuming no contraindications.) Please see protocol available on FirstPort for further guidance.
List of the recommended treatments
Sexual contact with someone who as Chlamydia, Gonorrhoea, Syphilis, Trichomoniasis, Epididymo-orchitis or PID (urgent)
Sexual contact with someone who has HIV (urgent)
If exposure has occurred less than 72 hours, please refer urgently to A&E or d/w Infectious Disease Consultant On-call as patient may be eligible for Post Exposure Prophylaxis After Sexual Exposure (PEPSE)
The window period for HIV is 3 months but many HIV infections show up by 4 weeks post exposure. Initial blood test can be done at that time.
Sexual Assault (urgent)
Women or men who make an allegation of sexual assault within the last seven days should be encouraged to self refer to Archway: Telephone: 0141-211-8175
The forensic examination can be carried out whether or not the woman or man wishes police involvement.
If the assault took place more than 7 days ago, the patient can be seen within sexual health for STI screening, Hepatitis B vaccination and further management.
We do NOT offer forensic examination.
Genital warts (routine)
If appropriate, please prescribe topical treatments in the first instance. Only cryotherapy can be used in pregnancy. If Podophyllotoxin has been ineffective after 4 weeks of use, please advise patients to attend a sexual health clinic. If Imiquimod has been ineffective after 4 weeks of use please ask patient to attend a sexual health clinic. However, if Imiquimod has started to take effect further treatments can be prescribed (maximum of 16 weeks in total).
It is good practise to offer an STI screen to all patients attending with genital warts.
Recurrent genital herpes (routine)
A HSV positive swab is required to confirm diagnosis prior to initiation of antiviral prophylaxis.
Suppressive antivirals are usually started in patients who have greater than 6 outbreaks of HSV/ per year.
Asymptomatic testing for STIs (routine)
This can usually be offered within Primary Care. For a male, a First void urine (after having not passed urine within the past hour) into a white topped universal container can be sent for Chlamydia and Gonorrhoea testing.
For females, a self obtained low vaginal swab (patient inserts swab 5cm into the vaginal and rotates for 15 seconds before placing it into container) can be sent for Chlamydia and gonorrhoea testing. Urine is not a good method of testing for these infections in women.
Blood samples can be sent in two yellow top tubes to microbiology for HIV and Syphilis testing.
Blood Borne Virus testing – Hepatitis B, C and HIV (routine)
This can usually be offered within Primary Care by sending 3 blood samples in yellow top tubes to microbiology.
Hepatitis B Immunisation (may need urgent referral depending on reason for referral)
We offer Hepatitis B Immunisation for the following groups :
- Sexual assault within past 6 weeks
- Post or pre sexual contact with someone who has Hepatitis B
- Men who have sex with Men
- Sex workers
- Clients who have regular contact with sex workers
- IVDU
- Partners of IVDUs
- Clients with multiple partners