Contraception for Travellers
Travellers should consider if current contraception is suitable for intended travel and which contraceptive services will be available in the country(s) being visited. The Family Planning Association of Britain, Marie Stopes International and International Planned Parenthood Federation (IPPF) can provide additional information.
Travellers changing to a new method of contraception prior to travel should allow enough time to try the new method to ensure suitability prior to departure.
Travellers should be aware that new sexual partners and unprotected sex abroad are not uncommon; increasing the risk of sexually transmitted infections (STIs). It is advisable to carry a supply of condoms when travelling.
Crossing Time Zones
- Ideally oral contraceptives should be taken at the same time each day, travellers should think about this when crossing time zones.
- Specific information on timeframe margins may be found in the patient information leaflets of each oral contraceptive pill.
- The Faculty of Sexual and Reproductive Healthcare and BNF advise that additional precautions are not required for those taking non-enzyme-inducing antibiotics alongside combined oral contraceptives or progesterone only oral contraceptives.
- Doxycycline is often used for malaria prevention, it is a non-enzyme inducing antibiotic.
- The use of additional precautions does apply if vomiting or diarrhoea occurs as a result of antibiotic use or underlying illness.
Vomiting and Diarrhoea
- The contraception injection, implant, IUS, IUD, contraceptive vaginal ring and contraceptive patch are not affected gastrointestinal upsets.
- Vomiting and persistent, severe diarrhoea may interfere with the absorption of COCP. If vomiting occurs within 2 hours of taking a COCP another pill should be taken as soon as possible. In cases of persistent vomiting or severe diarrhoea a barrier method should be used, continued throughout the stomach upset and for seven days after recovery (9 days for Qlaira®).
- Vomiting and persistent, severe diarrhoea may interfere with the absorption of POP. If vomiting occurs within 2 hours of taking a POP another pill should be taken as soon as possible. If a replacement POP is not taken within 3 hours (12 hours for desogestrel) of the usual time for taking the POP, or in cases of persistent vomiting or very severe diarrhoea, a barrier method should be used during illness and for 2 days after recovery.
- Reliable condoms may be difficult to find in some countries, condoms carrying the British Kite Mark or the European CE mark have been tested to ensure quality.
- Used properly, condoms can provide effective contraception and protection against STIs, however, latex condoms are easily damaged by oil based lubricants such as Vaseline, baby oil and suntan lotion.
- Condoms also perish with age, and heat, and should be discarded if they are out of date or show any signs of being brittle, sticky or discoloured.
Diaphragm/Cap with Spermicide
- After removal diaphragm/cap should be washed in water deemed safe to bathe in using a mild unscented soap, dried thoroughly and then stored in a cool, dry place in an airtight container.
- Travellers should consider how they will look after their diaphragm/cap in the country(s) they intend to visit.
- Excessive heat may perish rubber and the efficacy of spermicides may be reduced if they are not stored in cool, dry containers.
Hormonal and Intrauterine Device Methods
- The contraception injection, implant, IUS, IUD, contraceptive vaginal ring and contraceptive patch are not affected by time zones, gastrointestinal upsets or antibiotics.
- Travellers should consider the availability of contraception services in the country(s) they intend to visit, for example where they would obtain contraceptive pills in the event of theft or loss.
- The emergency (morning after) contraceptive pill may not be available in some countries, it may therefore be advisable for travellers to take a supply with them.
- Travellers wishing stand-by emergency contraception should discuss this option with their GP or usual contraception provider.
- In the UK emergency (morning after) contraceptive pills can be sourced through pharmacies for those 16 years old or over, however, this is restricted to situations where there is an immediate need for the medication and would therefore not be provided for those wishing to take the medication abroad.
- Menstrual bleeding can be managed by extended or continuous administration of the COCP; changing how the POP pill is taken will not delay menstrual bleeding. Further details can be found via NHS Choices.
- For those not on COCP it may be possible to obtain a prescription for medication to delay menstruation. Travellers interested in this option should discuss it with a suitably qualified healthcare professional.
Women using contraceptive patches, contraception vaginal rings or oral contraceptives have an increased risk of deep-vein thrombosis (DVT) during travel involving long periods of immobility (over 4 hours). DVT risks may be reduced by appropriate exercise during the journey and using Anti-embolism Stockings.
For further information on DVT risk management please refer to the Deep Vein Thrombosis advice sheet.