What a difference a month makes! Disruptions in supply chains, foregoing nonessential patient appointments, potential siphoning of funds from reproductive health programs and possibly decreased access to free or subsidized family planning care are predictions that have implications for providers and patients alike during the growing outbreak of Covid-19. (Check out the links, below, for information and recommendations to guide you and the patients you serve.) The simple response to patients’ questions about having sex would be that social distancing calls for a 6-foot space between people. Of course, sex in general, even if not face-to-face, involves a lot of touch and very little if any space, and certainly not 6 feet of it. And, kissing may be one of the most effective ways to transmit Covid-19—and for that matter, influenza, rhinovirus, etc., and maybe future emerging infectious diseases.
Your patients may be more encouraged to practice temporary abstinence if they know that the benefits of sexual activity need not be completely lost when keeping a distance. After all, sex fulfills many natural desires, including those of love, pleasure, and perhaps in times like these, comfort and release. All are desires that can emerge during current extended periods of social distancing that have been recommended. (Perhaps some of your patients are described in https://www.wired.com/story/dating-apps-coronavirus-covid-19/). Inform your patients that saying ‘no’ to activities such as kissing and sexual intercourse can still mean saying ‘yes’ to other sexual activities: solo or mutual masturbation, fantasy, erotic books or sites, or toys. In fact, the Contraceptive Technology website last month featured a monthly update on “Talking about Toys”…sanitized toys, of course.
While many health care providers feel comfortable asking patients about sexual behaviors as they relate to the potential risks of pregnancy and sexually transmitted infections, far fewer speak with patients about sexual knowledge, pleasure, or satisfaction, write Jenny Higgins and Patty Cason in Contraceptive Technology. Clients report that practitioners rarely ask them about sex, despite the evidence suggesting that discussions about positive sexual experiences and satisfaction (and not merely sexual risk) yield significant benefits for patient health as well as the quality of the provider-patient relationship. Maybe now is the time to begin those discussions.
Below are a few important Covid-19 resources on reproductive health for you and for your patients:
ACOG: Novel Coronavirus 2019 (COVID-19) Practice Advisory
Guttmacher Institute: The COVID-19 Outbreak: Potential Fallout for Sexual and Reproductive Health and Rights
CDC: Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings
Bedsider: Sex in the time of coronavirus