Shanghai

China / Shanghai

OVERVIEW

As one of the largest cities in the world, Shanghai has abundant private and public health care options. Contraceptives are available without a prescription, though foreign pills are limited to four main brands. Emergency contraceptives are also available without a prescription, practically all of which are Chinese brands, so you won't be able to find ellaOne in pharmacies. STI/STD tests are common and, if you are a foreign worker seeking a visa, they are required. Abortion is incredibly common in China, as well, which is considered the "abortion capital of the world," and it's legally permitted for up to 6 months of gestation.

In China, the public hospitals are the cheapest options. But they may be more inefficient and rudimentary in terms of services and facilities, and English-speaking may be limited. The private hospitals will, of course, cost more. But they may provide a more useful service to foreign visitors if they do not speak any Chinese.

Contraception

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

Contraception is legal and widely available in China. No prescription is needed and there are no known age restrictions. It is estimated that 84.6% of Chinese women in marriages or in unions use some form of contraceptive, with 39.6% using IUDs, 33% using female sterilization, 4.3% using condoms and 1.7% using the pill. It was also found that 6.9% used male sterilization. Furthermore, China appears to use more condoms than any other country in the world. Due to the One-Child Policy, contraceptives have been strongly encouraged by the government for decades, so there is practically no social stigma regarding its use for married couples. Premarital sex has been a social taboo for decades. Yet social views are progressively changing, especially for younger generations. At family planning offices, women receive free contraception and prenatal classes.

As reported by US China Daily, "'For young people, they are not covered by the family planning program because they are not married, so they fall through the cracks in terms of sex education and contraceptive access,' says Joan Kaufman, Distinguished Scientist at the Schneider Institutes for Health Policy at Brandeis University. 'They can certainly purchase birth control at drug stores, but it is harder for them access services from China’s free family planning program.'"

What to Get & Where to Get It

Yasmin birth control pills purchased in China

Marvelon, a common birth control brand found in China

In China, you don't need a prescription to purchase birth control. However, if you do want to consult with a doctor beforehand, you can typically schedule an appointment with a doctor at a Western hospital for 600-700 yuan or with a Chinese doctor for much cheaper.

When you go into a Chinese pharmacy, ask for 避孕药 (pronounced "bì yùn yào"), which translates to "contraceptive pill." You can also say 节制生育 (pronounced "jíe zhì shēng yù"), which means birth control, but it refers to all birth control, including condoms, IUDs, etc. There are four main oral contraceptives in mainland China, all of which are combined pills (contain both estrogen and progestin). According to SmartShanghai, "even if you go to a foreign-operated hospital like United Family or Parkway Health, chances are you won’t find more than these brands at their pharmacies."

Here's the brands:

• Marvelon (mā fù long 妈富隆): 1.5 mg desogestrel + 30 micrograms ethinylestradiol
• Mercilon (měiyì bì, 美意避): 1.5 mg desogestrel + 20 micrograms ethinylestradiol
• Yasmin (yōu sī mín, 优思明): 3mg drospirenone + 30 micrograms ethinylestradiol
• Diane-35 (dá yīng sān shí wŭ, 达英-35): 2mg cyproterone acetate + 30 micrograms ethinylestradiol

If you are interested in getting an IUD in China, here's a personal account of the experience. This woman got her IUD at Xinhua Hospital (insertions are done on Monday, Wednesday, and Friday at 1pm, as of September 2014). For additional recommendations for clinics to fit the IUD, check out the "Gynecological Exams" section.

While there are many pharmacies in Shanghai, here are some major and trusted pharmacies:

• Shanghai Huashi Pharmacy 上海华氏药房
• Shanghai Guoda Pharmacy Chain 国大药房
• Shanghai Lianhua Fosun Pharmacy 上海联华复星药房
• Parkway Health: "carries the Big Four over at its pharmacies, but you’ll need to set up a consultation with a doctor before you can buy it there. A pharmacist here explained to me that the pills they carry are manufactured in this country by Bayer (Germany) and Merck (United States)."
• United Family: "carries them too, though their pharmacist tells us that the versions they have are imported, so they’re a bit more costly: Diane-35 (150rmb), Yasmin (231rmb), Marvelon 63rmb), Mercilon (108rmb) and Postinor (81rmb). They also have a triphasic offering too, locally-made: 左炔诺孕酮炔雌醇(三相)片 —it translates directly as “levonorgestrel ethinylestradiol (three phase)—at 100rmb a box. Again, if you want to get your pills here, then you’ll need a prescription after meeting with one of United’s doctors for a consultation."

Warning: Some pharmacies in Shanghai have reportedly sold fake pills. So, if possible, try to purchase from a larger, well-known pharmacy.

Costs

In 2015, here were the prices for some birth control pills: Diane-35 (69rmb), Yasmin (138rmb), Marvelon (23rmb) and Mercilon (68rmb).

Emergency Contraception

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In China, emergency contraception is available without a prescription. It can be purchased at pharmacies.

What to Get & Where to Get It

In Chinese, the morning after pill is 避孕药 (pronounced "bìyùn yào"). If you go into a Chinese pharmacy, the pharmacist will probably ask if you want birth control pills for "every day" or "just one time." The "just one time" pills are emergency contraception/morning after pills.

• In China, if you want dedicated emergency contraception (the morning after pill), here are the brands that are anti-progestin. For these brands, you take 1 pill within 120 hours after unprotected sex: Fu Nai Er (10 mg), Fu Nai Er (25 mg), Hou Ding Nuo (10 mg), Hou Ding Nuo (25 mg), Hua Dian (10 mg), Hua Dian (25 mg), Si Mi An (10 mg) and Si Mi An (25 mg). For these brands, you take 2 pills within 120 hours after unprotected sex: Bi Yun (12.5mg).
• In China, if you want dedicated emergency contraception (the morning after pill), here are the brands that are progestin-only. For these brands, you take 1 pill within 120 hours after unprotected sex: An Ting (1.5mg), Bao Shi Ting (1.5 mg), Dan Mei (1.5 mg), Hui Ting, Jin Xiao (1.5 mg), Jin Yu Ting (1.5 mg), Ka Rui Ding and Xian Ju (1.5 mg). For these brands, you take 2 pills within 120 hours after unprotected sex: Ai Wu You (0.75 mg), An Ting (0.75mg), Bao Shi Ting (Postinor-2, 0.75mg), Dan Mei (0.75 mg), Hui Ting (0.75 mg), Jin Xiao (0.75 mg), Le Ting (0.75 mg), Yi Ting (0.75 mg), Yu Ting (0.75 mg).
• If you can't access dedicated emergency contraception, you can use regular birth control pills as EC. To do this, you can take Levonorgestrel Pill (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).

Costs

In 2015, Yu Ting (毓婷 / Yùtíng) was 36rmb and Postinor (左炔诺孕酮 / Zuǒ quē nuò yùn tong) was 49rmb.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

While many people in China have not had an STD test, all foreigners who plan to work in China (under the Z Visa, R Visa, etc.) must take an STD test. Here's an example of the final medical certificate you may receive when applying for a visa. If someone is found to have HIV/AIDS, syphilis or gonorrhea through their tests, their STI status must be reported to the national surveillance system, as stated by the Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases. This data is used to monitor STI rates. Since 2010, China no longer restricts HIV+ people from visiting the country. But it is difficult to completely verify this information, so if you are HIV+, according to HIVTravel: "do not declare your status on the visa application form. Historically, people declaring their status truthfully have been denied entry." Furthermore, you may want to look into anonymous testing facilities or self-testing kits. If you are found to be HIV+, you will not be allowed to attain any residence or work permits in China. However, if you are infected with other STIs, like chlamydia or herpes, your status will probably not be reported. See a discussion here about herpes and status reporting in China. Also, check out this general discussion about medical checkups and Chinese residence/work permits.

Historically, Chinese STI rates have grown in the last few decades. In the 1950s, China launched mass campaigns to reduce STI rates and prostitution. However, Chinese society began to liberalize in the 1980s, bringing about urban development, increased nightlife entertainment, and increased sexual activity outside of marriage. During this period, STI rates grew. For example, syphilis, which had been eliminated in the 1960s in China, came back -- and, as found in 2011, it was one of the most common STIs in China. Furthermore, the estimated number of people living with HIV in China rose from 350,000 in 2001 to 770,000 in 2009. Overall, HIV/AIDS prevalence is low in China. But certain areas are more heavily affected and, in 2009, AIDS became the leading cause of death among infectious diseases.

Chlamydia is the most common bacterial STI in China today. In 1999-2000, a study found that 2.1% of men and 2.6% of women were infected. The highest rates were found among female sex workers (infection rate of 16-18%). As for gonorrhea, while it is common for high-risk groups, rates have gone down over the past decade. Some studies show especially high herpes rates for pregnant women.

In China today, there is often strong social stigma regarding STIs/STDs. In a 2008 study of Shanghai migrant women, over 50% agreed that people who acquired HIV through drugs or sex deserved it. Yet only 3.7% had ever been tested for HIV. In 2016, another study concluded that "people who contracted HIV from 'blameless' routes (e.g., with stable partners) may have less stigmatized experience compared to people who contracted HIV from 'blamable' routes (e.g., injecting drug use, sex with sex workers).

Helpful Terminology

Chinese words for STDs/STIs:

"I want to do an AIDS test": Wǒ xiǎngzuò àizībìng jiǎnchá 我想做艾滋病检查

Gonorrhoea: Lìnbìng 淋病 Syphilis: Méidú 梅毒 Chlamydia: Yīyuántǐ 衣原体 Herpes: Pàozhěn 疱疹 HIV/Aids: Àizī bìngdú/Àizībìng 艾滋病毒 / 艾滋病 Hepatitis B: Yǐxíng gānyán 乙型肝炎

Testing Facilities

• Shanghai Skin Disease & STD Clinic (上海市皮肤病性病医院): This clinic is in a Chinese public hospital so prices are lower. Tests for chlamydia, hepatitis B, HIV, syphilis. Read an account here , here and here about getting tested at the clinic. Tests range from 400-500rmb with an 18rmb registration fee. Address: 196 Wuyi Lu, near Anxi Lu, 武夷路196号, 近安西路 PHONE: 6183 3107 AREA: METRO: 20 mins walk from Jiangsu Rd. Hours: Monday-Saturday, Morning Hours, Registration: 7:30-11am, Treatment Hours: 8am-Midday. Afternoon Hours: Registration: 12:30-4:15pm, Treatment Hours: 1:30-5pm.
• Huashan Hospital (华山医院): This is another public hospital where you can be tested at a cheaper rate. Tests for chlamydia, hepatitis B, herpes, gonorrhea, syphilis, HIV. Costs are about 452.50RMB, includes a registration fee of 15.50RMB (2012). Note that there are some English-speaking doctors on staff but you'll get your test results in Chinese. Click here for personal testimonial.
• Shanghai People's Number One Hospital: Tests for chlamydia, hepatitis B, gonorrhea, syphilis, HIV. Costs 285.50RMB, includes a registration fee of 15.50RMB. Click here for personal testimonial.
• Sino-Aid: This clinic "is where you can have sexual health check ups, included HIV and STD (Sexually Transmitted Diseases) testing. In our STDs Testing Center you should be seen anonymously if you want to be. Our STDs Center is located in both Pudong and Puxi area of Shanghai. You may need to make an appointment with us @ 021 - 5108 2260 or send your requires to info@sinoaid.cn."
• WorldPath: 1,000RMB/ consultation; 800RMB/smear test; 1,200RMB/ HPV test. Address: 399 Nanquan Bei Lu, near Century Avenue, Pudong (2020 7888). Open 9am- 8pm Mon-Fri; 9am-5.30pm Sat- Sun.
• Parkway Health: Tests for syphilis, gonorrhea, HIV and HPV. RMB1,300/consultation, RMB226/syphilis, RMB300/gonorrhea, RMB286/HIV, RMB1,060/HPV. Staff speak English, Spanish and French, depending on location.
• United Family Hospital: Staff speak English, Japanese, German, Portuguese and French, depending on locationIt. Costs vary but can be up to 1000 RMB for a consultation,RMB400-500/chlamydia; RMB300/syphilis; RMB300-400/gonnoreah; RMB600/HIV; RMB100/hepatitis B; RMB800/herpes (2013).
• Ren'ai Hospital VIP ward: "Renai hospital is a member hospital of Bo Ai medical group... the largest privately-owned Chinese healthcare group with 26 medical facilities across Chinese mainland... Renai hospital is the first private hospital, established in Shanghai in 2001. Renai pioneered the introduction of personalized care to healthcare service sector... The Renai International Medical Center, offers direct billing services with international and local insurance companies for policy holders. It is located in the bustling city center, Xu Jia Hui area, where there is convenient transportation from every corner of Shanghai." Appointment Center : (8621)54893781 Appointment Center : 64688888-801/810, 24hr ER Hotline : 15021633821, Address: No.127, Caoxi Rd. Xuhui District. Shanghai 200235 P.R.C
• Shanghai International Travel Healthcare Center: This is for foreigners. Address: 15 Jinbang Lu, Changning district. Contact: 021-6268-6171 (main line); 021-6268-8851 (physical examination for foreigners); 021-6268-5072 (vaccination for foreigners); fax: 021-6268-3088. Hours: No specific hours; make an appointment first., Fees: 640 yuan; 470 yuan (students). Additional fees, such as delivery fees, may apply.
• Shanghai Association for STD/HIV/AIDS Prevention & Control: This association is included in the AIDS Healthcare Foundation (AHF) directory. They may be able to refer you to a provider that works for you and may even test themselves (we're not sure). Address: No. 1477, Beijing West Road, Jingan District, Shanghai, Shanghai, China. Phone: (+86) 13701741904.

Support

• Shanghai Sexual Health Website: "Sexual Health Shanghai is dedicated to providing easy access to sexuality information, education, mutual support, counseling, therapy, healthcare, products and other resources for people who are living shanghai. There are many ways to find what you need through navigation or search tools on the top. You can call our supporting hotline at 021-5108 2260 or send email to info@shshanghai.com for any Health Relevant information which you need to know, but can not find in this site through your research."

Costs

• You'll typically pay a fee for a bundle of STD tests at public Chinese clinics. But you'll be charged an extra fee if you also want an HPV test.
• If you choose to go to a public clinic, prices will be cheaper. However, anonymity is not guaranteed. Overall, expect to pay anywhere from 300-1000 RMB for the consultation and between 100-800RMB per test.

Medications & Vaccines

Laws & Social Stigmas

While you'll find many medications in Shanghai, overseas prescriptions are typically not valid. Also, hospital pharmacies only accept prescriptions from their own doctors. China has strict laws regarding medicine imports, as well, which makes foreign/western medicines rather expensive. In the past, it was reportedly very common to buy antibiotics at Chinese pharmacies with no prescription, though is increasingly less common. If you don't speak Chinese, be sure to bring a Chinese translation of the medicine you want, as the specific brand may not be available in China. For a list of recommended pharmacies, check out the "Contraception" section.

If you are interested to learn more about pharmacies in China, here's an account written by a pharmacy student, visiting China from the United States.

What to Get & Where to Get It

Here's the name of one yeast infection medication in China: 按此看中文.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas

In China, pads are much more common than tampons. For an online discussion on this trend, click here and here.

What to Get & Where to Get It

Pads and pantyliners are more popular than tampons with locals. You'll be able to find tampons (usually with no applicators, like OB) at international stores, like Watson's and Auchan. Sometimes tampons are placed on higher shelves, so make sure to look thoroughly. As for menstrual cups, there are no known sellers of major brands (DivaCup, MoonCup, LadyCup) in China, so it's best to buy them online.

Gynecological Exams

What to Get & Where to Get It

Check out this article on Shanghai hospital tips.

International Clinics

• Global Healthcare, 1515 Nanjing Xi Lu, near Tongren Lu. If you want an IUD, up to 5,000RMB (depending on type of coil) plus 1,100RMB consultation fee; fitting carried out at a local referral hospital such as Renji, accompanied by an English-speaking nurse.See full address details.
• Parkway Health, 88 Century Avenue, near Dongtai Lu. If you want an IUD, between 7,300-9,300RMB, depending on type of coil fitted (includes consultation fee).See full address details.
• WorldPath Clinic International, 717 Nanquan Bei Lu, near Century Avenue. If you want an IUD, approx 6,000RMB (includes consultation fee). See full address details.
• International SOS clinic: Unit 1801 & 1804-1806, Tower B, Baoland Plaza, 588 Dalian Road, Yang Pu District, Shanghai, P.R. China 200082, Tel: +86 (0)21 5298 9538

Local Clinics

• Shanghai People's Liberation Army No. 411, 15 Jiangwen Dong Lu, near Duolun Lu. If you want an IUD, 110RMB.
• Shanghai Family Planning Research Institute Hospital,2120 Xietu Lu, near Wanping Nan Lu. If you want an IUD, 200-500RMB(depending on whether a preliminary examination is required) See full address details.
• Shanghai People's Liberation Army No. 85 Hospital 1328 Huashan Lu, near Jiangsu Lu.270RMB.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In China, abortion is fully legal. While most women receive abortions in their first or second terms, abortion is legally permitted for up to six months of gestation. This legality can be found in Criminal Code of China, enacted by the National People's Congress on 1 July 1979. All general reasons for an abortion are permitted, including: to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, fetal impairment, economic or social reasons, and available on request. The methods of abortion vary, depending on the length of the pregnancy. For early pregnancy, the vacuum aspiration technique is used. Second trimester abortions require an in-hospital procedure performed by a physician. The government of China provides abortion services as a public service. Once women receive an abortion, they are entitled to paid sick leave for 14 days (if the abortion took place in the first trimester) or 30 days (if the abortion took place in the second trimester). In some parts of the country, if the woman receives an IUD or sterilization after her baby's birth, paid sick leave is extended.

Today, China is considered the "abortion capital of the world," and it records 13 million abortions performed each year. But, historically, this was not always the case. In the early 1950s, abortion was only permitted under special circumstances, such as: medical concerns if the woman continued the pregnancy, spacing of children (i.e. if too close together), or if the woman had problems breastfeeding due to another recent birth. In all of these cases, a joint application of the couple and certification of the physician was required. In 1957, the Public Health Ministry liberalized abortion laws, removing requirements for age, number of children or certifications. Yet the government did not want to fully endorse abortion, and they hoped that they could chiefly stress contraceptives as a means of population control. For these reasons, the laws at the time only allowed abortions once a year within 10 weeks of pregnancy.

As the birth rate continued to grow in China, the government decided to include family planning into their economic planning. In 1976, during the time of Mao's death, the government introduced the "Later, Longer, Fewer" (Wan-Xi-Shao) campaign. This campaign encouraged people to start families after establishing solid careers ("later"), to space children 3-4 years apart in age ("longer") and to have less children ("fewer"). The campaign was considered rather successful, and China saw a substantial decline in birth rate.

In 1979, China replaced the "Later, Longer, Fewer" campaign with the One-Child Policy. This policy, which required that families should have only one child, was meant to last for only one generation. However, it became a general policy in China, lasting until 2015. Many Chinese citizens were not required to comply with the policy. During this time, free contraceptives were made available. There were some cases of forced abortions. By the 1990, it was found that 85% of women of reproductive age were using contraceptives, which was comparable to developed nation rates. The most common forms of contraceptives were IUD, female sterilization and male sterilization. Yet, after many Chinese women removed their IUDs, they did not typically find a substitute contraceptive, resulting in pregnancy. Overall, the majority of abortions in China today (70%) are estimated to follow "contraceptive failure."

Today, nine in ten Chinese women with premarital sexual experience have had an abortion. It's estimated that over 50% of abortion patients are under 25 years old. While China's liberal laws can partially explain these numbers, cultural factors also play a role. According to statistics collected by the China Population Control Center, 75% of children have never spoken to their parents about sex. Furthermore, half of Chinese young people find sexual health information from pornography or adult forums, which offers a limited window health practices. It was found that, even among university students, 45% did not know how to avoid pregnancy. Meanwhile, advertisements for "pain-free" abortions can be found throughout China. This leads to a cultural climate in which sexually-active young people are neither informed nor publicly conversing on safe sex practices, and where they may quietly seek out abortions that they're told are "pain-free" or "easy."

For a real testimonial on getting an abortion in China, click here.

What to Get & Where to Get It

See recommended hospitals/clinics under our 'Sexually Transmitted Infections' and 'Gynecological Exams' sections.

List of Additional Resources

• Click here to learn about LGBTQ rights and laws in China. It is important to note that, as of May 2018, homosexuality is legal in China but homosexual marriage is not recognized. It is legal to change your gender, but surgery is required by the government before they legally recognize the change in gender. There are no legal protections against housing or employment discrimination for LGBTQ people.
• All China Women's Federation: This women's rights organization was started in 1949, and it's the official leader of the women's movement in China. It works to promote policies and protections for women in the government and society.
• The Cultural Development Center for Rural Women: "The Cultural Development Center for Rural Women is an NGO promoting the advancement and personal development of rural women."
• Beijing LGBT Center: Their mission is "to empower China's LGBT community to live rewarding lives unconstrained by sexuality, gender, or other identities." Email: bjlgbt@gmail.com