Istanbul

Turkey / Marmara / Istanbul

OVERVIEW

As the largest city in Turkey, Istanbul has a wealth of health care resources available. But it can also be complex, often confusing, environment for women's health care. While birth control pills are available in many pharmacies ("eczanes" in Turkish) in the city center, and abortion is legal, it can be difficult to find reliable and responsive treatment. This is due to the conflicting messages surrounding women's sexual and reproductive freedom in the country.

On the one hand, Turkey is constitutionally secular and certain districts of the city, such as Beyoglu and Kadikoy, are famously progressive for Turkey. Furthermore, Istanbul is full of internationally accredited hospitals, making it a hotspot for medical tourism. On the other hand, it is typically considered taboo to discuss many aspects of sexuality, and unmarried women are often expected to remain virgins. This creates a discrepancy between the legal options and the social realities of the city. For this reason, it is especially important to do one's research in advance when looking for a gynecologist or STD test.

Contraception

Laws & Social Stigmas

In Turkey, you do not need a prescription to purchase birth control. While President Erdogan made headlines by advising Muslim families to avoid birth control in May 2016, birth control is still widely used. According to one study, it is estimated that 48% of Turkish women are using a modern contraceptive . According to a 1998 study, 63.9% of women practiced some form of birth control, with 4.4% on the pill, 19.8% with IUD and 24.4% practicing the pull-out method (http://www.infoplease.com/ipa/A0193123.html).

What to Get & Where to Get It

In Istanbul, birth control pills are available in many pharmacies ("eczanes" in Turkish). While pharmacies don't have tons of options, they do carry a few brands, including Yasmin and some generic brands. NuvaRing is also available in Istanbul. Most pharmacies do not carry the Nuvaring but the bigger ones (i.e. In shopping malls) have it - without prescription, max 30tl per pack (so for month) and no limitations as for how many packages you can buy.

There are no DivaCup sellers in Turkey so it should be purchased online.

Costs

Birth control pills should cost between 15-30 lira, depending on the brand.

Emergency Contraception

Laws & Social Stigmas

In Turkey, you do not need a prescription to purchase emergency contraception, and there is no age restriction. It is generally easy to purchase in pharmacies. However, according to a 2008 study, only 29.1% of Turkish women of reproductive age were aware of emergency contraception and only 2.3% had practiced it: [link to study by International Consortium of Emergency Contraception http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/turkey/].

What to Get & Where to Get It

Most pharmacies should have emergency contraception. For progestin only, they typically sell NorLevo .75 mg (take 2 pills within 120 hours). As another option, some people take Lo/Ovral, Lo-Femenal pr Microgynon 21 according to the following instructions: 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later. Another option is Miranova according to the instructions: Take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later. Source: Princeton Emergency Contraceptive Website (http://ec.princeton.edu/).

Costs

Emergency contraception should cost 20 TL (this is based on one stat from Bursa, so we'll need to collect more info).

Medications

Laws & Social Stigmas

You can access most medications in Istanbul for reproductive health and STDs. But this is not the case for everything. The European Centre for Disease Prevention and Control (ECDC) has recommended that all European teenagers receive the HPV vaccine, but Turkey has no program in place. Regarding HIV, PreP is not available in Turkey, and not all antiretroviral drugs are available either. But the HIV drugs that are available can be found in pharmacies.

What to Get & Where to Get It

Pharmacy Recommendation - Karacabey Pharmacy near Dunya Goz Hastanesi Etiler

You can get medications for yeast infection at Turkish pharmacies. The word of "yeast infection" in Turkish is "mantar enfeksiyonu," which translates as "yeast." You typically need a prescription for a urinary tract infection ("idrar yolu enfeksiyonu" in Turkish) since it's an antibiotic. However, you can often get drugs like Monural without a prescription. The word for "chlamydia" is the same and it seems that the word for "gonorrhea" is "belsoğukluğu." HIV and HPV are the same, and "Hepatitis" is " Hepatit."

Menstruation

Laws & Social Stigmas

You can easily find pads and panty-liners in Istanbul. Meanwhile, tampons are available but they are much more difficult to find.

What to Get & Where to Get It

Pads and panty-liners are easy to find in Istanbul. However, tampons are much more difficult to find. They are sold in select pharmacies. It's been reported that in expat areas, like Cihangir or Moda, you may be more likely to find them in grocery stores or stores like Gratis as well. If you do find tampons, they're almost always OB (so no applicator).

There are no known sellers of DivaCup in Turkey so it should be purchased online. The only known seller of Mooncup in Turkey is in Canakkale (Dedetepe Eco Farm ) so it's probably easiest to purchase it online as well.

Costs

One box of 32 tampons should cost you around 11 TL.

Gynecological Exams

Laws & Social Stigmas

While cervical screenings are common in Turkey, a July 2016 Hurriyet article claimed that "cervical screening remains taboo in Turkey."

What to Get & Where to Get It

Some useful terminology: biopsy of the endometrium (= endometrium in Turkish) is called probe curetaj . Curettage = curetaj. Myoma= myom . Fibroid = fibrom . Cervix = serviks. Uterus = uterus. Cyst= kist. Polyp= polip. Breast = meme . Nipple = Mamelon.

Anonymous Review

Acibadem Maslak - I was very unhappy with a gynaecological check up at Acibadem Maslak hospital lately. It is all about the money rather than about the patient. I am not complaining about the medical care but about the total lack of information i got by the doctor. (Asked the same question 3 times : why my endometrium was abnormally thick but all she could say was she had to do a hysteroscopy and perform a biopsy of my endometrium first and send it to the lab) This scared me to the point i agreed for immediate surgery the next morning without asking around, since i thought it might be cancer. I guess i was unlucky to end up with a gynaecologist that was bad in communication. She didn't even tell me i was going to have general anesthesia( so i planned to drive to the hospital myself) When i woke up I was not given any info, except that they had found polyps and sent it to the lab. Afterwards another doctor translated the report: they had removed a benign myoma and did a curettage) I was not given any hygenic pads (nobody told me beforehand i would be bleeding either). I was complaining about pain and they said it was normal, gave me a prescription to buy pain killers at the pharmacy before going home (in my country they give you the necessary medication before going home as well as complete detailed information by the doctor. ) I just felt awful and scared because i didn't know what was wrong with me.

Dr. Munip Berberoglugil, Vital Fulya Plaza, Sisli - I warmly recommend gynaecologist Dr. Munip Berberoglugil at Vital Fulya Plaza in Sisli who cares a lot about his patients, studied in Brussels and speaks perfect French and English. He fixed me up after the surgery at Acibadem which had left me with abnormal bleeding and lots of questions (they did not even bother to make a second appointment after surgery for control, which is often free - like at Amerikan hastanesi for example).

Prof. Dr. Yucel Karaman - He is an authority, both in Istanbul as in Brussels, in the field of fertility problems and excellent gynaeclogist. He also speaks French and English.

STD Tests

What to Get & Where to Get It

To say "STD Test" in Turkish, simply say "STD Test" (is the same). It seems that many hospitals can give tests for HIV, Hep B, Hep C and syphilis. However, it is much more difficult to also get tested for gonorrhea, chlamydia, etc. One way to get a free HIV, Hep B, Hep C and syphilis test is to donate blood to Kizilay (https://www.kizilay.org.tr/) because they test the blood and then get back to you. In July 2016, Şişli municipality launched a free and anonymous health service for the LGBT community, focusing on the prevention of STDs. Every 3 months, patients can receive a free STD test and examination. Patients can register with a nickname if they wish.

Here's a list of some clinics that do STD testing in Turkey: http://www.whatclinic.com/doctors/turkey/sexually-transmitted-diseases-testing

Costs

Tests for Turkish citizens are supposed to be free (can we confirm this?) at public hospitals. As for foreigners, this may greatly vary, depending on whether you go to a public or private hospital, as well as how many tests you order.

Pregnancy

Abortion

Laws & Social Stigmas

Since 1983, abortion has been fully legal in Turkey. Currently, you can get an abortion for up to 10 weeks of pregnancy. After 10 weeks, the abortion can only be performed if the woman's life is endangered or in cases of foetal impairment. Overall, legal reasons for abortion include: to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, foetal impairment, economic or social reasons, and availability on request. According to Law No. 2827 of 24 May 1983, Population Planning Law, married women need spousal consent, and minors or mentally disabled patients need approval from their parents, guardians or the magistrate's court. If there is endangerment to life or vital organs, no approval is required from spouses or parents/guardians. If there is a risk to the woman's life or risk of fetal malformation, two specialists (one ob/gyn and one specialist in a related field) must write their objective findings in a confirmation letter.

According to a UN report, "Despite the liberal nature of abortion laws in Turkey, the number of legal abortions performed in the country has been sharply restricted by the requirement that the procedure be carried out only by or under the supervision of gynaecologists. This factor is especially critical in rural Turkey, where medical specialists of any type are scarce or non-existent" (Abortion Policy - Turkey).

Misoprostol (the abortion pill) is no longer available.

Note that pre- and post-abortion counseling is not common in Turkey.

What to Get & Where to Get It

In March 2016, the Turkish Society of Obstetrics and Gynecology declared that public hospitals have effectively banned abortion. So it is best to look into private hospitals, despite their steeper cost, if possible.

Advocacy & Counseling

List of Additional Resources

• Istanbul Hollaback - Hollaback! is an international movement to end harassment. We believe that everyone has the right to feel safe and confident in public spaces. (http://istanbul-en.ihollaback.org/)
• Kirmiza Semsiye/Red Umbrella Sexual Health and Human Rights Association - "Red Umbrella Sexual Health and Human Rights Association aims to raise awareness and visibility regarding human rights violations experienced by male, female and transgender sex workers in Turkey." Based in Ankara. Phone: +90312.419.2991. Email: kirmizisemsiye@kirmizisemsiye.org(http://kirmizisemsiye.org/)
• Morcati - Anti-domestic violence organization (http://www.morcati.org.tr/tr/)
• Lamda Istanbul - LGBT organization (http://www.lambdaistanbul.org/s/)