Act now on your health to prevent emergencies later


I am a gynecologist practicing in New York City. Seeing a variety of patients from all over the city means no day is ever the same.

As New Yorkers, we’ve watched COVID-19 ravage our city, but seeing it as a physician brings a unique point of view.

Certainly, my mind and heart go out to those so acutely impacted by the virus. But what I’m seeing more and more now — and what I want to talk about — is the more subtle impact it’s had on our ability and willingness to tend to our basic health needs.

In gynecology, we encourage women to come back yearly for an annual exam. This may involve a variety of routine checks, including a pelvic exam where I look at overall health and structure of the pelvic region. A breast exam, looking for signs of breast cancer. And I also conduct regular cervical cancer screenings, what many women know or refer to as the “Pap.”

During a Pap test, we sample and look at the cells from the outside of the cervix for any cell abnormalities and warning signs of cervical cancer or pre-cancer. Often, this is conducted alongside an HPV test, as HPV has been strongly linked to cervical cancer.

When both of these tests are used together on the same sample, it’s referred to as “co-testing.”

Co-testing is the standard of care precisely because, together, Pap and HPV are the most effective way to gather information, detect disease, and hopefully prevent or enable early treatment of cervical cancer.

Lately, however, I see women missing their annual appointments, neglecting their basic gynecological care out of fear of being exposed to COVID-19. Others may delay because they’ve lost jobs as a result of the virus, and their insurance and ability to pay may be in question.

These fears are understandable. However, I am very concerned about the long-term impacts of putting off the “well woman” exam.

Many are in a pattern of hoping issues fade away over time. But when it comes to health — gynecologic and otherwise — detection and prevention can only come from knowing and prioritizing check-ins with your doctor. The annual “well woman” gynecological checkup allows us to make sure everything looks and feels normal — if something is not normal, then by coming in every year, we’re able to catch things early.

This allows for the highest potential to counsel lifestyle and next steps, treat minor or not-so-minor issues, or even in the case of cervical cancer, prevent it altogether.

Many women are viewing going to the doctor right now as an emergency-only event. What I want to stress is that by going to your annual gynecological exam, you and your doctor can help to prevent an emergency down the road. Knowing what’s going on with your body allows for mindful and meaningful action alongside your physician, and today we have very effective treatment for the warning signs of pre-cancer.

In the case of cervical cancer, if caught during the pre-cancerous stage, we can prevent it from becoming cancer at all.

I also understand and respect that many women put off their appointments because their insurance or ability to pay may have been jeopardized as a result of the virus. As a physician whose sole concern is your well-being, I want to make sure women know they have resources — no matter their position, no matter where they come from — to prioritize their gynecologic health.

The value of women has never been more recognized than it is today. We are essential to our families and to our societies. And our strength matters, which means gone are the days of putting our own health to the side.

Taking care of this piece of your health regularly is critical, because you — and this city — have seen enough unnecessary suffering.

The author is a board-certified OB-GYN currently practicing at NYC Health+Hospitals.

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Heather Irobunda,