When we first started cancelling plans due to coronavirus, we were optimistic. We thought we'd be taking rain checks soon enough. But with no clear end in sight, many of us are wondering what to do about more necessary appointments that aren't so easy to skip or delay indefinitely. Like visits to the gynecologist.
In some states, OB/GYN offices are open, explains Lisa Shah, MD, Advantia Health’s chief medical officer. But you might be hearing mixed messages from friends, the media, and even your doctor about what appointments really need to be kept.
So as we close out National Women's Health Week we asked Dr. Shah and Mary Jane Minkin, MD, a practicing OB/GYN and professor at Yale School of Medicine, to tell us what appointments are important enough to keep and what can wait.
Can I postpone my annual OB/GYN appointment?
In some cases, yes. If you've never had an abnormal pap smear, and you have no symptoms or questions you'd like addressed, it's safe to delay your appointment for your next pap smear and STD test until it's safer to go out, Dr. Minkin says. If you do have questions, you can request a telehealth appointment.
If you have had an abnormal pap smear, your doctor may suggest waiting a month for a follow-up pap. Even then, it's fine to delay another month or two, Dr. Minkin says. Most illnesses that cause abnormal paps are slow moving, and if you live in a hotspot, the risks of getting a second pap ASAP likely outweigh the benefits. “I wouldn’t say, oh let’s make it three years… But being off a month or two for a pap is highly unlikely to cause a problem," she says. "Similar thing with colposcopies," a procedure done to reveal abnormalities in pap smears.
If you're unsure, you can always call your doctor's office to ask if they'd see any risk to pushing your appointment back a month.
What if I have a UTI or yeast infection during coronavirus?
If you're pretty sure you have a yeast infection, you can try to treat it with an over-the-counter remedy like Monistat before heading to the doctor, especially if you live in an area with a high level of cases, Dr. Minkin says.
If you've had a urinary tract infection before and you're pretty sure you have one again, you could try getting a diagnosis and prescription for a broad-spectrum antibiotic via telehealth. But Dr. Minkin says it's typically worth going to an OB/GYN office or lab, where they can take a culture from a urine sample, and prescribe a more targeted antibiotic.
But if you think you're having your first UTI, or have any sort of pelvic pain or bleeding, get thee to a doctor ASAP. "It’s important that women not postpone urgent visits because of COVID-19,” Dr. Shah advises. “If the provider you normally see is not taking patients and you have an urgent problem, find another doctor. Don’t put off your pain.”
What if I think I have an STI?
If your partner tells you they have an STI or you're experiencing abnormal symptoms such as pain when you pee, lower abdominal pain, itching, warts, or unusual discharge, you should call your doctor and ask about STI testing. They'll likely have you come into the office, or go to a lab for testing.
What if I’m pregnant?
Dr. Shah says that if you’re pregnant, you’ll still need to come into a doctor’s office for many of your visits, although some that don’t require exams, lab work, or a sonogram can be supplemented with telehealth, which is often covered by insurance. During a virtual visit, your doctor may ask you to take your own blood pressure, and use a doppler, which you can buy online, to track your baby’s heartbeat.
“Postpartum visits may also be virtual, depending on your situation," Dr. Shah says. "Talk with your provider about what’s best for you.”
What if I just think I’m pregnant?
Dr. Minkin recommends starting with an at-home pregnancy test or two. If they come back positive, talk to your doctor about scheduling a visit. Just make sure you wear a mask when you go to the pharmacy to get your test.
What if I want an IUD?
If you don't currently have one but are interested, you can likely hold off a few months until it's safer to be around people in public. In the meantime, Dr. Minkin says you can ask your doctor about Annovera, a long-acting ring that women insert themselves and leave in for three weeks at a time.
If you already have an IUD and need to have it changed out, you may want to delay your visit by a few months. If you're outside the window of your IUD's effectiveness, Dr. Minkin says pushing it a few months shouldn't be an issue — but you should still use a backup method of birth control until you can get it replaced, just to be safe.
Many other forms of birth control, including the pill, can be prescribed over the phone.
Should I put off dealing with my OB/GYN until after the coronavirus is over?
Regardless of why you are supposed to be seeing your OB/GYN or whether you think you should delay your appointment or not, you should call your doctor to discuss your options before making a call either way, Dr. Minkin says.
Dr. Shah adds that most hospitals and clinics are taking additional cleaning precautions right now, so even if you had to go into a lab, you’d be safe — though you should still take precautions like wearing a mask.