Women and girls face unique health challenges in their lifespans. Even though life expectancy is higher for women than men in many countries, there are numerous health and social factors that impact the quality of life for women and girls. Lack of access to health care, lack of health care coverage, lack of access to education, and stigma and discrimination increase health risks for women.

The most important things you can do to stay healthy are:

• Get recommended screening tests.
• Be tobacco free.
• Be physically active.
• Eat a healthy diet.
• Stay at a healthy weight.
• Take preventive medicines if you need them.

Download or print this women’s health checklist and take it with you next time you go to see the doctor.

Find more information: AHRQ Prevention and Chronic Care

Reproductive & Sexual Health

Menstrual Cycle
Menstruation, or a period, is a woman’s monthly bleeding. Every month, your body prepares for pregnancy. If no pregnancy occurs, the uterus sheds its lining. The menstrual blood is partly blood and partly tissue from inside the uterus, or womb. It passes out of the body through the vagina. Periods usually start around age 12 and continue until menopause, at about age 51. Most periods last from three to five days. The events of menstruation cycle can be described as follows:

• The menses phase: During this phase, the lining of the uterus is shed through the vagina if pregnancy has not occurred. It typically lasts from day one to day five.
• The follicular phase: During this phase, estrogen levels rise to restore the lining of the uterus. Follicle-stimulating hormone (FSH) causes ovaries to grow. This phases typically starts from day six to 14.
• Ovulation: During this phase, the Luteinizing hormone (LH) surges, causing the ovary to release its egg. It typically occurs around day 14 in a 28-day menstrual cycle.
• The luteal phase: During this phase the egg travels through the fallopian tubes to the uterus. Progesterone hormone increases to prepare the uterus for possibility of pregnancy. If pregnancy does not occur, then the estrogen and progesterone levels drop and the uterus sheds again. If pregnancy occurs, then the egg is fertilized and attached to the uterine wall.

Premenstrual Syndrome (PMS)
1-10 days before your period, you might feel bloated or have diarrhea, nausea, backache, tender breasts or cramping. You might notice mood changes such as irritability, depression and decreased coping skills. These common symptoms are called premenstrual syndrome (PMS). Some women have all these symptoms every cycle; some never have any. Most have some symptoms with some cycles.

What you can do to relieve PMS symptoms:

• Cut down on salt and refined sugar.
• Avoid caffeine.
• Get regular exercise.
• See your health provider if symptoms are severe.

Regular Exams
See a health care provider every year for a gynecological exam, or as needed if you have vaginal changes such as pain, burning or itching; develop sores; have abnormal discharge, such as a bad odor or yellow or greenish in color; or have more discharge than usual.

You should also get a yearly pelvic exam, performed by a gynecologist, family doctor, or a nurse practitioner.

Pregnancy Prevention, Tests, and Pregnancy and Abortion Services

The New York City Abortion Access Hub provides confidential help finding an abortion provider in New York City, scheduling an appointment, getting financial assistance, and finding transportation and lodging. This help is available regardless of immigration status. You do not need to live in New York City to contact the Abortion Access Hub or receive a referral.

• Phone: 1-877-NYC-AHUB (1-877-692-2482)
• Live Chat
• Hours: Monday through Friday, 8 a.m. to 8 p.m.

The Hub does not collect or record any of your identifying information, and your phone number will be hidden.

NYC Health + Hospitals facilities offer abortion care (termination of pregnancy). Depending on various criteria seen below, this can be done by medication or procedure. To make an appointment to receive detailed counseling about your options, please call 1-844-NYC-4NYC.

Virtual ExpressCare – Abortion Access

ExpressCare offers options for counseling and medication abortion (termination of pregnancy) via telehealth, 7 days a week from 9 a.m. to 9 p.m. On-demand and no appointment needed to talk to a licensed provider from the comfort of your home. Receive counseling about your pregnancy options and abortion care in a confidential, judgement-free environment. Our providers will be able to prescribe you medication or set up any needed clinic visits for exams and treatment.

Visit Virtual ExpressCare to Talk-To-A-Provider Now or Call 718-360-8981.

When should you use ExpressCare?

• If you have taken a pregnancy test and you are positive and are considering your options to end or continue your pregnancy.
• You think you are pregnant and have questions about your options. We can also connect you with in-person services you may need.
• You must be at least 15 years old to be eligible for telehealth medication abortion, meaning to receive the medication by mail.

What to Know About Your Visit

At your visit:

• You’ll meet briefly with a telehealth agent who will connect you with your provider.
• ExpressCare provides interpretation services in over 200 languages.
• Your provider will discuss about your pregnancy options.
• If indicated, your provider will connect you with in-person services you may need, including an in-person physical exam, imaging, and testing.
• Follow-up calls, prescriptions and counseling may all be provided via telehealth.

What does the treatment entail? 

Treatment services include:

• Pregnancy options counseling and patient education including patient intake.
• Telehealth medical abortion evaluation, eligibility check, and medication delivery, if desired and appropriate, delivered to you within 1 to 4 business days.
• Connections to and facilitation of in-person care
• Follow-up after abortion care, both routine and problem based.

Medication abortion (Pill abortion)

Medication can be used to end a pregnancy up to 11 completed weeks of pregnancy (77 days). In the current political climate, the legal aspect of the abortion is everchanging. We will adapt our protocols and medications as needed to comply with the law, continuing to offer safe and effective options based on research and science.

If mifepristone and misoprostol are available,

• Mifepristone: You take the first medicine, mifepristone, in the office with us or at home.
• Misoprostol (Cytotec™): You take a second medicine one or two days later at home. These two medications work together to safely and effectively end the pregnancy.

If only misoprostol is available,

• You take the first dose in the office with us or at home.  You take the second dose 3 hours later and the third dose three hours after that. This medication safely and effectively ends the pregnancy.

During the process, you will experience strong cramping and heavy vaginal bleeding for several hours, followed by cramping and bleeding similar to a heavy period. After the medication abortion, it is normal to continue to have some spotting and/or light vaginal bleeding for approximately two weeks and sometimes up to a month.

You will need a follow-up appointment one to two weeks later to ensure that the abortion is complete. This can be done in person or by televisit (telephone visit).

You may ovulate as soon as two weeks after an abortion. If you would like to avoid future pregnancy, we can provide contraceptive options that are appropriate for you.

Abortion Procedure

Abortion procedure options depend on the length of the pregnancy (gestational age) and other health considerations. Depending upon these factors, the abortion can be completed in a single visit or require more than one visit. We will explain your options and work with you to make a plan. We will also explain what you can expect during and after treatment.

Pain management options are available to you and may include:

• Local anesthetic with numbing medication around your cervix
• Oral or injectable medications to help you relax and to help control pain
• Moderate sedation with intravenous (IV) medication
• Deep sedation and general anesthesia (available in the operating room)

Immediately after the procedure, it is normal to experience strong cramping and vaginal bleeding. During your recovery period, it is normal to experience bleeding similar to a period. Depending on the type of surgical abortion you receive, you may return to most normal activities as early as the day after the procedure. Counseling and support options are available to help you throughout the process.

Resources

1. Information about misoprostol-only medication abortion
2. Information about the mifepristone court case
3. National Abortion Federation (NAF) options counseling guide
4. Information about what to expect during a medication or surgical abortion
5. Information about medication abortion
6. Information about abortion on Bedsider
7. Abortion Is Legal and Protected in New York
8. Abortion in New York State: Know Your Rights

Breastfeeding and Pregnancy Amidst Covid-19 Pandemic

According to the CDC:

• Pregnant people are at a higher risk of becoming severely ill from COVID-19 as compared to non-pregnant people. Additionally, pregnant people with COVID-19 are more likely to give birth early.
• Newborns with COVID-19 had mild symptoms and recovered quickly.
• Current evidence suggests that breast milk is not likely to spread the virus to babies.
• COVID-19 vaccinations are recommended for those who are pregnant, breastfeeding, or thinking about getting pregnancy.

Certain Conditions

• Breast Cancer
• Cervical Cancer
• Ovarian Cancer
• PCOS
• Endometriosis