Birth Control is Healthcare

Birth Control is Healthcare

I was diagnosed with Premenstrual Dysphoric Disorder (PMDD) in late 2019. PMDD, to try to put it into words, is an emotionally draining and physically taxing time during the luteal phase of the menstrual cycle, meaning my PMDD symptoms flare up about two weeks before my menstrual cycle begins and end a few days into my menstrual cycle. Psychological and physical symptoms of the disorder include extreme mood swings, severe migraines, irritability, fatigue/insomnia, difficulty concentrating, and more. I personally experience these symptoms, along with unbearable physical pain that left me bedridden during my cycle when I was in middle and high school. I recall multiple occasions when the school nurse sent me home because my physical pain made it impossible to focus on learning.

For many years, my PMDD symptoms were misdiagnosed; PMDD is an overlooked and misunderstood disorder. It is estimated that about 90% of women who have PMDD do not know they have it or have been misdiagnosed with another psychological disorder, oftentimes bipolar disorder. This stems from misogyny in the medical space, because women’s complaints and symptoms are gaslighted as “normal,” or in some cases, “overdramatic.” Historically, women’s symptoms have been dismissed by male medical professionals because they had little-to-no research funding devoted to women’s health. This lack of research continues today because there is no research on why PMDD occurs in about 1 in 20 women (6 million women worldwide) have PMDD. However, the number is likely higher because of stigma grounded in sexism. My personal experience being misdiagnosed and dismissed by medical professionals as “crazy” has deeply affected my trust with medical professionals.

In part because of my misdiagnosis, over the years I have tried a multitude of natural remedies (teas, meditation, etc.) and medications, including SSRIs (selective serotonin reuptake inhibitors) and PMDD-related birth control, to address my PMDD symptoms. (Note: SSRIs are antidepressants for psychological disorders that are often prescribed to people who have PMDD in an attempt to ease symptoms. PMDD-related birth control is birth control specifically made to reduce PMDD-related symptoms.) When my doctor — the same one who finally correctly diagnosed me with PMDD — first introduced me to PMDD-related birth control, I was over the moon that there was a medication made specifically for people who have PMDD. But while it has helped, it is by no means a cure. Some people may only need to rely on an SSRI, but others like me rely on a combination of medications and lifestyle changes to ease PMDD symptoms.

PMDD is often linked to other psychological disorders, and people suffering from PMDD are also at higher risk for suicide, with about 30% of diagnosed women attempting suicide (this statistic does not include those who also suffer with suicidal thoughts). My PMDD exacerbates my obsessive-compulsive disorder (OCD) and anxiety symptoms during my luteal phase, making it especially hard to function. This makes access to SSRIs and other medications critical for me and others who have PMDD. Accessibility to SSRIs and other medications quite literally saves lives.

The combination of PMDD-related birth control and an SSRI have been a gamechanger for my mental and physical health. Instead of being bedridden for a week, I am bedridden for a couple days of my luteal phase. Instead of leaving school when I was younger due to the unbearable pain, I can focus on college. I can walk my dog and make a simple meal and write this blog post, all of which would have been impossible before my current regimen of PMDD-specific birth control and an SSRI. These small steps towards a more routine life mean that I can be a successful student and intern despite having PMDD.

Without having access to the PMDD-related birth control through my health insurance, I might never have been able to get to where I am today. Not having access to medications related to this disability is detrimental to those diagnosed with PMDD. While some birth control is free because of the Affordable Care Act (ACA), mine is not. While the ACA is a critical component of expanding access to health care, our system is imperfect.

Insurance companies find ways to bend the rules to profit off people with disabilities or who have complex medical needs. For example, many insurance companies will only support one type of birth control per category instead of supporting all variants of birth control. This means that some birth controls are free if they are in pill form; however, mine is not covered because it is specific to my disability. Disability-related medications must be affordable for individuals with disabilities and people should be valued over profit. I did not choose to have PMDD, and my disability requires a specific type of medication to help me mitigate symptoms. All forms of birth control methods must be covered by the ACA to ensure everyone has access to the medication they need to live their full lives.