I got my first period when I was nine. About six months later, symptoms of a condition that runs in my family, endometriosis, became present during my periods. Endometriosis is a condition in which the tissue that ordinarily lines the uterus – endometrium – is found outside the uterus, usually in other parts of the reproductive system. The tissue develops into lesions that often become inflamed and bleed along with the lining of the uterus during the menstrual period. This is a horrifically painful condition that is very difficult to diagnose without surgery.
I was a relatively tough kid; shots didn’t even make me flinch when I was little. But during my time of the month, I would be lying on the floor, sobbing. I told my mother at age eleven that I wanted my reproductive organs removed because having children in the future could not possibly be worth this amount of pain. I had to take the maximum dose of pain relievers – sometimes several different kinds at a time – in order to function.
Endometriosis can often be a progressive disease, as affected tissue can build up with each menstrual cycle. The pain seemed to get worse every month. In addition to the horrible cramps (and perhaps because of them), I would also experience nausea, vomiting and fatigue. By high school, I was missing at least one day of school every month, and leaving early more often than that. Even with the pain relievers, heating pads, portable heat wraps and everything else I tried, I could not live my life.
In my senior year of high school I started taking birth control pills, as a last effort to take my life back. It took about six months for my body to adjust to the hormone changes. After that, my periods started to become more manageable, and eventually they faded into the background. Now, I can usually take more reasonable doses of pain relievers. I rarely miss school or social events. I don’t look at the calendar and feel like the world is about to end when I notice my period is due.
If you ask me about my position on birth control, I will give the usual arguments. Women, and people in general, should be able to decide if they want to have sex or not. They should be able to decide if they want a baby or not. They should be able to decide what contraception to use, and they shouldn’t have to pay through the nose to get it.
But I’ll also tell you that birth control pills are not just about contraception. They can be used as medicine for people with real conditions. In fact, according to the Guttmacher Institute, 14 percent of people who take birth control pills use them exclusively for non-contraceptive reasons, and 58 percent use them in part for non-contraceptive reasons. In addition to endometriosis, birth control pills are often used to treat polycystic ovary syndrome (PCOS) or hormone imbalances to lessen the severity of PMS or PMDD (premenstrual dysphoric disorder), or to simply make periods more regular and manageable.
Millions of people (not just women, as men and non-binary people can also have uteruses) suffer from unpleasant menstrual symptoms, regardless of whether or not they have a specific condition. If these horrible symptoms can be reduced or even stopped entirely by a hormonal birth control pill, what right does anyone have to deny it to them? The alternatives for someone like me are grim, and no one should even have to go there. An eleven year old should not want to get her uterus removed, nor should a high school student risk getting hooked on Vicodin because of pain that can be lessened by a hormonal birth control pill.
Birth control pills need to be easier to access. Even with laws like California’s SB 493, which allows patients to be prescribed hormonal birth control by a pharmacist rather than a doctor, getting birth control can still be a difficult process. In fact, very few pharmacies are actually offering the services allowed by the California law. And even though it’s theoretically supposed to be free under Obamacare, many people are still charged.
In addition, there are loopholes allowing religious and non-profit employers to deny their employees access to birth control, and with the Supreme Court case sent back to the lower courts, it is unclear whether those loopholes will remain an issue.
Beyond those very specific issues, it’s often just plain difficult and aggravating to finally get that pill pack in your hand. I’ve had to undergo as many as three Pap tests in one year to get birth control prescribed, even when I provided my doctors with paperwork documenting recent Pap test results. That extra stress could be easily avoided if birth control was more readily prescribed, or if it was widely available over the counter.
People should have access to birth control pills, no matter the reason. But it’s also important to remember that contraception isn’t the only reason.