Wednesday, January 16, 2019 // The Statement 
 
7B

hours of sleep a night,” Student 2 said. “I was doing really 
poorly in a class that I shouldn’t have been just because my 
brain didn’t seem to work. And I was picking fights with 
my roommate and with my boyfriend. Something was 
wrong physically.”
She called UHS and was told to give herself some more 
time to adjust. When symptoms hadn’t improved after 
a month, she called again and was given a different pill. 
But there was no change. When she approached UHS 
again, the clinician she spoke to told her she should see a 
psychiatrist. 
“She was like, ‘I don’t know what your home life is like, 
maybe you should see a psychiatrist,’” Student 2 said. 
“They were like, ‘It’s probably in your head, and we don’t 
believe you that this is something wrong with your body. 
We don’t believe that it’s our fault for prescribing you this 
birth control’ … and that was so dismissive.”
So, she kept taking it. She said her relationship with 
alcohol spiraled, and her anxiety worsened. She cried 
easily, even randomly, at things that would not normally 
trigger tears. She tried going off the birth control, but her 
cramps that month were so bad she was forced to miss 
work. 
Student 2 went back to UHS and saw a doctor affiliated 
with Michigan Medicine. They had a long, extensive 
conversation about her symptoms and her family’s 
medical history. The doctor ultimately diagnosed her 
with premenstrual dysphoric disorder, which the birth 
control was exacerbating.
“She was like, ‘You don’t have a mental health disorder. 
You have PMDD, a very severe case of it,’” Student 2 said. 
“During the luteal phase of your periods, the second 
two weeks after you ovulate … I have a genetically 
inherited protein abnormality in my brain that triggers 
an abnormal response to hormones. It’s very easy to treat 
with medication.”
After a journey of a little over a year, Student 2 is 
finally feeling better. The doctor she met with prescribed 
her medication to treat her PMDD, and she’s on birth 
control that’s specific to her condition. Studies have not 
established a consensus on whether people with PMDD 
and premenstrual syndrome are harmed or helped by 
birth control.
Student 2 said while she appreciated how willing UHS 
was to prescribe her birth control and how progressive 
the women’s clinic is in general, she didn’t feel like she 
was taken seriously in this instance. 
“All it took was the (the Michigan Medicine doctor) 
listening and saying these experiences are not normal and 
you shouldn’t feel that way,” Student 2 said. “Having a girl 
tell a nurse or a doctor, ‘Oh, my birth control is making 
me cry a lot.’ That’s not normal. And then being like, ‘Oh, 
it’s probably just you. You don’t know what you’re talking 
about?’”
Ernst said UHS practitioners always note the side 
effects birth control may cause during contraception 
consultations. Sometimes patients will experience mood 
changes, but usually these symptoms resolve over time. If 
patients have follow-up concerns, they’re encouraged to 
call or reach out through the patient portal. 
“We explain that there are many different formulations 
of hormonal contraception and if they don’t tolerate the 
one we started, we can always change them to another 
method that works better for them,” Ernst said.
Student 2 has been thinking a lot more about the 
intersection of reproductive health and mental health, 

especially after learning of the high suicide rates linked to 
PMDD. Student 2 said she’s thankful she figured it out, but 
still wonders why she didn’t get the right medical advice 
the first time around. She said the lack of conversation and 
understanding about mental health and contraception was 
a big barrier for her. 
“If this were a different medical condition, if it didn’t 
have to do with my reproductive system, would they 
believe me more?” Student 2 said. 
“I wish that nobody had to worry about the 
cost of contraception” 
E

rnst said in a better world, no one would have 
to worry about the cost of contraception. 
Many insurance companies have arbitrary 
requirements regarding contraception, she said. 
“You’re just putting up barriers so that people can’t get 
the care that they need. I would say that drives me insane,” 
Ernst said. “I really wish there was universal health care, 
because everyone deserves the same care. Everyone 
deserves to have the best care that they need.”
McAndrew said UHS builds their systems to address 
issues most students are facing, while also trying to 
address individual student needs. This is something they 
continue to work on, she said. 
“Unfortunately, there are some times when we can’t 

do everything that we want to do for somebody, and that 
is challenging, and that’s difficult, and it’s frustrating,” 
McAndrew said. “So, we just try to put our heads together 
about what is the best possible scenario we can make 
possible for this person.”
Jennifer Villavicencio, clinical lecturer in obstetrics and 
gynecology, said the best practice is to make clear what 
services are offered in a compassionate, nonjudgmental 
way. She emphasized that contraception is extraordinarily 
safe, but that it’s not a one-size-fits-all model. UHS has 
the power to make their services even more accessible to 
students, she said, and they should use that power. 
“Those who have power always have the ability to 
use that power for good, and for equalizing and moving 
towards equity,” Villavicencio said. 
Cheff is already using her power for good. She’s helping 
a friend with similar circumstances — strict parents, 
inability to pay for birth control on her own — navigate her 
contraception options. 
“She’s scared because she wants the birth control,” 
Cheff said. “She’s really scared because she’s not in a state 
to have a child, obviously. So, I’m helping her saying, ‘This 
is what I did, this is how it worked out for me. Whatever I 
can do to make it easier for you so that you can be safe and 
still enjoy what you’re doing.’”

Wednesday, December 11, 2019 // The Statement
7B

INFOGRAPHIC BY JONATHAN WALSH

