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