Attention to prevention

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Photos and design by Jaquan Leonard.

Some women pop a tiny pill every day. Others go through a five minute procedure in a doctor’s office. Still more wear a patch, a ring, a diaphragm, or get a shot or implant. Each of these technologies aims to sidestep one of the most basic elements of human life — getting pregnant.

But what if a woman has other plans for herself? What if getting pregnant would be a detriment to her future? What if  she views going to college, graduate school, or getting a steady job as more important?

A casual survey of college-aged women reveals a consensus: most are not financially or emotionally ready to have a baby. Getting good grades, spending time with friends and landing internships and jobs has become the new requirement. For these reasons, contraceptive methods are in high demand. According to the Guttmacher Institute, more than 99 percent of women in childbearing years (ages 15–44) who have had sexual intercourse have used at least one contraceptive method. That is  fairly predictable. Since 1960, when the first oral contraceptive was invented, millions of women have turned to various pharmaceutical methods in order to prevent pregnancy. In earlier times, natural methods were used.

More and more women are using birth control for reasons other than preventing pregnancy. Junior Kailey Charles explained that her initial reason for getting on the pill when she was eleven was to help alleviate her heavy periods. Medication was also key in preventing endometriosis – when endometrial tissue is found outside the uterus – a disease in her family history.

Sophomore Amanda Tanhellian shared that birth control treated her acne and “helped me stabilize my weight, too. I was underweight. When I was 16, I had a hard time keeping on weight, and it helped me keep weight on.”

My personal reasons for getting birth control were completely different, but no less urgent.

In March of my freshman year, my normal menstrual cycle went through a prodigious change. What had once been tolerable cramps, lasting no longer than a day or two for a couple hours at a time, turned into agonizing pain which racked and tortured my body. The cramps would come every day for at least five hours at a time, and were occasionally so painful that I could not get up from my bed or walk around.

After about a week and a half, the cramps were replaced by bloating, and my period still had not started. It didn’t matter what I ate, if I consumed more salt than usual, if I drank too much water, if I had been sitting down too long — no matter what I did, every night my abdomen would swell so much that I looked pregnant. The bloating created painful pressure in my abdomen and I found myself using the restroom constantly. My stomach always felt full and heavy, so I started eating less in an attempt to feel better.

Fast forward about ten days, and my period still had not come. I scheduled an appointment with Student Health Services, called my father (a doctor) frantically, consulted WebMD out of pure desperation and cried a lot.

On a Saturday afternoon in late March, I was taking a nap when an excruciating pain woke me up. The feeling was in my lower abdomen and I almost wanted to scream. The pain felt like something was grinding my organs and wouldn’t stop. I felt exhausted, but I couldn’t sleep. I knew that I wouldn’t be able to get down from my bed, much less walk around. By the next morning, the pain was gone. No cramps, no bloating. It was as if my debilitating pain, which few people even knew about, had never happened.

The next step was an appointment with a gynecologist for an ultrasound. Intimidated by the word and afraid of what I might find out, I was reluctant to go to Roper St. Francis. What if they found something seriously wrong with me? What if it was so bad that I could never come back to school?

The sonographer explained that I had an ovarian cyst, something fairly common in women who are menstruating. In a normal cycle, ovaries grow cyst-like structures called follicles every month. They produce two essential hormones: estrogen and progesterone. Follicles also release an egg during ovulation. According to the Mayo Clinic  “sometimes a normal monthly follicle keeps growing.” This creates tremendous pain and irregular periods — exactly what happened to me. The day when I was in so much pain that I could not leave bed, the cyst had ruptured. During my follow-up at Student Health, a nurse suggested that I look into birth control as a preventive measure against future ovarian cysts. After consulting with my parents, we made an appointment with a gynecologist and I was prescribed Minastrin 24 Fe. This pill contains two hormones, estrogen and progestin.

I had a conversation with Dr. Dee DiBona, an Obstetrician-Gynecologist who works at Student Health several days a week, about the effects and types of certain birth controls. When asked about the seriousness of side effects, she replied “That really depends on the person. I think that some people can have an increased moodiness on certain types of birth control. But I think the benefits, such as non-painful periods and actually some improvement in mood in some people, are much more common than any of the bad side effects.”

Headaches, nausea, weight gain, mood changes and decreased libido are all common of the pill, the most popular form of contraception in the U.S. According to The Guttmacher Institute, 9,720,000 women in the U.S. took the oral contraceptive as of 2012. Dr. DiBona believes that the intrauterine device, commonly known as the IUD, is the safest form of birth control. An IUD is a little, flexible piece of t-shaped plastic that is inserted into the uterus in order to prevent sperm from fertilizing an egg. “It’s the most effective, and it only has the hormone progestin in it, and it doesn’t have estrogen like a lot of other birth controls do. Estrogen is the hormone that can cause increased risk of stroke and heart attack.”

This is why it is important to know what you put in your body. Even though Tanhellian went to Planned Parenthood, Student Health and her gynecologist at home to get as much information as possible before going through an IUD procedure, she still ended up having a regretful experience.

“It was worse than anything I’ve ever experienced. Like honestly, worst pain I think I’ll ever experience. They said that my heart rate and my blood pressure were like those of women in labor.”

Tanhellian shared that one reason why she was initially prescribed birth control pills at 16 was because her family has a history of ovarian cysts. Tanhellian’s doctors explained that going on estrogen-based birth control could reduce her risk. “They put me on it when I was 16 for a lot of other reasons, because the painful cramps can also be a sign of endometriosis, which is another female disease, because we literally get everything. So they also thought that over time, I could develop that, and that it would go ahead and help.”

While the birth control pill worked wonders for Tanhellian, the IUD had the opposite effect. Tanhellian shared that she “would so much rather have the anxiety [of getting pregnant] than both the emotional and physical stress that the IUD caused me.” Tanhellian also said that when she went to Student Health and asked if they could take out her IUD, they declined. “I was like, why not? And they were like, I really think you should stick it out. And I was like, it’s not your body.”

When I asked about the incident, DiBona was surprised. “Oh, no, I do IUDs all the time. Now if I think it’s unsafe and it’s a problem, I’ll take it out immediately. If I think it’s an issue of we need to work through some specific steps beforehand…[we’ll leave it in]. Sometimes it’s just a matter of waiting, and sometimes I take them out. If I can’t get it to work for you, I will take it out.”

However, DiBona made it clear that while the IUD, the pill, or any other kind of birth control may cause pain and distress in some women, the same type could greatly benefit others. DiBona brought up a program in which young women at the College of Charleston who want birth control but do not have health insurance can get an IUD. The program, called ARCH, was developed by the manufacturing company BAYER, which produces IUDs. DiBona attests that ARCH will “provide free IUDs to people who are either denied by their insurance and they don’t make a lot of money.”

Without health insurance or benefactorial help from a  company, IUDs can cost $600– at a minimum. DiBona explained that young women without health insurance can sidestep this obstacle – “if they qualify for the ARCH program. I’ve only had one person denied.”

It is always important to know exactly what you are putting into your body, especially regarding birth controls containing different levels of hormones.

Birth control comes in many different forms and works differently in many women. Birth control patches, vaginal rings, pills, shots, implants, cervical caps, diaphragms and IUDS (to name a few of the many methods available to women in 2017) all prevent pregnancy, and can even impede diseases such as endometriosis and ovarian cysts.

Women looking for available options at the College of Charleston need only to do a quick search of the Student Health Website, where they will learn that “(SHS) prescribes birth control pills, vaginal rings and Depo Provera injections.” Student Health can also schedule OB/GYN consultations to see if an implant or IUD would be a safe option.

However, before seriously looking into a specific type of birth control, always consult a gynecologist, whether it is at the College, hospital or private practice.

*This article first appeared in the February 2017 issue of The Yard. 

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