Periods have never been a happy experience for me.

Part of it was deep-seated shame; I don’t know why I was embarrassed, but I was, and I refused to talk about it. Until late high school, I couldn’t really talk about periods with anyone. 

And that wasn’t the only thing making me miserable. In the week leading up to my period, I would suffer a severe decline in my mental health, which was frequently a huge setback for me. And abdominal cramps have always been debilitating for me, making the first day or two of each period almost unbearable. I couldn’t eat, sleep, or learn normally. 

Last fall, I was diagnosed with premenstrual dysphoric disorder (PMDD) which not only leads to the depressive episodes I was used to, but also augments many premenstrual syndrome (PMS) symptoms in the week leading up to each period. To deal with PMDD, I now take birth control.

I know I’m not alone in these struggles. One in 12 people assigned female at birth have PMDD in the U.S. But more importantly, I’m surrounded by loved ones who use birth control for a variety of reasons that, like me, aren’t purely to prevent pregnancy: curtailing gender dysphoria associated with periods, managing symptoms of endometriosis, and preventing the extreme symptoms that come with many people’s periods.

So, for my sake and the sake of everyone around me who relies on birth control, it’s terrifying that birth control could be on the chopping block.

In June of 2022, the Supreme Court’s decision in the Dobbs v. Jackson case overturned the 1973 case Roe v. Wade. The most immediate consequence of this was a lack of abortion protection for people across the U.S. who live in states that don’t support abortion access. But the provisions of the case, and the precedents it established, also threaten access to in-vitro fertilization (IVF) and birth control.

This February, the Alabama Supreme Court ruled that because of the state’s strict abortion laws, embryos created via IVF must also be considered full human beings, threatening the very existence of IVF. In a subsequent federal bill meant to protect IVF access nationwide, Senate Republicans shot it down.

It’s a scary parallel to a 2022 bill meant to preserve access to birth control, which 195 House Republicans voted against.

We know that banning life-saving abortions will lead to a maternal mortality increase of 24 percent, because many people will be forced to carry babies to term who are unable to give birth safely, while others will seek unsafe abortions. But what about banning other forms of reproductive healthcare?

Over 12 million babies have been born internationally since 1978 using IVF. IVF is used by families experiencing infertility, as well as same-sex couples and single parents, who want to have children but don’t have the ability to do it unassisted. Without IVF, their children would not exist. And birth control is used by the vast majority of people assigned female at birth between the ages of 15 and 49.

Using birth control to mitigate PMDD can reduce suicidality, saving lives. For PMDD and other health problems such as endometriosis, it’s one of the only treatments available. Untreated endometriosis can lead to severe consequences, such as infertility.

Birth control access is already heavily along class lines. Lower-income people who are uninsured or otherwise have difficulty affording and accessing medical care are far less likely to be able to use birth control, even when they need it. So how can we stand by as access to birth control is tightened even more?

It’s so important to remember that reproductive health care restricted by the overturning of Roe v. Wade is not just about abortion. It’s about everything people assigned female at birth need to survive, grow their families, and protect their freedoms. With a Republican-led government, those freedoms will go away.

With proposed bills by Republicans, including presidential hopeful Donald Trump, abortion access will be heavily restricted or all but disappear. The precedents set by these laws will cause ripple effects across the world of reproductive healthcare, sending life-saving treatments and care into peril. Meanwhile, Republican-proposed repealing of Obamacare and the Affordable Care Act will widen the income gap of access to reproductive healthcare of all kinds.

Voting for Republican legislators and a Republican president this November won’t just allow these laws to pass, however – it also increases the likelihood that conservatives will be able to further stack the Supreme Court, whose decisions such as in Dobbs v. Jackson will almost certainly threaten important reproductive rights and healthcare.

Birth control isn’t just about preventing pregnancy – although that’s a perfectly valid use for it. It’s gender affirming care. It’s mental health care. It’s life saving. It is essential.

And protecting abortion and voting for officials who will also protect it isn’t just about abortion, but preserving the right to exist as a person assigned female at birth without the government breathing down your back every time you try to access care meant for your body.

And it’s about destigmatizing these treatments, so more people can not only access them, but know to ask for them.