I’m in a relationship with my birth control, and, yes, it’s serious. I can confidently say hormonal birth control made me a healthier, more capable person—and my decision to take it had nothing to do with preventing pregnancy.

While birth control is often touted as pregnancy prevention, the role it plays in a person’s life can go beyond family planning. Far more than a one-trick contraceptive pony, birth control brings relief for pain brought on by chronic medical conditions. That’s why last month’s U.S. Supreme Court ruling in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania that the Trump administration has the power to allow employers to opt out of providing birth control coverage for religious and moral reasons was such a callous attack on the health of chronically ill people.

Before I started taking birth control, my periods were miserable. My period experience involved being doubled over in pain, suffering bouts of depression, and sneaking a heating pad in between work meetings for relief. Rather than going through a normal menstrual cycle, I often felt radiating pain that left me lethargic and, ultimately, depressed.

I was caught in a swirling vortex of anxiety and hopelessness. One or two weeks before each period, I would find myself crying unexplained tears while browsing grocery store aisles, escaping to the office bathroom, or watching Netflix—no mundane task was safe. Even on days when I felt composed, a seed of doubt would often plant itself in my mind and deteriorate my mood.

My experience didn’t resemble the tropes—sobbing at sappy commercials or craving chocolate—usually associated with premenstrual syndrome (PMS), often in ways that diminish the experience of those suffering from PMS. Once my period came, the symptoms would disappear within 24 hours, leaving me wondering if the pain I had felt was some kind of fever dream. It was a perplexing cycle that left me without answers.

While a majority of people who menstruate deal with PMS symptoms like cramping, breast tenderness, food cravings, and fatigue, some experience an intensified version called premenstrual dysphoric disorder (PMDD), an entirely different monster. According to the federal Office on Women’s Health, five percent of menstruating people suffer from PMDD. The two conditions overlap, but PMDD can cause emotional and physical symptoms that are particularly draining. Thankfully, hormonal birth control can help mitigate the condition.

As a teenager, my opinion of birth control was poorly informed by mediocre sex education and puritanical stigma. Gossip spreads through small cities like wildfire, and hearing about a teenage girl on birth control in my hometown would have set suburban moms ablaze. I avoided contraceptives out of fear of judgment, myths of weight gain, and the false narrative that birth control meant you were “promiscuous” and less “wholesome.”

When I finally decided to try hormonal birth control at 27, I underestimated just how crucial it would be to my happiness. The weeks that were once controlled by intense discomfort soon became a mere few days of light cramping. I no longer signed away three weeks of my life per month to my reproductive system. My period stopped dictating my life entirely.

People use birth control for myriad noncontraceptive reasons including PMS, acne, and chronic illnesses like polycystic ovary syndrome (PCOS) and endometriosis. According to Dr. Bhavik Kumar, medical director of primary and trans care at Planned Parenthood Gulf Coast, hormonal birth control has been shown to reduce the incidence of endometrial and ovarian cancers, ovarian cysts, and iron deficiency anemia. 

I wanted to talk to a couple people who use birth control for chronic illness to learn just how crucial it is to their health, so I started close to home.

Chelsea Quinn, a childhood friend of mine, first started experiencing painful ovarian cysts when we were in middle school and was prescribed birth control to keep the cysts from growing. When she tried to get off contraceptives in her early twenties, she immediately felt unlike herself.

“Those few months were absolutely miserable,” she told me. “I felt emotionally unstable, got PMS symptoms but never got my period, could not stop crying, and had horrible pain that made me unable to get out of bed for days at a time.” 

After being diagnosed with PCOS, a medical condition that can lead to ovarian cysts and infertility, birth control became Quinn’s means to a healthier life. In her eyes, the pill may only be one step towards healing, but it has “evened the playing field.” 

“I cannot imagine what my life would be without birth control,” she said.

I also spoke with Michelle Juergen, a Los Angeles-based freelance writer, who found herself fighting a chronic illness she knew little about. In 2019, she was diagnosed with endometriosis, a painful disorder where bits of the tissue that line the uterus grow elsewhere. “My body felt like every inch had been slammed into a wall,” she told me. “I could barely have a conversation because I was so focused on managing pain.”

After her doctor’s recommendation, Juergen underwent surgery for her endometriosis in December. “While it wasn’t a cure-all, it definitely helped dial back the pain,” she said. Birth control allows her to help minimize the chance of her endometriosis symptoms returning.

Calling contraceptives life-changing is an understatement. Adding a barrier to health care that is critical for people suffering from chronic illness to function isn’t just cruel; it’s a form of institutionalized discrimination.

And the Supreme Court doesn’t seem to care.