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Letter 38: Letter from Sophia

Dear Annie,

If I felt the way I did reading your story, I cannot imagine the devastation and fury your family experienced when grappling with their loss. I am sorry for all the backstops that were not there, all the warnings that were ignored, and all the systems in place that were meant to protect you but ended up doing the opposite.

When I was learning about what happened to you, I felt my stomach drop when I discovered that Yaz was at the center of it all. A year into college, I had a blood test done that revealed I have low platelets. A series of visits to a hematologist confirmed that I have idiopathic thrombocytopenia, which means that my body attacks its own platelets for reasons we can’t identify. Low platelets make it so that I bleed easily, which turns menstruation into an uncontrollable nightmare. That was, until I got a prescription from my OBGYN for oral contraception. The prescription was for Yaz.

At first, I was so happy to have something to control the bleeding. That was the only thing that mattered to me, like I was unwittingly blinded to any other effect of the drug. But over time, my mental health took a turn. It became increasingly difficult to differentiate which habits were coming from me and which were from my medication. I asked my primary care provider if my birth control pills could be the source of this additional unhappiness in my life, but she didn’t think that was the case. Looking into Yaz’s side effects, however, further opened my eyes to all the risks of oral contraception. Even in my first year of medical school, we have had patient cases in which oral contraception was the culprit for something like a pulmonary embolism.

The risks of birth control pills are scary. What’s scarier is that I can’t help but feel like we only allow dangerous medications like Yaz to remain on the market because it’s a drug meant for women. I am almost positive that pressure to take things off the market would be much better heard if the population affected was men. Instead, we’re complacent in allowing women to experience excruciating hardship while silencing their cries of alarm.

Annie, I am sorry it took the loss of your life for some people to understand the dangers of oral contraception like Yaz. It feels infuriating, and heartbreaking, and unjust. One day, I’ll be the person women come to in order to secure a birth control prescription. I will keep your story close to me as I make these decisions. I can never forget that my foremost priority is to protect the health and wellbeing of my patients. I can’t do that without knowing stories like yours.

The University of Texas Southwestern Medical Center ‘24

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