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Catholic Life | Tag Archive | The Pill
Tag Archives: The Pill

Is there ever a medical reason for using the Birth Control Pill?

One of the troubling things about Catholic discussions of appropriate therapeutic use of “the pill” is that most people who are black-and-white assertive types don’t actually know what they are talking about, and the experts who do know what they are talking about confuse people. For instance, what is your first thought when reading this Catholic expert answer?

Q:  Is there ever a medical reason for using the Birth Control Pill? There is always an alternative which may uncover the problem which caused the gynecologic disorder for which the pill was prescribed. There is always a reason why women don’t ovulate normally, have intermenstrual bleeding, have pain or infertility. To prescribe the pill for these symptoms may delay or prevent a diagnosis. Source.

Do you see what that actually says? You might think that it is a very long drawn out “no” but that isn’t what it says. What it basically says is that prior to going on the pill there is always an option for diagnosing the actual source of the issue. Going on the pill without investigating the issue might mean risking a lack of correct diagnosis.

But this says nothing about whether there will be non-pill remedies once a diagnosis is made, or whether the diagnosis will be helpful for anything other than having a nice name for one’s symptoms.

The real answer is that yes, there are sometimes medical reasons for using the pill, and even NFP only doctors will prescribe it for therapeutic reasons. One can hope that they will first do a good job of making a correct diagnosis and then exhausting other options for treatment, but sometimes the same hormones that are used for contraception can also be used to eliminate pain and preserve fertility.

It is confusing and troubling to some, but it is also reality. And it is probably better to simply not address the subject if one is unable to address it fairly.

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“Natural Hormones” for Reproductive Health

Some people have asserted that even if there is no proof that “the Pill” causes abortions, it is still wrong for women to use it because there are “natural” hormonal options which will help women. While I am a huge fan of holistic medicine, I have always been suspicious of “natural” options being proclaimed as superior for prolife reasons.

When I was 9 years old my mother went to the healthfood store for something or other to help with her menopause symptoms. But for some reason she hesitated to actually start her new regimen. It turned out that she was pregnant, and my childhood was shaped by my mother’s expressions of thankfulness that she had delayed her natural remedies since it was extremely likely that they would have ended her pregnancy before she even knew about it.

In high school and college I read feminist literature of all sorts, and that included information about ancient, natural means for “interrupting pregnancy.” I cannot find any of the websites now, but the more legitimate looking ones included disclaimers and statistics of this or that method having been observed to work 30-50% of the time, but that it was at least worth a shot before one went to an abortion clinic.

So I tend to view “natural” ways of dealing with gynecological problems with at least as much suspicion as modern medicine. And I am quite bothered by those who tell others that using the pill for menstrual problems is sin, but give carte blanche to all “natural” remedies.

But I am still shocked to see what seems to me to be pretty stinking obvious indications that natural remedies are far more likely to result in abortion/miscarriage than the pill.

I recently read What Your Doctor May Not Tell You About Premenopause. It is completely against the pill and instead offers suggestions of natural remedies to deal with various women’s health issues. The section on endometiosis begins with the statement that “endometriosis is very difficult to treat” which filled me with optomism since it seemed as if they were taking it seriously. Then came:

Dr. Lee has successfully treated endometriosis using relatively high doeses of progesterone cream to create a pseudopregnancy state from day 5 to day 28 (or whenever yoru normal cycle ends) of the menstrual month. This involves using 40 to 60 mg progesterone daily during those days, or 960 mg per month. This will often cause the pain to subside by the third or fourth month. In some patients with particularly stubborn endometriosis, he has increased the daily dose to 80 mg per day. Once the pain has been reduced, the dosage may be reduced gradulally each month to find a dose that keeps the pain away.

Progesterone, at doses similar to the first month of pregnancy, limits the endometrial tissue buildup caused by estrogen. By preventing the monthly release of blood in the endometrial islets, the inflammation that previously flared each month will subside, and the healing forces of nature will return the endometrial islets back to normal tissue.  (Source pages 192-193)

That all sounds great, right? It does the same thing as the pill, except it is natural!

Except, of course, for the fact that unlike the pill, it hasn’t actually been tested to prevent ovulation, so you have no idea how the pseudopregnancy state is actually working in your body, and taking the week-long break is setting your body up for miscarriage. In short, you are much more likely to be conceiving and then miscarrying using this method than using the pill. And the troubling thing is that is obvious to anyone who actually reads the entire book. It isn’t exactly a secret.

In the section on infertility, the book offers this advice:

If you want to be pregnant and you’re using progesterone cream, it’s very important to keep using progesterone until you find out whether you’re pregnant. (You can take a pregnancy test a few days after your period would normally be due.) The sudden drop in progesterone levels created if you stop using the cream can cause what is, in effect, an abortion, by bringing on menstruation. This is the same concept used in the so-called morning-after pill, only in that case a very potent synthetic progestin is used in high doses.

So the advice given to women with endometriosis is, according to the infertility section, setting them up to “cause what is, in effect, an abortion, by bringing on menstruation” each month!

And I am no more impressed by the other suggestions that I have seen for herbs to use. For instance, one list of herbs recomended is:

  • 4 capsules vitex
  • 2 capsules blue cohosh
  • 2 capsules milk thistle
  • 2 capsules wild yam root
  • 2 capsules dandelion root
  • 2 capsules pau d’arco

You do not need to look up everything on the list unless it interests you, but “everyone” knows that vitex (also called chasteberry and who knows what else) is contraindicated during pregnancy because of what it does to the uterus, and blue cohosh? That only shows up on all the lists of abortion-inducing herbs. Nothing to worry about. Oh, except for the fact that since you have no idea what strength you’re taking you may overdose and seriously hurt yourself as well.

This should not be taken as an indication that I oppose herbal remedies. I do not oppose herbs or other natural remedies. I just happen to think that “natural” remedies are much more likely to both allow a pregnancy and then harm it than any pill taken as prescribed. So please do not tell me that “there are effective, natural alternatives to the pill” without telling me exactly what it is you’re so excited about. And if you want to combat reproductive health treatments that might possibly harm babies, you should probably focus on condemning “natural” remedies, not the pill.

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Problematic Pill Logic

Note: this post is serious and not sarcastic.

I am quite saddened by the number of faithful Catholics who assert that it is immoral for women to use artificial hormones (henceforth “the pill”) for therapeutic purposes (henceforth endometriosis, because ultimately everything is about me). This is one of a series of posts which will explain why I find their arguments sadly unconvincing. If you see what I’m missing, do chime in and kindly explain. Of course convincing me on one issue will not automatically change my mind, but it would be a start.

Dr Van der Vange’s research used high resolution ultra-sound which visually showed that women ovulate on the popularly prescribed low dose pill. A blood test confirmed that ovulation had occurred. The pill can have a break-through ovulation rate that can be as high as 17 ovulations per 100 women who used the pill for one year.

Other researchers have shown that the low dose pill has an even higher rate of break-through ovulation of almost 27 ovulations per 100 women per year.


The ovulation rate has been reported to be about 27 ovulations in 100 women using the pill for one year. But the detected pregnancy rate is much lower at around 4 pregnancies per 100 women using the pill for one year.

As you can see, there is a big difference between the number of women who ovulation (27) and the number of detected pregnancies (4). What has happened within the woman’s body to reduce the high ovulation rate to such a low number of detected pregnancies? I suggest that one answer to this important question is that pregnancies have begun, because ovulation and fertilization have occurred, but some of these pregnancies are terminated because implantation cannot take place. The pill has damaged the lining of the womb, stopping implanation[sic]. Source

I think we’re missing something. Let’s do the math. And since I’m not so great at math, you’re more than welcome to correct me.

A healthy woman (of unknown age, but in her reproductive years) has about a 25% chance of pregnancy for each month of randomly timed sexual intercourse with no attempt at avoiding pregnancy. Wikipedia says so, so it must be true.

But back to the women on the pill: 27 women who ovulate and have randomly timed intercourse. The pregnancy rate should be… ::counts on fingers. realizes fingers will never work and pulls up the calculator:: 6.25. But wait! That 27 number was from the low dose pill. And what woman with serious hormonal issues like endometriosis is going for the low dose pill? Certainly not me! So I’ll have to add this up again.

17 x 0.25 = 4.25. Now isn’t that funny! That looks a whole lot like the 4 pregnancies observed! Of course it isn’t realistic to expect a woman with reproductive health issues to have the same rate of pregnancy since the very issue which causes her to seek out the pill may also cause infertility.

I don’t think that this example proves that the pill is permissible, but it does indicate to me that this sort of anti-pill logic ignores reality. A woman’s body does not normally function with a 1:1 ratio or ovulation to pregnancy. There may well be *no* “missing” pregnancies.

Furthermore, if it is true that the pill can fail in one area (allowing ovulation) while still working correctly in another (preventing the thickening of the uterine lining) there is no reason to believe that it might not also succeed in the third area (making the cervical fluid inhospitable to sperm). If that is the case, then there is yet another explanation for lack of pregnancy: the sperm was prevented from reaching the egg. That would certainly count as contraceptive, but not abortifacient .

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Failing NFP & Learning a Bit of Charity

I was full of dread as I approached the door to enter our final natural family planning class. When it was time to review my chart I nervously joked to the instructor that I had found a way to “fail” natural family planning before I was even married. It wasn’t that I was pregnant; I had started hormonal birth control and had an early temperature spike to prove it.

Thankfully the instructor was perfectly gracious. She was not especially surprised since my first month’s chart was disturbed by a laparoscopy which had confirmed endomentriosis but done nothing to ease my pain. She asked whether  the doctor had a plan other than keeping me on hormones for life. The doctor did not have a plan, but my primary goal was to get through the semester. I did not have the option of seeking out a specialist for another surgery, and I could not continue to function through the pain.

The hormones worked so well that I wondered why I had spent years insistent on avoiding them. It was so very wonderful to be able to function normally and I was thrilled to be able to concentrate on an intense semester. Then summer came. As I waited in a long line for the Sacrament of Reconciliation I thought about how easily I am distracted from God. It seemed that I turned away from every opportunity to join myself to the Savior’s suffering. And so I returned to the pain of my normal menstrual cycle.

Two months after I got married I again had a very strong need to be able to function physically. I tried the same hormones that I had been on before, but without success. It did not reduce my pain and I observed the signs of my fertility with the wry thought that it was a good thing I was not using the hormones to avoid conception! I got a prescription for a different mix of hormones, but by the time I had waited for my body to adjust I simply did not want to go through it all again. So I gave up on artificial hormones.

I am profoundly thankful for my experience. Without it, it is quite possible that I would be one of those Catholics who say things like “the pill is never a good option for Catholic women!” It does not matter how clear the Church is that artificial hormones are permissible for therapeutic purposes. Some continue to insist that no health issue can possibly make resorting to the evil of hormonal contraception legitimate.

I would never have directly questioned the fact that artificial hormones were allowed, after all Humanae Vitae could not be more clear:

the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever.

But I was all too ready to agree with those who asserted that doctors were just lazy and there was no reason for any woman to be on artificial hormones. I still think that the pill is over-prescribed, and I am still glad that I made the choice to have a laparoscopy rather than starting hormones without knowing the source of the problem. Information is good, even without pain relief. But the fact that many doctors are too willing to prescribe hormones without considering the underlying health issues does not negate the fact that there are very good reasons for therapeutic use of artificial hormones.

Even minor surgery has risks and it is somewhat naïve to imagine that it is always affordable and effective. I wish that no women had to deal with the physical pain of reproductive disorders, but I am thankful that there are many options for treatment and pain-suppression. If you know a woman who is able to treat pain with something as simple as a birth control pill, please consider suspending judgement long enough to ponder thanking God that she does not require anything stronger.

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