Birth control for medical purposes

what is the Catholic Church’s position on the use of birth control for medical purposes? I have a friend whose doctor wants to put her on birth control for different medical reasons and she doesn’t know what to do from a moral perspective!

This is an exchange between a congressional panel and Bishop William Lori from 2012:
*Blake Farenthold (to Bishop Lori) - The Catholic Church does not have a problem with contraceptives for medical purposes. So I would assume from that it wouldn’t be morally objectionable to the Church to pay for those for medical purposes. I’m not trying to put you on the spot, I’m just trying to make sure I understand where the Church stands.

Bishop Lori - That would be my understanding also.*And later:*Bruce Braley - A significant portion of women, 1.5 million, use the Pill exclusively for medical purposes other than contraception. They use contraceptives to treat severe menstrual pain, migranes, uterine fibroids, and endometriosis. Oral contraceptives also help prevent ovarian cancer. … Do your religious teachings prohibit the use of contraception for health-related purposes, such as treating ovarian cancer?

Bishop Lori - I think Catholic moral theology is very nuanced. It recognizes that the same drug can operate in different ways and accomplish different things. If it is used to prevent birth, it is against our teaching. And so we have operated with a considerable–– with a lot more nuance than we’re usually given credit for. Also observe, by the way, that 90% of all private health care plans give access to contraception. We’re talking about a very narrow band, and for very specific purposes here.*And here is Fr. Francis Hoffman on Relevant Radio from 2012:*If a person is taking the birth control pill for other reasons, then during the time they’re taking the pill they must refrain from marital relations. Because there are no proportionate reasons to put a conceived human embryo in danger of dying. So can you use it as a medicine for other reasons? Yes, but you must refrain from relations during that period. *See here for more quotes.
And see here for the dangers of remaining on such drugs.

so the short answer is you may use it for medicinal purposes but you may not have sexual intercourse while on the pill?

Yes.

There’s nothing intrinsically immoral about hormone treatments.

I would strongly urge you, though, to consider whether that particular drug is medically necessary. It can wreak havoc on your reproductive system and jeopardize your future fertility.

I suggest you not refer to using “birth control for medical reasons”. That is ambiguous and misleading.

What you can do is take a medicine for a legitimate medical reason that also has the foreseen but unintended side effect of temporary or permanent sterility. Doing so requires that the situation meet all of the criteria of the Principle of Double Effect.

If there is a therapeutic reason that meets double effect, one may use it. In Humanae Vitae it is called lawful therapeutic means.

The Church does not teach this specifically. Various theologians come down on both sides of the argument.

The few places the Church speaks about it in official documents, it stops short of saying one may not have intercourse in such a circumstance.

Yes, Humanae Vitae does say that. However, there are alternatives to The Pill depending on the condition.

stlouisreview.com/article/2012-05-03/catholic-doctor

aaplog.org/aaplog-physician-directory/

Hope this is helpful,
Ed

This argument, if true, disallows relations while receiving certain cancer treatments, certain treatments for chronic diseases, certain courses of antibiotics, the list goes on. I’ve never seen anybody of any import say it is fundamentally immoral to have relations while on the whole list of category X drugs, or any of the lesser categories. As you have quoted, some individual people do choose to single out the pill. But lots don’t, too.

I don’t know if contraceptives per se are singled out because their primary purpose is to target the body into sterility which would differentiate them from the other remedies you mention which might have sterility as an unintended consequence. I’m not enough of a bio-ethics expert. But what antibiotics or procedures specifically do you mean?

I don’t know what Pug was referencing, but I can say that there are certainly medications available and used, that would be contraindicated for women that might become pregnant.

One is methotrexate. It is used to treat cancer and autoimmune diseases. But it is also used for chemical abortions.

There are many examples. An unexpected one is perhaps certain specific vitamin supplementation, though surely more studies are needed. Here is a news article I read recently about a particular combination of vitamins increasing by 32% the risk of miscarriage. But previously I had only heard that high doses of Retinol (vitamin A) causes birth defects. Or methotrexate is prescribed for lupus, among other things, but is rated category X by the FDA. That category means drugs that are proven to cause harm to the baby, birth defects, increase in miscarriage or whatnot. There are many category X drugs, such as Arava - rheumatoid arthritis, Trimethadione - epilepsy, Lithium - manic depression, etc. There are also category D drugs, which cause harm but are considered less troublesome, like Xanax - panic disorder, for example. Not all category X apply to the first trimester, as far as I know, and I don’t know the details for every drug I mentioned. Also there is radiation treatment. Opposite of the vitamin example is known vitamin deficiency due to illness or malnutrition. So you could be aware that your baby would have somewhat higher chances of blindness or other harm should you conceive then.

Among those I mentioned, methotrexate is the most likely to be considered similar to the pill, because mtx is used for chemical abortion, as maryjk mentioned.

As noted by other posters, there is no official Church position on this, and moral theologians come down on both sides.

However, it is worth noting that apologists on this forum have consistently come down on the side that abstinence is not required (ie yes, you may have sex while taking medication that has an unintended secondary contraceptive effect):

forums.catholic.com/showthread.php?t=4618

forums.catholic.com/showthread.php?t=797408&highlight=birth+control+medical

From Humanae Vitae:

"Lawful Therapeutic Means

“15. On the other hand, 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. (19)”

Source: vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html

Peace,
Ed

Part of the problem with varying replies among priests or apologists could be that not every person reacts identically to the same medicines. So when “statistics” show a X% chance of inducing a miscarriage, what is the percentage that classifies it as a true contraceptive? What is the gravity of the purpose of taking the medicine? Are there comparable alternatives available such as edwest provided above? Etc…

Humana Vitae, as mentioned above, refers to “therapeutic means necessary to cure bodily diseases” as a grave enough matter to allow the unintended consequence of a procreative impediment. What constitutes a serious enough bodily disease is not clearly defined to my knowledge, and may be quite difficult to define. As I said, different persons have different physiologies.

The risk of blanketly saying it’s okay to take a contraceptive and still have relations is that some couples could use the “medicinal” angle as an excuse, and perhaps even doctor-shop, while they themselves intend for the contraceptive consequence.

We at least all seem to agree with all apologists and priests that at a minimum, the couple cannot intend for the contraceptive consequence of a medicine that may cause that. It’s probably best for a couple to consult a priest and a Church-friendly medical professional if there is doubt.

Here are a couple medical resources I’ve heard on Catholic radio:
The National Catholic Bioethics Center
Downers Grove OB/GYN

I can tell you what my priest told me - I currently take hormonal contraceptives for various medical reasons completely unrelated to birth control. According to my priest, I can continue to take these medicines when married, as they are to treat a legitimate medical issue. However, if I continued to use them with a contraceptive mentality, then it would be a problem. But if you have a legitimate need for a medication that has a side effect of preventing pregnancy, the church is not going to tell you to not get the medical treatment you need.

Just my personal experience. Years back , the Doctor put me on B.C. pills to treat a medical condition. I was only 17 years old at the time. As a matter of fact, my Mom had to be there with me , since I was not considered to be of legal age. During the time I used them , I was
NOT. sexually active .

Re. sexual relations:

I’d be VERY careful to make sure that the medicine in question is not abortafacient (i.e., allows conception but not implantation of the embryo). While taken for licit reasons, it can nevertheless cause an unintended abortion. Many progesterone-only pills, for example, allow ovulation more often than not.

You could take it and still follow and “NFP-style” approach to relations - avoiding during the time of potential ovulation. But in this case it would be not to avoid pregnancy, but to avoid the destruction of a new life.

In general, I’d advise to look into non-chemical means of healing - positive changes in diet, reduced stress, increases in exercise, and some supplementation can often resolve these issues without the need for pharmaceutical intervention.

I think the OP’s friend should consult with a priest first. I used to have severe endometrosis and my doctor decided to put me on depo provera to avoid more surgery. I consulted with abpriest on my case under my circumstances my priest said it was OK as I had a legitimate medical reason. However with the pill specifically I know too many doctors that like to give birth control pills like candy so given that is the pill I would look for a second or third medical opinion. Talk to others doctors find out about what condition do they want to treat, are there any alternative methods that you can use other than the pill, find out The mechanism of how the pill work and the effect in your body and how that specific mechanism is going to treat the condition (for example in my case,emdometrosis, tissue grows in areas where it shouldn’t and depo stops the growth of it so the depo had a direct effect to stop my condition). Get informed get more medical opinions and talk to a priest. I think that is the way to go.

The bolded is false. It is a contradiction to say that you can have an unintended abortion. If the death of the child is unintended then it is not an abortion, it is a miscarriage. Abortion, by definition, is the intentional taking of an unborn child’s life. So the correct thing to tell the OP is to be aware of that the side effect of some of these hormonal treatments can include an increased risk of miscarriage.

Also, its not really possible to use NFP while on the pill or other such hormonal treatments. One of the effects of the hormones is that it stops your cycles. And, since NFP is based on changes that occur brought your cycle due to the hormonal changes that normally come with a cycle it won’t really work if you add hormones and that prevent your cycles from occurring.

As a parent with a daughter who suffers (yes, suffers) with stage 4 endometriosis, I would actually encourage her to use whichever medication helped her with the horrendous symptoms. She has had 3 laser surgeries to remove endos that had attached to her intestines, gallbladder and appendix. The surgeon was absolutely floored when she removed her appendix and it was covered with endos. The ones attached to her rectum cause her the most pain. Instead of putting her into a state of early menopause, the Endometriosis specialist placed a Merina IUD during her last procedure. It has worked much better than any oral meds she tried. At age thirty her baby clock is ticking down quickly. If she already had children she would have had a hysterectomy already. As far as the “moral” aspects of having sex while on any form of medication that is also considered ABC, I do not see that as a sin. Put it on the page that reads “the rule of unintended consequence”. I pray that those who read CAF are not completely shattered by the responses of those posters who are just interested in black and white dogma instead of what the Church really teaches.:confused:

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