IUD, NFP, family planning

Hi,
I’m meeting my gynaecologist tomorrow. I have PCOS, and endometriosis (among other things). At present I am on no treatment, but the doctor is constantly suggesting the Mirena coil (IUD) to help with my symptoms. I have always declined but am at a point now where I really need my symptoms controlled. I think she will probably suggest it tomorrow again.

I have recently posted about family planning issues, and am strongly considering NFP but have not yet started. At present my husband and I are abstaining.

My question is… if I use an IUD for the intended purpose of helping my gynae symptoms. (Or an oral contraceptive pill [but not for contraception reasons])… Is this ok in the eyes of the church?

If contraception is a secondary effect but not an intended effect… is that acceptable?

My issue is this - Deep down I would welcome the contraceptive effect (see previous post if you can be bothered reading), so I worry that I would be sinning by using this treatment.

BUT I really need my symptoms treated as they are interfering with my life so much.

If I happened to use IUD, but also engaged in NFP to ensure an egg is not fertilised etc, is that acceptable?

Any advice welcome

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The Church allows things like the pill and the IUD if the purpose is to control things like endometriosis. I know this is true for single people who are chaste. I am not sure if being married and active makes it unacceptable. I am inclined to say that those who are married and who use these methods should remain abstinent until the treatment ends. Getting pregnant with an IUD (it happens more than people realize) comes with many health risks to mother and baby.

I also suggest researching the side effects and method of action of these drugs before you decide to use them. Many doctors simply will not tell you that prolonged use can cause permanent infertility even after stopping the drug, or various cancers. Educate yourself on them, because it’s possible your doctor won’t. (I have experience with that.)

It would be a good idea for you to talk to your priest. He can better guide you. If you do, make sure to include your concern about how you feel about birth control.

Even with NFP one cannot “ensure” that an egg does not become fertilized. Though NFP may decrease one’s chance of pregnancy, it never rules it out completely.

Personally I like this idea.

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I would also like to add that using an IUD (and the pill) would render NFP impossible. NFP uses the body’s natural menstrual rhythm. Hormonal IUDs (which is the kind used for endometriosis, etc) Stop ovulation and the cycle. You would no longer even have the signs of a cycle to go off of. This is because these forms of birth control release a hormone in the body called progesterone (or progestin – synthetic progesterone) and basically forces your body to “act pregnant”.

The IUD and the pill can also act as an abortifacient if fertilization happens while you are on them.

It may sound like a good idea to use NFP and the IUD, but this is not possible. Because the IUD would disrupt the body’s natural processes that enable NFP to begin with.

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Gah! Of course. Why didn’t I think of that. Of course NFP would then not be accurate.

I really don’t know what to do now.

If I decide to go for the IUD, and weigh up all side effects and reasons for using etc… Can I really justify that it’s just for symptom management (which it would be - I would never ever get for contraception) when I know deep down it’s a contraceptive too?

I really, really suggest making an appointment with your priest to discuss this. And please, PLEASE educate yourself on these drugs so you understand the risks you would be taking. I also struggle with endometriosis.

I cannot give you medical advice. So again I say, educate yourself and talk with your priest. I know how painful endometriosis can be, it knocked me off my feet a number of days. I hope you find relief!

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Double Effect

This link might help.

Clearly you would need the treatment whether you were sexually active or not and you’ve done your best to delay as much as you can.

Definitely reassure yourself by having a word with your Priest but, having seem the state of my friend when her gynae issues flared, you totally have my sympathy and you need to follow medical advice.

Prayers and best wishes!

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No don’t worry I have been educating myself on this for years which is why I haven’t jumped into it before now. But my symptoms are really getting on top of me that I’m having to reconsider.

Unfortunately I won’t get a priest between now and tomorrow.

Just wanted to have my options clear in my head before going to my appointment, and now I have no idea.

I find gynae doctors here never discuss ethical or faith considerations which makes things very difficult.

Bring it up with your Priest to be sure.

Do you have to have a final answer by tomorrow?

I won’t get a priest in the next few hours unfortunately.

And even if I could, I wouldn’t know who to go to. I’ve literally only come back to the faith a few months, during lock down in my country, and with minimal opportunities to get to know any priest. Would really struggle with lifting the phone up to contact the parish hall to discuss this.

The National Catholic Bioethics Center can help address your concern. You can even submit a question directly for a response: https://www.ncbcenter.org/

That said, the Church permits the use of drugs for legitimate medical treatment even if it has the non-intended, accidental side effect of causing infertility (temporary or permanent). That you would on some level be relieved by the accidental effect doesn’t negate it’s morally licit use.

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No it won’t have to be final by tomorrow, but because of covid these appointments are impossible to get so I would like to have a fairly firm idea of what I wanted to do.

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That’s a good suggestion - thank you

Thank you. As mentioned in that article…

“The Church does not consider 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 (Humanae Vitae 15)”

If the impediment to procreation is not intended, but is welcomed, is that still not considered illicit?

Note I am currently not in a situation to have other children (complicated) hence the abstinence with my husband. But we would like to be intimate again soon so was considering NFP in order not to conceive.

Now if I use the IUD would that be, on a deeper level, willing contraception?
Even though I would never use it for the intended purpose of contraception?

I’m even confusing myself.

I think you’re reading into it too far, here. You’re not “welcoming” it for the purpose of stopping conception, you’re needing it for the purpose of treating an illness. You’re not intending it for any motive, just for treatment.

Do speak with your priest, but as far as I can tell, you’re fine and shouldn’t have to use NFP (nor can you anyway, as another poster pointed out).

Have you discussed laparoscopic surgery as a treatment from your gynecologist?

Hormonal contraceptives just slow the growth of endometriosis.

I have endometriosis and had surgery in 2014. The surgery is not a cure, there is no cure, but the growth has not returned enough for me to experience any symptoms at this point in time.

The surgery as a treatment takes the morality concern out of the equation.

Might depend on one’s insurance and level of finances, tho’. Surgeries are usually very pricey.

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Thanks for your reply. So in your opinion you feel I would be ok to use the contraceptives for the benefit of the symptoms… and have intercourse with my husband knowing I can’t conceive as an extra “perk” of the medication? Is that not sinful… that I’m happy with the fact I shouldn’t become pregnant?

I will speak with a priest at some stage. And I won’t make any decisions solely based on all of your advice… just seeking opinions really.

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