Ask a Question - or - Return to the Faith and Spirituality Forum Index

Question Title Posted By Question Date
Hormones to have menstrual cycles at all Sue Saturday, March 24, 2007

Question:

I have a unique problem, so I hear from my gynecologist. I never have menstrual cycles unless I use hormones (e.g. birth control pills). Now since when I haven't used hormones, I have not been able to get pregnant during 10 of the years I have been married, and I don't have cycles on my own, and possibly don't ovulate, is it wrong to use the hormones to force the body to have cycles, even though this too would prevent pregnancy?

My concerns are double:

2 gynecologists I have had both told me that if I don't have cycles ever, my chance for getting cancer (ie uterine, ovarian) is really high. My grandmother died from one of these cancers when my father was 9 after having 10 babies. I haven't had any babies, and with my age and no natural cycles occurring my gynecologists say that my risk is quite high.

My 2nd concern is that if I were to get pregnant, if I could, I would also put myself and the fetus in danger because I have severly high blood pressure. I have to take certain blood pressure medication now to keep it in a safe range, but would not be able to take it if I were ever to get pregnant (it is what they call category d harmful to unborn baby).

Is my use of hormones at this time part of the principle of double effect? My thought is that even without the hormones I cannot or have not gotten pregnant, and it seems logical to believe that I might not ovulate at all, so taking a hormone that forces the uterus to go through monthly cycles but prevents pregnancy is kind of a good and bad thing, but we don't know if there really is a bad thing occurring (death to a fetus) because we don't know if their ever is an egg being set forth in the first place.

My intention is not to prevent a pregnancy (for I don't think I can get pregnant without the drug anyways), it is just for the reduction in risk to cancer. (And we haven't begun to think about menopause yet, I am not quite old enough for that yet).

Question Answered by Bro. Ignatius Mary, OLSM

Dear Sue:

I applaud your devotion for the Faith and the courage to even ask the question; many would not have asked.

I need to say first off that I am not a physician, but the primary point of your question is not medical, but that of moral theology.

While the "hormone" therapy through birth control pills may bring you regular cycles and reduce the chance of some cancers, we have to ask, "at what cost?" There are also cancer risks using birth control pills and a whole hosts of other health risks. More importantly, we need to remember that while birth control pills "may" prevent a woman from conceiving, the drugs may also kill a baby who has been conceived by making it difficult for the baby to implant in the womb. This is a form of an abortion which is why these drugs are called abortifacients.

While it is possible that you will not conceive while on the drugs, you don't know this. What if you do conceive a baby and the baby is killed by the drugs? You may not even know it, but that is not the point. The very possibility must be considered in evaluating the issue.

As to how the pill works, the Couple-to-Couple League has an article on their website that explains a lot of this: About the Pill

As for double effect there are four conditions that must be true. ALL four conditions must be true to justify the application of double-effect:

  1. The act itself must be morally good or at least indifferent.
  2. The agent may not positively will the bad effect but may permit it. If he could attain the good effect without the bad effect he should do so. The bad effect is sometimes said to be indirectly voluntary.
  3. The good effect must flow from the action at least as immediately (in the order of causality, though not necessarily in the order of time) as the bad effect. In other words the good effect must be produced directly by the action, not by the bad effect. Otherwise the agent would be using a bad means to a good end, which is never allowed.
  4. The good effect must be sufficiently desirable to compensate for the allowing of the bad effect

Receiving medical treatment to correct a medical condition (to cause your cycles to start and be regulated to avoid risk of cancer) meets condition #1. That motive is morally good or at least morally indifferent.

The motive of the doctor and yourself is not to prevent pregnancy, but to treat other legitimate medical conditions. The bad effect is a side-effect, but not the intended effect of the treatment. This may satisfy condition #2.

The good effect (starting and regulating your cycle and reducing cancer risk) must be a result directly from the treatment (birth control drugs) and NOT a result of the bad effect (the prevention of pregnancy or the spontaneous termination of a pregnancy caused by the abortifacient). This is true in your case. The good effect comes from the treatment of the drugs and not because pregancy was avoided. Thus, your case appears to satisfy condition #3.

Finally, regardless of the first three conditions, is the good effect (starting and regulating your cycle and reducing cancer risk) sufficiently good enough to overcome the the bad effect (prevention of pregnancy or the possible death of a child caused by the abortifacient)? On this one, only you can determine whether this condition is met.

I know this is very difficult and personal decision for you. All I can do in advise:

1) get ALL the medical facts -- including what other therapies that may be available, the risks of each method and the risk of doing nothing; maybe there is an alternative? I would advice contacting the Couple-to-Couple League. (see the P.S. below for the their address and telephone number.They may be able to help you discern the medical issues, and perhaps even refer you to a doctor who may have another opinion and a different treatment. If there is an alternative then you have a moral obligation to at least investigate that alternative to see if it will work for you;

2) consider the fact that it could be possible for you to get pregnant, and then the baby die from the the birth control medication;

3) consider the spiritual issues concerning trust in God, Faith, Church teachings, what God is telling you in his "still small voice", the advice of wise spiritual directors, etc.;

4) remember that one of the fundamental truths of civilization let alone Christianity is that "the ends do not justify the means (but then the means can sometimes be justified by the Double-Effect principle); and

5) consider the double-effect analysis as it applies to your situation.

Bottomline: Only you can decide this. Evaluate all the issues--on the one hand, one the second hand, and the third hand, and the fourth. (One needs many "hands" to evalute this complex situation). Consider that the ends do not justify the means, and that the means can sometimes be justified by double-effect. Consider the risks of cancer without the drugs and the risk of cancer with the drugs. Consider the obligation to family and friends to stay alive as long as possible. Consider the possible death of a child in utero caused by the drugs. Consider all this, and also seek possible alternatives.

Put all this together, take it to prayer, ask others to pray for you (we will be praying for you), ask a spiritual director for feedback, ask God for guidance, and then make a decision according to your own conscience.

I am glad I am not in your shoes :)  ... then if I were, I would be famous and in Guiness Book of Records :).

Sorry, such a heavy topic needs a little levity.

You have a very difficult decision to make. Trust in God to guide you, then evaluate, listen, and decide.

God Bless,
Bro. Ignatius Mary

P.S.

The Couple to Couple League International, Inc.
P.O. Box 111184

Cincinnati, OH 45211-1184

Phone Numbers:
(513) 471-2000 | (800) 745-8252

 


Footer Notes: This forum is for general questions on the faith. See specific Topic Forums below:
Spiritual Warfare, demons, the occult go to our Spiritul Warfare Q&S Forum.
Liturgy Questions go to our Liturgy and Liturgical Law Q&A Forum
Liturgy of the Hours (Divine Office) Questions go to our Divine Office Q&A Forum
Defenfing the Faith Questions go to our Defending the Faith Q&A Forum
Church History Questions go to our Church History Q&A Forum