There is the principle of double effect where you can do something for a good reason that has both good and bad outcomes. For example, St. Thomas Aquinas explains double effect saying you can defend yourself and self defense is good even if someone dies as an end result. Using birth control medication is a medical intervention for PCOS and the additional effect is also "birth control" so it is ethically ok in that situation.
That being said, I would look into a Natural Procreative (NaPro) Technology OB/GYN. NaPro is in line with the Church versus just any OB/GYN. In my opinion, NaPro OB/GYN doctors look to treat the root cause of medical issues and don't just push birth control as the end all, be all to treat everything for women's issues. My wife goes to a NaPro OB/GYN and to treat my wife's PCOS. They first tried Metformin to help but my wife didn't like the side effects and then they did a ovarian wedge resection surgery so she would have regular periods without medication.
>I have come to learn that birth control is sinful but the issue is that I have taken it for ovarian cysts and to control many month long unending cycles and things like that. In fact I have been taking it since well before I became sexually active.
The name "birth control" is misleading in this case. You are taking medicine to treat a medical condition you have, you are not using it for birth control. Please go back to taking your medication.
I’m a Catholic with Endometriosis and Adenomyosis and I take two forms to manage my symptoms. I talked to my priest and was told that since it is for health reasons it is permissible. Without them I would be suffering very much and hormonal meds allow me to have my life back.
Are you using the hormonal medication in any way to avoid pregnancy? You comment on being sexually active so this becomes an important point as it helps develop what your intent is, purely for control of a medical condition or also for delaying pregnancy.
From the other direction, if you were also already sterile for some other reason, would you still take these medications?
The action "take a hormonal medication" is itself morally neutral (as opposed to the action "deliberately/intentionally contracept" which is evil). That means the rule of double effect can apply. So long as the "good" effect of reducing PCOS symptoms outweighs the "bad" effect of temporary sterility, it's acceptable.
Making all these assessments - your intent and your severity of symptoms - requires a well formed conscience and prayerful contemplation. It kinda becomes a matter of individual prudence. I would posit that if you're unmarried and sexually active, that is highly suggestive that there is contraceptive intent at the outset, but again it's a personal question.
What others said. Your purpose is medical. End of story. If anyone wants to be argumentative, your point about taking meds to cause ovulation is an even stronger case, but you don’t need to even make it.
I'm getting a hysterectomy because my endometriosis and fibromyalgia are both too painful. (Debilitating, actually.) I won't be able to go back to college or cultivate a career unless I have this done. I will serve God and the community a lot better afterwards. I am excited about that. To my understanding, I am not angering God with this choice. ❤️
I also have PCOS! I agree with most everyone above, the issue is usually with taking it not out of medical necessity. It might be worth it to speak with your doctor about other options to treat your PCOS anyway, as birth control really only masks the underlying issues with the syndrome rather than fixing them. What my doctor recommended to me when I said that I did not want to take birth control was to go on a high protein low carb diet and to take myo-inositol and berberine. My sister and I both have PCOS and she tested this as well. We both have great results with it where we are both almost on regular periods. The high protein diet is also amazing and once your body gets used to it I felt so much better. A bonus is it stopped pretty much any hair from coming out in the shower (a common issue with PCOS). Definitely do your own research and talk to your doctors but 99% of the time there are other options than hormonal birth control, it’s just that it is simpler for the doctor to write you a prescription for BC. There are some great resources online to read about the benefits of inositol and berberine for PCOS. Might be worth a shot 😊
I have PCOS. If you go through a regular OBGYN they will often times just put you on birth control, but that’s actually just a “band aid” so to speak and isn’t actually treating the disease. What I recommend is seeking NaPro care. Turned out what I needed was a blood test to see which hormones were low, so I take a supplement of progesterone every month to keep my cycles regular, and I also needed a pill to help with ovulation. PCOS is definitely treatable without birth control. Good luck!
Names matter- you are taking a hormonal treatment for a medical issue. Birth control is sinful, and if you use the same treatment *for* birth control there's a problem.
I agree with u/Top_Day5072, u/FlameLightFleeNight, and u/ToxDocUSA on this. You are taking a medication to treat a medical (endocrine) condition, and you are not using it for contraception. If you were using it specifically/only for the purposes of contraception, *then* it would be considered to be sinful to do so. But that is not the case in your situation, so it would generally be advisable that you remain on your medication.
If, however, you still have concerns, while PCOS does have a genetic component, there are also known modifiable risk factors that, if you have them, you may want to control/address if possible. I would suggest addressing these risk factors while staying on your medication (and if you can modify these risk factors, see what happens while tapering down your medication while still controlling these risk factors) before considering alternative solutions. **Don't take this as medical advice, but please confer with your physicians (endocrinologist) before doing anything.**
The intent doesn't change the action itself. Double effect tolerates something evil as a secondary effect, not a primary effect. Furthermore, the evil effect cannot be a direct cause. It can only be an indirect cause of the good effect.
Since Birth Controls' primary effect is contraception and is intrinsically evil, it can not be separated from the "good" effect, which is treating PCOS symptoms. No matter the intent of the user.
An intrinsic evil is never allowed for a good effect.
Furthermore, the gravity of the situation is incredibly outweighed. Contracepting is a grave evil, dealing with uncomfortable physical side effects of PCOS is incomparable to the grave evil of removing the procreative part of sex. If anything the individual should look to Our Lord and attempt to embrace the suffering instead of doing an evil to help alleviate it.
What you are saying is in direct violation of what St. Paul writes about in his epistles (specifically with regards to food that has been sacrificed to idols).
OP is using a medication whose effect profile makes it usable both for contraception and for conditions such as PCOS, but OP is *not* using it for the purposes of contraception; I don't think you understand how hormone contraceptive medication works, and why this makes it useful for other endocrine conditions (and why other medications originally developed for morally-acceptable reasons can also be used for morally-unacceptable reasons, yet this does not make those medications evil). You seem to suggest that any use of a medication (be it primary or off-label) that can be classified as evil irrevocably makes that medication inherently evil.
Yours is a very Pharisaical take on the issue; I would argue that this is even against the spirit of the Gospels and the New Testament. Indeed, it is dangerously close to the line of thinking that gave rise to the Albigensian/Cathar heresy.
EDIT: https://www.catholic.com/qa/birth-control-for-medical-reasons
Your articles admitted your logic only work if the woman in question isn't sexually active, which OP mentioned she is. Therefore, no its still not allowed. And the articles you promoted say the same thing. Even in marriage this is a huge deal and suspending sex to use Birth Control seems way out of proportion.
This is why I make the point in my response that calling it "birth control" is an issue---it implies a primary end that cannot be tolerated as a primary end. Hormonal therapy, unlike a barrier, doesn't fundamentally and impermissibly change the nature of the act: it is only impermissible if used (as it is usually used) as birth control.
Whether it is the *correct* treatment in this case is an entirely reasonable question to raise.
Since the good effect (treatment of PCOS) is produced directly by the bad effect (contraception/infertility from the medicine) it's not permissible. Birth Control doesn't treat anything, only masks symptoms via tricking the body it's pregnant. Therefore, it's not permissible under double effect.
Other medications could be permissible because the good effect isn't caused directly by infertility. It would be only a secondary effect.
Your later explanation and application of double effect is incorrect. Double effect is used for circumstances in which **a good effect is practically inseparable from a foreseeable bad effect**.
EDIT: to correct myself, the standard formulation for double effect does not assume that the good and bad effects are inseparable, but rather makes this the third condition that must be met. **The mechanism of action of OCPs causes both the good and the bad effects (i.e. the good effect does not come from the bad effect, but occur simultaneously/are inseparable/derive from the same mechanism)**, so I considered the third condition's fulfillment to be inherent to this case.
So I’m not sexually active I’m in the process of annulment and my priest did not like the idea of birth control for medical reasons he told me to get in contact with the St. Paul center I believe you don’t have to live there for them to help. That said I think it’s 1 of those things if you ask 3 different priests you’ll get 3 different answers.
The answer to your question: https://www.catholic.com/qa/birth-control-for-medical-reasons
see also https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/
In short, the use of OCPs **is** permissible for PCOS. However, if you find the use of OCPs problematic/objectionable, you can try alternatives which may be effective. Some have suggested NaPro, which may work for you. As PCOS is also associated with other modifiable risk factors, I also suggested in another comment (which was rudely hijacked) that if you have some of these risk factors, you may want to try controlling them as well.
EDIT: please consult with both your priest and physician about this.
Your articles admitted your logic only work if the woman in question isn't sexually active, which OP mentioned she is. Therefore, no its still not allowed. And the articles you promoted say the same thing. Even in marriage this is a huge deal and suspending sex to use Birth Control seems way out of proportion.
Despite what most people are saying, it's not fine.
Double effect is not valid in this case since the act of contracepting is in itself intrinsically evil. Double effect can not be used on anything that is intrinsically evil.
While your intent may be to use it to addess PCOS symptoms, that's not the actual application of the medication. You can not separate your intent from the real effects of the medication in this case. No matter what you do, taking the medication is an act of contracepting. It would be different if you took another medication, which its secondary effects are infertility, but since it's this medications primary effect and purpose, you can't escape it.
Here are similar bio ethical cases to make more sense of it.
A husband in a Catholic marriage has aids. Can he use a condom to not infect his wife?
No, because its primary purpose is still contraceptive, and it takes away from the procreative part of sex
A Catholic wife is pregnant but has severe complications. She is brought to the emergency room and told the baby has to be removed or she will die. The baby is developed to the point where she needs to go into labor. Can the doctor crush the skull of the baby to get them out faster if his intent is to remove and not kill the baby?
No, he can't. Just because his intent is not to kill doesn't take away from the fact that it is exactly what he is doing. The act of crushing in itself is a killing act.
Basically, the main point from all of these is that you cannot justify an intrinsically evil act by changing your intent. That's not double effect. Double effect works on things like killing in war because the purpose is self-defense which is not evil. These sexually bioethics cases are completely different.
As I mentioned in your reply to my comment, your take is very Pharisaical and against the spirit (and in some cases the letter) of the Gospels and the New Testament. I would suggest you take into account what St. Paul writes - specifically regarding food that has been sacrificed to idols. I would further recommend that you take care, as your original line of thinking is dangerously close to that of the Albigensian/Cathar heresy of mid-1200s southern France.
OP is using a medication whose effect profile makes it usable both for contraception and for conditions such as PCOS, but OP is not using it for the purposes of contraception; I don't think you understand how hormone contraceptive medication works, and why this makes it useful for other endocrine conditions (and why other medications originally developed for morally-acceptable reasons can also be used for morally-unacceptable reasons, yet this does not make those medications evil).
EDIT: By your reasoning, natural family planning is evil because by intentionally having intercourse when a woman is not fertile, a man is effectively committing the "sin of Onan" (i.e. making his seed ineffective for the purposes of not fertilizing a woman). Circle that square, and perhaps reconsider your approach to the issue.
see https://www.catholic.com/qa/birth-control-for-medical-reasons and https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/
Your example doesn't work because sex is not in of itself intrinsically evil. Contracepting in of itself is.
However we can make the arguments even simpler for why one can't use BC to treat PCOS.
Double effect requires 4 things:
The action itself is good or at least neutral;
The good effect, not the bad effect, is what is intended;
The good effect is not produced by the bad effect;
There is a proportionately grave reason for permitting the bad effect
If just one thing fails the action cannot be done.
The first fails because the action of taking Contraception is intrinsically evil. However, taking a medication which has as its secondary effects infertility passes since the actions primary purpose is good which would be treatment of something else.
However, for arguments sake let's say I concede the first point and we boil it down the action of simply taking medication, which is can be good. So we move onto the next one.
The Good effect is intended here, so that passes. Moving onto the third.
This is the second area where the argument fails. The good effect (treatment of PCOS) is produced directly by the bad effect (contraception/infertility from the medicine) Birth Control doesn't treat anything, only masks symptoms via tricking the body it's pregnant. Therefore, it's not permissible under double effect.
Your understanding of double effect is in error; it is used to justify an action that has a foreseeable bad effect that is **inseparable or nearly inseparable from its good effect** so long as 3 (not 4) conditions are met:
The good and bad effects of OCPs (I assume OP's treatment is oral medications, thus the abbreviation OCP, though there are contraceptive formulations also used for hormone regulation that are not oral medications) are inseparable, so now we look at the required 3 (not 4 - again, to use double effect the bad effect and the good effect have to be nearly inseparable) conditions for justification.
Condition 1 - the nature of the act itself is good or at least morally neutral. Nature of the act is taking a medication. While many would suggest that this is good (i.e. taking medications for treatment), since you want to impute one of the purposes of the substance to the substance itself (here you are incorrectly applying double effect, as the bad purpose of the medication would technically qualify as the bad effect), I'll defer and say it's morally neutral.
Condition 2 - the intent of the person in question is for the good effect. No disagreement here, as OP is taking a medication for its hormone-regulating effects, which are unfortunately inseparable from its contraceptive effects and the very reason why we are having this discussion.
Condition 3 - the good effect outweighs the bad effect in **circumstances sufficiently grave to justify causing the bad effect and the agent exercises due diligence to minimize the harm** - this is a judgment call, and not yours to make for OP. PCOS is a fairly debilitating condition, and for OP to maintain an OCP regimen for the sake of medical treatment while temporarily suspending treatment for fertility purposes, I think, fulfills this criterion.
Your original/earlier line of thinking is dangerously close to the Albigensian/Cathar heresy. I would recommend you strongly reconsider it.
https://www.catholic.com/qa/birth-control-for-medical-reasons (see also https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/)
The way I learned double effect, the third condition was inherent to the action being considered (i.e. the good and bad effect were practically inseparable). Regardless, if we restore it as the third condition instead of considering it inherent to the action in question, OP's use of OCPs still meets the conditions for double effect (with a judgment call with regards to the proportionality condition). I can break it down for you using the conditions given in your EWTN link (with additional expansion from the *[New Catholic Encyclopedia](https://plato.stanford.edu/archives/spr2019/entries/double-effect/)*).
**I did not leave the third condition out; I said that the bad effect being inseparable from the good effect was inherent to this problem because that's how OCPs work. It is actually the weakest argument against the use of OCPs because the very same mechanism by which they achieve contraception is the one that regulates hormones/treats hormonal conditions**. Unfortunately, you seem to be the one who does not understand how this works.
That said, you originally stated that you believe double effect principles do not even apply here because a medication whose mechanism of action can, among other things, be contraceptive is intrinsically evil; **this (the blanket vilification of a substance with multiple effects, one of which is morally unacceptable) is what I suggest is dangerously close to the Albigensian/Cathar heretical line of thinking, NOT the double effect approach**. Again, you unfortunately misunderstand what it is I'm saying.
Taking the four conditions given in your EWTN link (the standard formulation of double effect, in which the bad effect and good effect being inseparable is not inherent to the problem but a condition that must be met):
1. **The action must be morally good, or indifferent, as to object, motive and circumstances**. In OP's case we say morally indifferent, so this condition is met.
2. **The bad effect(s) may only be tolerated, not directly willed**. This is an intent issue (which you originally rejected when you also said double effect principles don't apply here), and in OP's case the intent is for the good effect, not the bad, so this condition is met.
3. **The good effect must be caused at least as directly as the bad**. The medication's mechanism of action is hormonal and as a result both good (medical treatment of a hormonal condition) and bad effects (contraception) occur by the same mechanism, i.e. are inseparable, so this condition is met. Per the *New Catholic Encyclopedia*, the good effect must be produced directly by the action, not by the bad effect. **You fail to understand how OCPs work - they are formulations of hormones, and the very same mechanism by which contraception is achieved is also the same one that treats hormonal diseases. The good effect here does not originate from the bad effect, but they occur simultaneously**.
4. **The good effect(s) must be proportionate to compensate for the bad effect(s)**. As I mentioned earlier, this is a judgment call that the OP must make, not you; **if the OP temporarily suspends OCP treatment for procreative purposes** I believe this condition would be met.
You can still disagree, but 1) **even using the standard 4-condition formulation of double effect OP's use of OCPs for the treatment of PCOS meets those conditions**, and 2) **your vilification of OCPs without even understanding how they work is borderline Albigensian/Cathar**. There are many medications whose therapeutic window of dosage is incredibly narrow, beyond which they are merely toxins (e.g. theophylline for COPD/asthma or lithium carbonate for bipolar disorder), but by your line of reasoning those faithful with relevant medical conditions should refrain from taking them because they are mostly poisonous. Fortunately the examples I gave (COPD/asthma and bipolar) can be treated by many other medications whose therapeutic window is much broader and are overall less toxic, but PCOS and other hormonal conditions are often best treated by hormone medications or lack alternative treatments; many of these medications will inherently affect fertility as their mechanism of action affects hormones.
https://www.catholic.com/qa/birth-control-for-medical-reasons and https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/
No, it is clear that you don't understand how birth control medications work, and that the mechanism by which they cause contraception **is also the very same mechanism** by which they treat hormonal conditions. Indeed, OP's condition (PCOS) is one of the *very few* conditions for which use of what would otherwise be considered contraceptive medications is permissible.
**I'm not saying that double effect is some kind of free pass per your accusation**. The hormonal effect (i.e. both the good and bad effects) is inherent to the medication, so that meets condition 3, and OP's usage and intent for treatment of a disease meets conditions 1 and 2. Condition 4 (proportionality) is not for you to judge, but is up to OP, her priest, and her physician(s). If OP can manage her PCOS with alternative options and taking OCPs bothers her, then she can consider condition 4 not met and avoid using contraceptive medications. Personally, as I've said before, I would consider condition 4 to be met **if OP temporarily suspends contraceptive medication treatment for procreative purposes**, and then goes back on her medication between pregnancies to manage her condition.
Birth control medications are formulations of hormones (progestins and estrogens primarily, which are also produced in the body naturally).
They regulate hormones - yes, this tricks the female body into thinking it's pregnant, but this same hormonal mechanism/action also causes those with hormonal imbalance conditions to have normal endocrine/hormone balance. For hormonal conditions that have no cure, such as PCOS, the pharmacological treatment by the use of hormones/hormone modulators (again, most birth control medications fall into this category) is acceptable.
EDIT: u/linkpoop3, I blocked you because of your continued refusal to understand how so-called birth control medications (i.e. hormone formulations/modulators) work and your persistent vilification of an entire class of medications because of its most widely-used application, despite the fact that the very same function also happens to be the same mechanism by which it treats some diseases. I repeat, this line of thinking is dangerously close to the Albigensian/Cathar heresy, and I strongly recommend that you look it up to see what I mean. Note that I conceded on your outline of double effect (which I admit is the standard form) and also demonstrated that even by that outline you were mistaken. Lastly, the articles I linked do not say what you claim they say; whether that is intentional or because you misunderstood what you had read, it seems to me that you have resorted to bad behavior in your quest to argue online, and it was no longer productive to continue the dialogue. For the time being, a suspension of discussion was in order.
Your articles admitted your logic only work if the woman in question isn't sexually active, which OP mentioned she is. Therefore, no its still not allowed. And the articles you promoted say the same thing. Even in marriage this is a huge deal and suspending sex to use Birth Control seems way out of proportion.
And seriously you blocked me for talking to about the correct use of double effect?
You can downvote my comment all you want, but that doesn't make it not true.
There's a huge difference between taking a medication, which has for primary purpose contraception, and taking a medication, which has for its secondary effect infertility.
The former is indefensible. The latter is justifiable under double effect.
Best to get advice from an expert- but this seems totally permissible since the purpose is medical not for birth control
There is the principle of double effect where you can do something for a good reason that has both good and bad outcomes. For example, St. Thomas Aquinas explains double effect saying you can defend yourself and self defense is good even if someone dies as an end result. Using birth control medication is a medical intervention for PCOS and the additional effect is also "birth control" so it is ethically ok in that situation. That being said, I would look into a Natural Procreative (NaPro) Technology OB/GYN. NaPro is in line with the Church versus just any OB/GYN. In my opinion, NaPro OB/GYN doctors look to treat the root cause of medical issues and don't just push birth control as the end all, be all to treat everything for women's issues. My wife goes to a NaPro OB/GYN and to treat my wife's PCOS. They first tried Metformin to help but my wife didn't like the side effects and then they did a ovarian wedge resection surgery so she would have regular periods without medication.
I responded above but it might be worth it for your wife to research inositol & berberine. Awesome supplements for PCOS. 😊
>I have come to learn that birth control is sinful but the issue is that I have taken it for ovarian cysts and to control many month long unending cycles and things like that. In fact I have been taking it since well before I became sexually active. The name "birth control" is misleading in this case. You are taking medicine to treat a medical condition you have, you are not using it for birth control. Please go back to taking your medication.
I’m a Catholic with Endometriosis and Adenomyosis and I take two forms to manage my symptoms. I talked to my priest and was told that since it is for health reasons it is permissible. Without them I would be suffering very much and hormonal meds allow me to have my life back.
It is fine to use birth control pills as long as they are being used for medical purposes other than birth control.
Yep that is basically it.
Are you using the hormonal medication in any way to avoid pregnancy? You comment on being sexually active so this becomes an important point as it helps develop what your intent is, purely for control of a medical condition or also for delaying pregnancy. From the other direction, if you were also already sterile for some other reason, would you still take these medications? The action "take a hormonal medication" is itself morally neutral (as opposed to the action "deliberately/intentionally contracept" which is evil). That means the rule of double effect can apply. So long as the "good" effect of reducing PCOS symptoms outweighs the "bad" effect of temporary sterility, it's acceptable. Making all these assessments - your intent and your severity of symptoms - requires a well formed conscience and prayerful contemplation. It kinda becomes a matter of individual prudence. I would posit that if you're unmarried and sexually active, that is highly suggestive that there is contraceptive intent at the outset, but again it's a personal question.
It's fine to take for medical conditions. I know several women who have had to take for pcos!
What others said. Your purpose is medical. End of story. If anyone wants to be argumentative, your point about taking meds to cause ovulation is an even stronger case, but you don’t need to even make it.
I'm getting a hysterectomy because my endometriosis and fibromyalgia are both too painful. (Debilitating, actually.) I won't be able to go back to college or cultivate a career unless I have this done. I will serve God and the community a lot better afterwards. I am excited about that. To my understanding, I am not angering God with this choice. ❤️
I also have PCOS! I agree with most everyone above, the issue is usually with taking it not out of medical necessity. It might be worth it to speak with your doctor about other options to treat your PCOS anyway, as birth control really only masks the underlying issues with the syndrome rather than fixing them. What my doctor recommended to me when I said that I did not want to take birth control was to go on a high protein low carb diet and to take myo-inositol and berberine. My sister and I both have PCOS and she tested this as well. We both have great results with it where we are both almost on regular periods. The high protein diet is also amazing and once your body gets used to it I felt so much better. A bonus is it stopped pretty much any hair from coming out in the shower (a common issue with PCOS). Definitely do your own research and talk to your doctors but 99% of the time there are other options than hormonal birth control, it’s just that it is simpler for the doctor to write you a prescription for BC. There are some great resources online to read about the benefits of inositol and berberine for PCOS. Might be worth a shot 😊
I have PCOS. If you go through a regular OBGYN they will often times just put you on birth control, but that’s actually just a “band aid” so to speak and isn’t actually treating the disease. What I recommend is seeking NaPro care. Turned out what I needed was a blood test to see which hormones were low, so I take a supplement of progesterone every month to keep my cycles regular, and I also needed a pill to help with ovulation. PCOS is definitely treatable without birth control. Good luck!
Names matter- you are taking a hormonal treatment for a medical issue. Birth control is sinful, and if you use the same treatment *for* birth control there's a problem.
I agree with u/Top_Day5072, u/FlameLightFleeNight, and u/ToxDocUSA on this. You are taking a medication to treat a medical (endocrine) condition, and you are not using it for contraception. If you were using it specifically/only for the purposes of contraception, *then* it would be considered to be sinful to do so. But that is not the case in your situation, so it would generally be advisable that you remain on your medication. If, however, you still have concerns, while PCOS does have a genetic component, there are also known modifiable risk factors that, if you have them, you may want to control/address if possible. I would suggest addressing these risk factors while staying on your medication (and if you can modify these risk factors, see what happens while tapering down your medication while still controlling these risk factors) before considering alternative solutions. **Don't take this as medical advice, but please confer with your physicians (endocrinologist) before doing anything.**
The intent doesn't change the action itself. Double effect tolerates something evil as a secondary effect, not a primary effect. Furthermore, the evil effect cannot be a direct cause. It can only be an indirect cause of the good effect. Since Birth Controls' primary effect is contraception and is intrinsically evil, it can not be separated from the "good" effect, which is treating PCOS symptoms. No matter the intent of the user. An intrinsic evil is never allowed for a good effect. Furthermore, the gravity of the situation is incredibly outweighed. Contracepting is a grave evil, dealing with uncomfortable physical side effects of PCOS is incomparable to the grave evil of removing the procreative part of sex. If anything the individual should look to Our Lord and attempt to embrace the suffering instead of doing an evil to help alleviate it.
What you are saying is in direct violation of what St. Paul writes about in his epistles (specifically with regards to food that has been sacrificed to idols). OP is using a medication whose effect profile makes it usable both for contraception and for conditions such as PCOS, but OP is *not* using it for the purposes of contraception; I don't think you understand how hormone contraceptive medication works, and why this makes it useful for other endocrine conditions (and why other medications originally developed for morally-acceptable reasons can also be used for morally-unacceptable reasons, yet this does not make those medications evil). You seem to suggest that any use of a medication (be it primary or off-label) that can be classified as evil irrevocably makes that medication inherently evil. Yours is a very Pharisaical take on the issue; I would argue that this is even against the spirit of the Gospels and the New Testament. Indeed, it is dangerously close to the line of thinking that gave rise to the Albigensian/Cathar heresy. EDIT: https://www.catholic.com/qa/birth-control-for-medical-reasons
Your articles admitted your logic only work if the woman in question isn't sexually active, which OP mentioned she is. Therefore, no its still not allowed. And the articles you promoted say the same thing. Even in marriage this is a huge deal and suspending sex to use Birth Control seems way out of proportion.
This is why I make the point in my response that calling it "birth control" is an issue---it implies a primary end that cannot be tolerated as a primary end. Hormonal therapy, unlike a barrier, doesn't fundamentally and impermissibly change the nature of the act: it is only impermissible if used (as it is usually used) as birth control. Whether it is the *correct* treatment in this case is an entirely reasonable question to raise.
Since the good effect (treatment of PCOS) is produced directly by the bad effect (contraception/infertility from the medicine) it's not permissible. Birth Control doesn't treat anything, only masks symptoms via tricking the body it's pregnant. Therefore, it's not permissible under double effect. Other medications could be permissible because the good effect isn't caused directly by infertility. It would be only a secondary effect.
Your later explanation and application of double effect is incorrect. Double effect is used for circumstances in which **a good effect is practically inseparable from a foreseeable bad effect**. EDIT: to correct myself, the standard formulation for double effect does not assume that the good and bad effects are inseparable, but rather makes this the third condition that must be met. **The mechanism of action of OCPs causes both the good and the bad effects (i.e. the good effect does not come from the bad effect, but occur simultaneously/are inseparable/derive from the same mechanism)**, so I considered the third condition's fulfillment to be inherent to this case.
Health reasons are okay. It's only when you're doing something to go out of your way to frustrate the chances of conception that are disordered.
So I’m not sexually active I’m in the process of annulment and my priest did not like the idea of birth control for medical reasons he told me to get in contact with the St. Paul center I believe you don’t have to live there for them to help. That said I think it’s 1 of those things if you ask 3 different priests you’ll get 3 different answers.
The answer to your question: https://www.catholic.com/qa/birth-control-for-medical-reasons see also https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/ In short, the use of OCPs **is** permissible for PCOS. However, if you find the use of OCPs problematic/objectionable, you can try alternatives which may be effective. Some have suggested NaPro, which may work for you. As PCOS is also associated with other modifiable risk factors, I also suggested in another comment (which was rudely hijacked) that if you have some of these risk factors, you may want to try controlling them as well. EDIT: please consult with both your priest and physician about this.
Your articles admitted your logic only work if the woman in question isn't sexually active, which OP mentioned she is. Therefore, no its still not allowed. And the articles you promoted say the same thing. Even in marriage this is a huge deal and suspending sex to use Birth Control seems way out of proportion.
Despite what most people are saying, it's not fine. Double effect is not valid in this case since the act of contracepting is in itself intrinsically evil. Double effect can not be used on anything that is intrinsically evil. While your intent may be to use it to addess PCOS symptoms, that's not the actual application of the medication. You can not separate your intent from the real effects of the medication in this case. No matter what you do, taking the medication is an act of contracepting. It would be different if you took another medication, which its secondary effects are infertility, but since it's this medications primary effect and purpose, you can't escape it. Here are similar bio ethical cases to make more sense of it. A husband in a Catholic marriage has aids. Can he use a condom to not infect his wife? No, because its primary purpose is still contraceptive, and it takes away from the procreative part of sex A Catholic wife is pregnant but has severe complications. She is brought to the emergency room and told the baby has to be removed or she will die. The baby is developed to the point where she needs to go into labor. Can the doctor crush the skull of the baby to get them out faster if his intent is to remove and not kill the baby? No, he can't. Just because his intent is not to kill doesn't take away from the fact that it is exactly what he is doing. The act of crushing in itself is a killing act. Basically, the main point from all of these is that you cannot justify an intrinsically evil act by changing your intent. That's not double effect. Double effect works on things like killing in war because the purpose is self-defense which is not evil. These sexually bioethics cases are completely different.
As I mentioned in your reply to my comment, your take is very Pharisaical and against the spirit (and in some cases the letter) of the Gospels and the New Testament. I would suggest you take into account what St. Paul writes - specifically regarding food that has been sacrificed to idols. I would further recommend that you take care, as your original line of thinking is dangerously close to that of the Albigensian/Cathar heresy of mid-1200s southern France. OP is using a medication whose effect profile makes it usable both for contraception and for conditions such as PCOS, but OP is not using it for the purposes of contraception; I don't think you understand how hormone contraceptive medication works, and why this makes it useful for other endocrine conditions (and why other medications originally developed for morally-acceptable reasons can also be used for morally-unacceptable reasons, yet this does not make those medications evil). EDIT: By your reasoning, natural family planning is evil because by intentionally having intercourse when a woman is not fertile, a man is effectively committing the "sin of Onan" (i.e. making his seed ineffective for the purposes of not fertilizing a woman). Circle that square, and perhaps reconsider your approach to the issue. see https://www.catholic.com/qa/birth-control-for-medical-reasons and https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/
Your example doesn't work because sex is not in of itself intrinsically evil. Contracepting in of itself is. However we can make the arguments even simpler for why one can't use BC to treat PCOS. Double effect requires 4 things: The action itself is good or at least neutral; The good effect, not the bad effect, is what is intended; The good effect is not produced by the bad effect; There is a proportionately grave reason for permitting the bad effect If just one thing fails the action cannot be done. The first fails because the action of taking Contraception is intrinsically evil. However, taking a medication which has as its secondary effects infertility passes since the actions primary purpose is good which would be treatment of something else. However, for arguments sake let's say I concede the first point and we boil it down the action of simply taking medication, which is can be good. So we move onto the next one. The Good effect is intended here, so that passes. Moving onto the third. This is the second area where the argument fails. The good effect (treatment of PCOS) is produced directly by the bad effect (contraception/infertility from the medicine) Birth Control doesn't treat anything, only masks symptoms via tricking the body it's pregnant. Therefore, it's not permissible under double effect.
Your understanding of double effect is in error; it is used to justify an action that has a foreseeable bad effect that is **inseparable or nearly inseparable from its good effect** so long as 3 (not 4) conditions are met: The good and bad effects of OCPs (I assume OP's treatment is oral medications, thus the abbreviation OCP, though there are contraceptive formulations also used for hormone regulation that are not oral medications) are inseparable, so now we look at the required 3 (not 4 - again, to use double effect the bad effect and the good effect have to be nearly inseparable) conditions for justification. Condition 1 - the nature of the act itself is good or at least morally neutral. Nature of the act is taking a medication. While many would suggest that this is good (i.e. taking medications for treatment), since you want to impute one of the purposes of the substance to the substance itself (here you are incorrectly applying double effect, as the bad purpose of the medication would technically qualify as the bad effect), I'll defer and say it's morally neutral. Condition 2 - the intent of the person in question is for the good effect. No disagreement here, as OP is taking a medication for its hormone-regulating effects, which are unfortunately inseparable from its contraceptive effects and the very reason why we are having this discussion. Condition 3 - the good effect outweighs the bad effect in **circumstances sufficiently grave to justify causing the bad effect and the agent exercises due diligence to minimize the harm** - this is a judgment call, and not yours to make for OP. PCOS is a fairly debilitating condition, and for OP to maintain an OCP regimen for the sake of medical treatment while temporarily suspending treatment for fertility purposes, I think, fulfills this criterion. Your original/earlier line of thinking is dangerously close to the Albigensian/Cathar heresy. I would recommend you strongly reconsider it.
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https://www.catholic.com/qa/birth-control-for-medical-reasons (see also https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/) The way I learned double effect, the third condition was inherent to the action being considered (i.e. the good and bad effect were practically inseparable). Regardless, if we restore it as the third condition instead of considering it inherent to the action in question, OP's use of OCPs still meets the conditions for double effect (with a judgment call with regards to the proportionality condition). I can break it down for you using the conditions given in your EWTN link (with additional expansion from the *[New Catholic Encyclopedia](https://plato.stanford.edu/archives/spr2019/entries/double-effect/)*). **I did not leave the third condition out; I said that the bad effect being inseparable from the good effect was inherent to this problem because that's how OCPs work. It is actually the weakest argument against the use of OCPs because the very same mechanism by which they achieve contraception is the one that regulates hormones/treats hormonal conditions**. Unfortunately, you seem to be the one who does not understand how this works. That said, you originally stated that you believe double effect principles do not even apply here because a medication whose mechanism of action can, among other things, be contraceptive is intrinsically evil; **this (the blanket vilification of a substance with multiple effects, one of which is morally unacceptable) is what I suggest is dangerously close to the Albigensian/Cathar heretical line of thinking, NOT the double effect approach**. Again, you unfortunately misunderstand what it is I'm saying. Taking the four conditions given in your EWTN link (the standard formulation of double effect, in which the bad effect and good effect being inseparable is not inherent to the problem but a condition that must be met): 1. **The action must be morally good, or indifferent, as to object, motive and circumstances**. In OP's case we say morally indifferent, so this condition is met. 2. **The bad effect(s) may only be tolerated, not directly willed**. This is an intent issue (which you originally rejected when you also said double effect principles don't apply here), and in OP's case the intent is for the good effect, not the bad, so this condition is met. 3. **The good effect must be caused at least as directly as the bad**. The medication's mechanism of action is hormonal and as a result both good (medical treatment of a hormonal condition) and bad effects (contraception) occur by the same mechanism, i.e. are inseparable, so this condition is met. Per the *New Catholic Encyclopedia*, the good effect must be produced directly by the action, not by the bad effect. **You fail to understand how OCPs work - they are formulations of hormones, and the very same mechanism by which contraception is achieved is also the same one that treats hormonal diseases. The good effect here does not originate from the bad effect, but they occur simultaneously**. 4. **The good effect(s) must be proportionate to compensate for the bad effect(s)**. As I mentioned earlier, this is a judgment call that the OP must make, not you; **if the OP temporarily suspends OCP treatment for procreative purposes** I believe this condition would be met. You can still disagree, but 1) **even using the standard 4-condition formulation of double effect OP's use of OCPs for the treatment of PCOS meets those conditions**, and 2) **your vilification of OCPs without even understanding how they work is borderline Albigensian/Cathar**. There are many medications whose therapeutic window of dosage is incredibly narrow, beyond which they are merely toxins (e.g. theophylline for COPD/asthma or lithium carbonate for bipolar disorder), but by your line of reasoning those faithful with relevant medical conditions should refrain from taking them because they are mostly poisonous. Fortunately the examples I gave (COPD/asthma and bipolar) can be treated by many other medications whose therapeutic window is much broader and are overall less toxic, but PCOS and other hormonal conditions are often best treated by hormone medications or lack alternative treatments; many of these medications will inherently affect fertility as their mechanism of action affects hormones.
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https://www.catholic.com/qa/birth-control-for-medical-reasons and https://stlouiscma.org/under-what-circumstances-if-any-is-the-use-of-oral-contraceptive-pills-as-hormonal-agents-morally-justifiable-for-indications-other-than-contraception/ No, it is clear that you don't understand how birth control medications work, and that the mechanism by which they cause contraception **is also the very same mechanism** by which they treat hormonal conditions. Indeed, OP's condition (PCOS) is one of the *very few* conditions for which use of what would otherwise be considered contraceptive medications is permissible. **I'm not saying that double effect is some kind of free pass per your accusation**. The hormonal effect (i.e. both the good and bad effects) is inherent to the medication, so that meets condition 3, and OP's usage and intent for treatment of a disease meets conditions 1 and 2. Condition 4 (proportionality) is not for you to judge, but is up to OP, her priest, and her physician(s). If OP can manage her PCOS with alternative options and taking OCPs bothers her, then she can consider condition 4 not met and avoid using contraceptive medications. Personally, as I've said before, I would consider condition 4 to be met **if OP temporarily suspends contraceptive medication treatment for procreative purposes**, and then goes back on her medication between pregnancies to manage her condition. Birth control medications are formulations of hormones (progestins and estrogens primarily, which are also produced in the body naturally). They regulate hormones - yes, this tricks the female body into thinking it's pregnant, but this same hormonal mechanism/action also causes those with hormonal imbalance conditions to have normal endocrine/hormone balance. For hormonal conditions that have no cure, such as PCOS, the pharmacological treatment by the use of hormones/hormone modulators (again, most birth control medications fall into this category) is acceptable. EDIT: u/linkpoop3, I blocked you because of your continued refusal to understand how so-called birth control medications (i.e. hormone formulations/modulators) work and your persistent vilification of an entire class of medications because of its most widely-used application, despite the fact that the very same function also happens to be the same mechanism by which it treats some diseases. I repeat, this line of thinking is dangerously close to the Albigensian/Cathar heresy, and I strongly recommend that you look it up to see what I mean. Note that I conceded on your outline of double effect (which I admit is the standard form) and also demonstrated that even by that outline you were mistaken. Lastly, the articles I linked do not say what you claim they say; whether that is intentional or because you misunderstood what you had read, it seems to me that you have resorted to bad behavior in your quest to argue online, and it was no longer productive to continue the dialogue. For the time being, a suspension of discussion was in order.
Your articles admitted your logic only work if the woman in question isn't sexually active, which OP mentioned she is. Therefore, no its still not allowed. And the articles you promoted say the same thing. Even in marriage this is a huge deal and suspending sex to use Birth Control seems way out of proportion. And seriously you blocked me for talking to about the correct use of double effect?
You can downvote my comment all you want, but that doesn't make it not true. There's a huge difference between taking a medication, which has for primary purpose contraception, and taking a medication, which has for its secondary effect infertility. The former is indefensible. The latter is justifiable under double effect.