If there’s one group of women who shouldn’t need to worry about birth control, it’s Catholic nuns, who have taken a vow of chastity to better serve the Church. But now researchers in Australia argue that these very women could benefit greatly from being on the pill, not for contraception, but for reasons of health.
Kara Britt at Monash University and Roger Short of the University of Melbourne, writing in the journal Lancet, argue that the scientific evidence is strong enough to consider whether nuns, who do not bear children — a lifestyle that puts them at higher risk of certain reproductive cancers — could be protected by taking the birth control pill. The Catholic Church, however, rejects any form of artificial contraception.
As early as 1713, an Italian physician noticed that nuns had a high incidence of that “accursed pest,” breast cancer. In the past century, researchers confirmed the observation with studies showing that nuns were more likely to die of breast, ovarian and uterine cancers than the general population. It wasn’t until the 1970s, however, that a scientist figured out why — the fact that the nuns did not have children during their lifetimes meant that they had more menstrual cycles, and the increase in cycles led to a higher risk of reproductive cancers.
In the case of breast cancers, the hormonal changes of each cycle mean breast tissue is exposed to surges of hormones like estrogen, which can promote cell growth. In the case of ovarian tumors, the physical stress of ovulating once a month can damage tissues enough to prompt abnormal growths to emerge.
The birth control pill works by preventing the ovaries from releasing an egg each month (without an egg to fertilize, pregnancy can’t occur). But by preventing ovulation, the pill may also protect the endometrium and ovaries from developing runaway growths that could lead to tumors. In two large studies published last year, says Britt, researchers showed that women who used the pill had a 12% lower overall risk of death during the studies’ follow-up period, compared with non-users. They also had a 60% lower risk of endometrial and ovarian cancers, and no increase in breast cancer risk. “The pill reduces the risk of these cancers to a point that’s similar to women who have children early,” says Britt. That means nuns can offset some of the health risks celibacy with a pill meant to curb fertility.
So how does the Catholic Church feel about the data? Britt notes that in the Humanae Vitae, which laid out the Church’s opposition to contraception, as explained by Pope Paul V in 1968, there was an allowance for the therapeutic use of agents that could cure disease, even if they had a contraceptive effect.
“The Church has never opposed using contraceptive medications when they are medically indicated,” said Sister Mary Ann Walsh, director of media relations for the U.S. Conference of Catholic Bishops, in an email response to queries about the Lancet commentary. “The issue presented in the Lancet is a medical, not a moral one. … The chemicals found in birth control pills may have a valid medical use, for some conditions and some women. That doesn’t pose a fundamental moral problem if the drugs are not used for a contraceptive purpose.”
Of course, any decision to prescribe medications such as oral contraception to prevent certain cancers requires consideration of the whole patient, as well as the risks and benefits of the drug. “Considerations in making medical decisions obviously include weighing the risks associated with contraceptives, such as blood clots and stroke, against the likelihood of developing illnesses, such as ovarian and uterine cancer. To suggest the church dole out meds en masse to nuns sounds pretty primitive. Family history, lifestyle, the presence of other diseases, environmental factors, etc., all play a part in wellness. A nun’s decision needs to be worked out between the nun and her doctor,” said Walsh.
That’s a sound assessment, and one that Britt hopes is common throughout the Church, including at the highest levels of doctrinal authority. She is planning to present her data at an international conference, which happens to be in Rome, in coming weeks, and attendees are promised an audience with the Pope. She doesn’t know whether she will get an opportunity to broach the subject, but Britt is hopeful that somehow the Catholic Church and the Pope, will be made aware of the data supporting contraceptive use among nuns.
“I’m hoping [the Pope] will understand, and will consider relaxing the Church’s view on oral contraceptive use among nuns,” says Britt, noting that at least one former nun she consulted in Melbourne agreed and thought the Church would even support the use of birth control pills to treat menstrual disorders as well as endometrial and ovarian cancers.
From the Church’s perspective, however, a more ideal solution would be a treatment that protects the endometrium and ovaries without working as a contraceptive. But there’s no evidence to believe it can be accomplished without blocking ovulation, so for now, there’s only the pill.