Dear Judie,

Oral contraceptives apparently have been shown to reduce the risk of ovarian cancer. This does not seem right to me, but I have learned that there are some Catholic clergy who have indicated it is O.K. for a married woman to use oral contraceptives in high risk cases in order to prevent ovarian cancer. The rationale indicated is the principal of double effect.

How can this be correct when oral contraceptives can act as an abortifacient.

Could you please comment?

Thank you so much.

Der Anonymous

I forwarded your question to Anthony Dardano, M.D. and this is his response:

This question is a bit more involved than it seems on the surface. Yes, there have been some reports that ovarian cancer is less frequent in women who have been on the pill. The mechanism is not known but probably has something to do with suppression of ovarian function. The big HOWEVER is this. Ovarian cancer is the least common of the female malignancies. Breast cancer is far more common and estrogen/progesterone usage (components of the pill) have been shown to increase the risk of breast cancer. The jury is still out yet on the link between cervical cancer and pill use but I suspect pill usage promotes cervical cancer as well. Then of course there are the other medical side effects of the pill including hypertension, stroke, migraine, blood clots, just to name a few.

Ethics and morals aside for a moment, the risk of using the pill far outweighs the benefit. One must remember that the pill usage has to be for a considerable amount of time to suppress ovarian cancer greatly increasing the risk of the aforementioned complications. Morally I understand in theory that the principle of double effect might be considered but only along with abstinence or in the celibate woman. While here one might find a moral "loophole", in my opinion it would be negated by the medical risk involved since the "therapy" has to be for a prolonged period of time. Anyone who has read my responses in the past will recall that if I ever recommend the pill as a medical therapy it is always for a short period of time (usually 3 months) and that abstinence is recommended along with the treatment because of the abortifacient side effect of the pill. Women who are at a high risk for ovarian cancer will do well with frequent gyn exams, pelvic ultrasound and screening with the CA-125 blood test. Frequent monitoring has been shown to be effective as well in combating this silent killer.

Anthony N Dardano, MD, FACOG, FACS

COPYRIGHT 2009

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