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Saint Paul
Tuesday, March 19, 2024

A better way for women’s health care

Dr. Amy Fisher

Editor’s note: This is the third in a series of columns exploring the content and impact of “Humanae Vitae,” Blessed Pope Paul VI’s 1968 encyclical affirming the Church’s proscription on the use of contraception. This year marks the 50th anniversary of
its promulgation.

Dr. Amy Fisher
Dr. Amy Fisher

In 1960, the first birth control pill was approved by the Food and Drug Administration. Since then, physicians have been using the birth control pill and a multitude of other hormonal methods packaged as injections, implants and intrauterine devices to regulate fertility and suppress women’s menstrual cycles. These methods both separate sex from childbearing and are used to treat reproductive disease. Using hormonal forms of birth control, gynecologists can eliminate a painful or irregular period, lighten a heavy period and even eliminate periods when desired for both health concerns and social ease of life.

But 50 years ago, Pope Paul VI laid out a different vision for women and couples in “Humanae Vitae.” To the breakthrough of science in creating effective contraception, he stated that “The Church is the first to praise and recommend the intervention of intelligence in a function which so closely associates the rational creature with his Creator; but she affirms that this must be done with respect for the order established by God” (16, paragraph 1). He acknowledged that “man cannot find true happiness — towards which he aspires with all his being — other than in respect of the laws written by God in his very nature” (31, paragraph 1). Finally, he echoed Pope Pius XII in asking that “medical science succeed in providing a sufficiently secure basis for a regulation of birth founded on the observance of natural rhythms” (24, paragraph 1).

As a practicing obstetrician gynecologist in 2018, I see that Pope Paul VI’s vision of what could be achieved while remaining true to Church teaching has revolutionized women’s health care by opening up new ways of seeing health through cooperating with the body to recognize and effectively manage disease. Many women, Catholic and non-Catholic, seek holistic and natural ways to manage their health and fertility. Because of the call for research by Pope Paul VI, women and families today have alternatives to what mainstream gynecology offers.

An example of common concerns: Susan is a 29-year-old woman who goes to her physician seeking care for her irregular periods. She is looking forward to her wedding in six months and is wondering how this will impact her ability to have children. She has always struggled with acne and abnormal hair growth on her face. She exercises three times a week, but cannot seem to lose any weight. She also has mood swings before her periods, which are interrupting her ability to achieve her work and social goals. What can be done for her?

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Mishell’s “Comprehensive Gynecology” textbook — considered a classic in the field — lists multiple treatments for abnormal bleeding patterns, including hormone therapies, ibuprofen-like medications, male steroids, menopause-inducing medications and surgery. Medical treatment options are meant to treat symptoms, suppress ovulation and thereby stop the menstrual cycle. Surgery is often a last resort because of the risks compared to the “success” of menstrual suppression in treating symptoms. But for women seeking to follow Church teaching and those desiring more holistic health management, there are alternatives.

In response to “Humanae Vitae,” some Catholic physicians and researchers have listened to the call for effective cooperation with natural law and with the body. They have gone beyond the basics of using natural family planning methods for achieving and avoiding pregnancy; they have created systems of reproductive health management that allow cooperation with the menstrual cycle even in cases of disease. Just as there is a large body of research into the pill and other hormonal contraceptives, there is more than 50 years of published research detailing methods that cooperate with fertility, restore regular ovulation and improve overall health.

If we return to Susan, this knowledge can be used to address each of her concerns. Important lifestyle modifications to achieve regular cycles can be reviewed. She can learn how to chart her cycle to best evaluate the fertility signs that her body is currently displaying. Within a few cycles, patterns are recognized that guide evaluation of the underlying cause of her irregular periods. Lab values, directed medications and treatment options in conjunction with continued charting are used to help guide management to restore ovulation, restore regular cycles and achieve healthy functioning of the body in a holistic manner.

In my surgical training, I was taught to “restore normal anatomy;” modern methods of natural family planning give us the opportunity to help restore normal physiology rather than suppress it. The call of Pope Paul VI in “Humanae Vitae” was heard by Catholic men and women of science and medicine. Over these last 50 years, they have supplied us with the knowledge and the tools to restore normal function in cases of reproductive disease, to achieve fertility in cases of infertility and to effectively avoid pregnancy in cases of grave indication while continuing to respect and honor the moral and natural law God has written on our hearts.

Fisher practices at Allina Health Eagan Women’s Health Clinic and United Hospital in St. Paul. She and her husband, Scott, have two children and are members of St. John Neumann in Eagan.

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