A Frank Ob/Gyn's Message

An honest assessment of all things medical and ethical.

In my last column, I wrote about the uniquely human capacity to choose when and if to act on our natural sexual instincts. This should be sufficient grounds to accept that we should be held accountable and responsible for all of our actions in this regard. This applies not only to the most serious issue of consent but also other issues such as the proper context in a minimum of a natural marriage which doesn’t require religious belief or ceremony. As we come to appreciate that every act of marital intercourse is a conscious decision of the free will, we can better understand how the practice of periodic continence or “natural family planning” (NFP) is an entirely reasonable approach to postponement of child bearing that fully respects the man and woman’s human dignity.

We acknowledge that there do exist legitimate situations where it may be advisable for serious reasons (medical or others) to avoid pregnancy for a time or indefinitely. Accordingly, there is nothing intrinsically evil about delaying pregnancy. However, as with any noble goals (ends), there are morally licit (good) ways of seeking ends, and there are illicit (evil) manners of attaining the same end. A commonly used analogy is one where a father seeks to provide for his family. He could do so by performing honest work or he could do so by stealing or other criminal activity. Similarly, with regard to human fertility and marital intercourse, we know that those actions which intentionally cause the man or woman to be infertile at a time when conception might otherwise occur are contrary to human nature and also violate God’s law.

A frequent objection to the seemingly subtle distinction between contraception and “NFP” is that they are ethically equal since they have the same goal of avoiding pregnancy. In other words, why isn’t NFP just a Catholic version of contraception? The answer can best be understood in the context of the need to exercise self-control in a way that contraception actions do not require. The previous discussion on how animal behavior are not subject to free will explains why the Catholic Church does not condemn contraceptives and sterilization when applied to animals. Those familiar with animal population control programs are quite familiar with various types of contraceptives (even in vaccine form) that are routinely used among animal populations. Sadly, I think it needs to be stated hear clearly that those practices which are entirely legitimate for us to apply to animals are frequently in no way acceptable for human beings.

A more specific analogy that illustrates how NFP differs fundamentally from contraception can be seen in the comparison of dieting and fasting versus binging and purging with regard to weight loss strategies. Maintaining a healthy weight with occasional fasting and exercising self-restraint with regard to portions and food choices follows natural law and therefore promotes good health. Attempting to maintain a normal weight with the practice of induced vomiting and diarrhea (purging) after gorging on unhealthy quantities and types of food is contrary to natural law and is accordingly harmful to one’s health. Sexual love, like eating, were designed to be enjoyable as they are also required for maintaining and creating new life. Likewise, when these natural functions are abused (as only humans can do), profound spiritual as well as physical harm results.

On the most pragmatic level, as a physician, I must appreciate that the only 100% effective methods of avoiding pregnancy are either complete abstinence or complete castration. Many people should practice complete abstinence for at least some time for various reasons. One such example would be during the 6-8 weeks of healing after a vaginal surgery. Complete castration should only be performed when such is required to treat serious disease such as malignant cancer of the reproductive organs. Fertility awareness methods (my preferred term for what is often described as natural family planning) are equally or more effective than any of the various forms of contraception. Further development and defense of this point will follow in my next article.

Sincerely,

Dr. Frank

 

Do animals or humans have free will?

In this column, we’ll shift gears a little and talk the uniquely human capacity for reason and free will.

 While spiritual beings also share free will, no other animal does. I distinctly remember being taught in my psychology 101 university class that modern psychology has essentially dismissed the idea that free will exists, although some consider it an interesting theory to remember for historical significance. I’ll explain why such a position is utter absurdity later. For now, I’d like to simply state that this idea is quite valid and reasonable when applied to the (non-human) animal kingdom. The famous Pavlov’s dogs are but one good example of how such an understanding can provide great insights into animal behavior. Animals are indeed products of their nature and nurture, their genetic predispositions and their environment. Therefore, an animal cannot choose between good and evil. A rabbit cannot choose to be a holy rabbit any more than it can choose to be a sinful rabbit—it can only be a rabbit.

 Human beings, on the other hand, represent an entirely different situation. Popular and fashionable psychology theories notwithstanding, we are very much capable of choosing between good and evil. With the use of our reason combined with free will, we actually make several moral decisions each day. Because of this we are accountable for our actions. Bad habits (which progress to addictions) can certainly weaken our free will as we become enslaved to such destructive behaviors. In such situations, our individual culpability may therefore be less for a particular repetitive mistake, as human beings, we are responsible for every one of our conscious actions. Such and understanding should be universally accepted, however, in our age of moral relativism and abdication of personal responsibility for anything, we have tickled our ears with the false teaching that we are merely animals with no free will.

 I’ll demonstrate a common-sense based logical demonstration of this key distinction between humans and all other animals. Arguably, no human action draws as much universal condemnation from other humans as rape. Efforts to address the problem of rape is one of the few legitimate causes left among the various so-called women’s rights organizations that have otherwise been corrupted with a dedication to abortion. On this issue, I stand not only with them, but with all people (be they religious, agnostic, or atheist) who condemn such unthinkable and inexcusable violence. No amount of bad genes and poor upbringing can excuse a man for violating a woman in this most inhuman manner.

 What about animals? Is there any equivalent to rape in the animal kingdom? Why not? Anyone who has been in the presence of dogs, or other pets long enough has witnessed a mating process that in no way reflects the standard of mutually consenting adults we have for humans. We intuitively understand and accept that such animals act purely on instinct and have no responsibility for their actions in any sort of moral or ethical sense.

 It is precisely because we are so different than animals in this most obvious example that we are held to an entirely different standard. We are not bound to act according to mere natural instincts. We have the capacity both for reason and subsequent free decisions of the will. Such a rational understanding of human beings explains why we should be held accountable for our actions. Whether this issue is cigarette smoking or premarital sexual activity, we are neglecting dour duty to give appropriate guidance and instruction when we treat such reckless behavior with indifference or dismiss it with the tire old adage “they’ll do it anyway.” Far too often today, especially at the highest levels of public policy, we provide our youth the message that we expect them to behave like animals in heat without any expectation of self-control. Sadly, this frequently becomes a self-fulfilling prophesy.

 Young people deserve better. As rational human beings, we have a responsibility to affirm their human dignity and to teach them how to live in a way they will find true freedom and fulfillment.

 Sincerely,

 Dr. Frank

 

Is abortion safe? part 3

Today, we’ll conclude our overview of abortion’s harm to women with a discussion of associated mental health problems. While a person’s health is comprised of interrelated physical, mental, and spiritual aspects, my professional competencies only cover the physical and mental (clergy and religious leaders can better address the spiritual components). Several years ago, I did some in-depth research on the issue of psychological effects of abortion. If I had any doubt as to the depth and severity of women’s suffering from this, it has been thoroughly removed after numerous personal stories I’ve since witnessed.

Sadly, I’ve had many patients suffering from the regret and sorrow of a terrible mistake they cannot undo—a suffering that the politically correct and pro-abortion culture pretends does not exist. One woman in particular comes to mind who, through tears, explains to me how not a day goes by that she doesn’t think about the abortion she had years ago. She related to me how the memory of this and the regret is destroying her marriage and making her less capable of caring for her living child. In the short space I have left, I can only describe one example of such resultant psychiatric problems.

In 1992, Anne C. Speckhard and Vincent M. Rue defined and described Postabortion Syndrome (PAS) as a variant of Posttraumatic Stress Disorder (PTSD). Four basic components of PAS are defined:

(a) exposure to or participation in an abortion experience, which is seen as the traumatic and intentional destruction of one’s unborn child; (b) uncontrolled negative reexperiencing of the abortion event; (c) unsuccessful attempts to avoid or deny painful abortion recollections, resulting in reduced responsiveness; and (d) experiencing associated symptoms not present before the abortion, including guilt about surviving.

This designation gives much insight into the nature of the symptoms to expect from and to use in assessment of those suffering PAS. The study prompting the PAS specification of PTSD was a large-scale random survey showing that at least 19% of women suffer from diagnosable PTSD three to five years following an abortion. This study also found that 45% of the women reported having at least several symptoms of PTSD (Barnard 1990). For example: intrusive nightmares, intrusive thoughts, flashbacks, reenactment, reexperience, denial, psychogenic amnesia, and psychic numbing are all reported as regularly encountered symptoms of PAS (Speckhard 1992). Unfortunately, this figure of 19% is probably far less than the actual number of women suffering from PAS since women suffering abortion-related stress usually avoid questionnaires and other such surveys pertaining to this subject matter—as would be expected with any other case of PTSD wherein the patient “makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who arouse recollections of it (Criterion C2).”

Anniversary reactions are one of the particularly painful symptoms of PTSD and the PAS variant is no exception. One study found this unique symptom to be present in 36% of the women who responded to surveys (Franco 1989); again the actual number could be much higher. In clinical practice, patients typically report the onset of severe psychological distress on dates as early as the first anniversary of the perceived birth date for the child, or the date of the abortion. Such distress commonly includes overwhelming guilt and an associated episode of major depression (Tishler 1981, Spaulding 1978).

The greatest tragedy in all this is that such suffering is discredited and denied by most of the medical profession and, of course, nearly all major media outlets.

For more information, the following website is one of the best on this issue:

afterabortion.org/

Sincerely,

Dr. Frank

Is abortion safe? part 2

In my experience and research, the greatest fear women have after an induced abortion is that it may put them a greater risk for complications in a future pregnancy. Sadly, the medical evidence shows that this concern is indeed warranted. In fact, the most thoroughly documented and incontrovertible physical risk associated with induced abortion is preterm birth in a future pregnancy.

For example, a Canadian group recently undertook a comprehensive analysis of all the studies available throughout the world that addressed this issue. Their metanalysis compiling the data showed that one induced abortion increased the risk of future infants being low birth weight (LBW) by 35% and increased the risk of preterm delivery (PTD) by 36%. For women subjected to more than one induced abortion, their risk of future LBW babies and PTD was increased by 72% and 93% respectively [1]. To my surprise, even the United Sates Institute of Medicine (IOM) acknowledged induced abortion as a major contributing factor as recently as 2007 in it’s book entitled Immutable Medical Risk Factors Associated with Preterm Birth.

To put the meaning of this in perspective that, one should consider that preterm births and their subsequent complications are widely recognized as the single largest cause of infant mortality in the world. (Of course, such assumptions do not account the far greater and more direct contribution by induced abortions.)

In a related matter, various studies in the past have shown an association with induced abortion and subsequent miscarriage. In 2006, a United Kingdom study analysing potential risk factors for miscarriage found induced abortions to be among the factors independently associated with subsequent spontaneous abortions [2].

Several other medical risks have also come to light. For example, an increased risk of placenta previa after induced abortions has been well documented [3]. Previa is a complication wherein the placenta covers the cervix and requires cesarean delivery to avoid life-threatening hemorrhage during labor . Perhaps most interestingly, evidence is now emerging that induced abortions likely play a role in autoimmune diseases among women [4].

The takeaway message in summary: the physical harms caused by induced abortion do not end with the procedure’s primary target. Rather, the child’s mother and younger siblings frequently experience serious physical harms as well.

As the medical profession has grown in an appreciation of the interconnectedness between mental and physical health, we need to be careful not to compartmentalize mental illness as being unrelated and to other medical problems. Perhaps one of the greatest injustices against women today is that, despite over 30 studies in the past 7 years alone having demonstrated significant psychological harm to women, one of the chief rationalizations still used to excuse abortion is that it is particularly beneficial to her mental health. When the rate of suicide is 6 times higher among women having abortions, nothing could be further from the truth! [5]. Next week, we’ll finish our discussion with more detail on confirmed mental health harms attributable to induced abortion.

–Dr. Frank

 

  1. Shah PS, Zao J, Knowledge Synthesis Group of Determinants of preterm/LBW births. BJOG. 2009;116(11):1425.
  2. Risk Factors for First Trimester Miscarriage-Results From a UK-Population-Based Case-Control Study. London School of Hygiene and Tropical Medicine, December 4, 2006, pp. 1-17.
  3. Thorp, John M. Jr.; Hartmann, Katherine E.; Shadigian, Elizabeth. Long-Term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence. Obstetrical & Gynecological Survey: January 2003, Vol:58, pp 67-79.
  4. Miech, Ralph P. The Role of Fetal Microchimerism in Autoimmune Disease. International Journal of Clinical and Experimental Medicine. June 2010; 3(2): 164-168.
  5. Mika Gissler, Elina Hemminki, Jouko Lonnqvist. Suicides after pregnancy in Finland, 1987–94: register linkage study. BMJ 1996;313:1431

 

 

 

  1. Read more…

Is abortion safe? (Part 1)

As an obstetrician and gynecological surgeon, it is my duty to inform women of the risks of any procedure they undergo. Providing honest and accurate medical information to a woman before a procedure is required to live up to the ethical standard of informed consent. The need for such informed consent is especially critical when the procedure being considered is an induced abortion.

Incredibly, despite this being one of the most frequent medical or surgical procedures performed on women, there is very little awareness of the short-term and long-term medical risks that these women are exposed to. No doubt, the extreme reluctance to allow any public discussion on the legality of induced abortion has given this procedure a “sacrosanct” status wherein it has avoided the normal scrutiny that any other procedure would receive. Worse, all attempts to publish and bring awareness to the valid research showing harm to women are immediately dismissed as “anti-abortion” propaganda. In essence there is a veritable censorship by public media outlets and official medical bodies against any scientific evidence that contradicts the dictum that “legal abortions” are the “safest procedures in medicine.” Such blatant suppression of healthy debate in search of truth is eerily reminiscent of the kind of oppressiveness intrinsic to both communist and fascist dictatorships.

Perhaps the most thoroughly documented and incontrovertible risk associated with induced abortion is that of preterm birth in a future pregnancy.

In addition to preterm birth, the other major long-term physiologic risk associated with induced abortion is that of breast cancer. No doubt, the incredible popularity of breast cancer awareness campaigns has much to do with the particularly intense efforts to discredit the scientific evidence showing the association. To allow this compelling evidence to surface would risk subjecting the dogma of “safe legal abortion” to the scrutiny of the armies of people authentically concerned about women’s health.

For example, according to Dr. Angela Lanfranchi, a surgical oncologist and breast cancer specialist, abortion causes breast cancer in about 5% of women who have an abortion. This results in approximately 10,000 cases a year of breast cancer that can be attributed to abortion. After an induced abortion, the female is exposed to very high levels of estrogen, which can act as a mitogen and a carcinogen on breast tissue. This would leave her with more places for cancers to start.

Overall, 51 of 68 epidemiological studies since 1957 report an abortion-breast cancer (ABC) link. The most recent of these is an Armenian study-whose authors examined type diabetes , reproductive factors, and breast cancer, found a statistically significant association showing a 2.86-fold increased breast cancer risk from one induced abortion. The study, led by Lilit Khachatryan, included researchers from the Johns Hopkins School of Public Health and the University of Pennsylvania.

 Not surprisingly, prominent pro-abortion organizations like the Royal College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists continue to ignore the preponderance of such compelling evidence in order to perpetuate the misleading idea that abortion is safe.

 For more information, including the latest updates on the abortion breast cancer (ABC) link, see the following websites:

www.abortionbreastcancer.com/index/

http://www.abortiontruths.net/abortionbreastcancerreferences.html

http://stopabortionbreastcancer.org/

Next, we’ll look at the preterm birth risk and similar problems attributable to induced abortion.

Sincerely,

Dr. Frank

How the Irish are saving civilization…again!

I write today’s column with a sense of profound gratitude for my Irish heritage and for the privilege to write to the people of my ancestral homeland. Just two days in advance of celebrating Ireland’s most well known hero, St. Patrick, the Irish government issued a report confirming its affirmation of existing laws protecting preborn life–thereby rejecting recommendations and mounting pressure by the United Nations (UN) to legalize abortion on demand. Indeed, it appears the Irish are once again being called upon to save Western Civilization. 

Hypocrisy upon hypocrisy is the theme when one looks into the details of the international pressure and coercion to legalize abortion on demand. For starters, the two UN agencies most vocal in such efforts to increase abortion are the UN Committee against Torture and the UN Human Rights Council. These are the very bodies who should be doing the opposite and urging other countries to follow Ireland’s example of protecting the human rights of preborn children while simultaneously preventing the most frequent forms of torture against women and their children. During the UN Human Rights Councils so-called Universal Periodic Review process of Ireland last October, six member nations called on Ireland to follow their example of legalized abortion on demand. These were the United Kingdom (UK), Spain, Norway, Slovenia, Denmark, and the Netherlands. Before we examine some demographic statistics, bear in mind that the calls for such unrestricted abortion are increasingly being made on grounds of maternal health and safety. The idea being promoting is that legalizing abortion procedures makes them safer, hence the slogan “safe, legal abortion.” Even though countless repetitions of these three words together do not make it true, the shear repetition does deceive many— if only on a subconscious level.

 What does do the best data on maternal health as compiled by the UN’s own World Health Organization (WHO) show? Since Ireland is so “far behind” other European nations (especially the six aforementioned) in terms of women’s health, she should have the poorest record in maternal health, right? Wrong! Of the 172 nations in the WHO’s most recent report of 2010, Ireland ranked #2 in the world for lowest maternal mortality rate (MMR). Incidentally, Greece’s maternal mortality rate was slightly lower (by only 0.001 %) even though Irish women are having almost twice (1.75 times) the number of children. As for the six nations most arrogantly telling Ireland to follow their example of legalized abortion: Denmark ranked #5, Spain #6, Norway #7, Netherlands #9, UK #12 (MMR nearly triple that of Ireland), and Slovenia #18 (MMR nearly 4 times that of Ireland). The United States ranked #24 with a MMR 8 times higher than Ireland! For further perspective, of these nations I’ve described, the United States is the one whose birth rate is closest (though still lower) to the Irish.

 Clearly, a truly objective assessment of such data should prompt one to examine Ireland as a model for the rest of the world to follow in terms of women’s health. The UN Human Rights Council and the UN Committee against Torture would both be more worthy of their respective titles if only they will follow the wisdom of the courageous members of the Irish government who continue to defend Ireland’s constitutional protection for preborn children. Indeed, this time, not only western civilization, but the future of the entire world may depend on the courageous leadership from the Land of Saints and Scholars. Éirinn go Brách (Ireland forever)!

St. Patrick, pray for us!

–Dr. Frank

Is the Church against science?

Today, I’d like to address a frequently believed myth and bias against members of the Catholic faith. Namely, there is an ungrounded prejudice that faithful Catholics are somehow opposed to sound scientific thought, research, and advancement. Fortunately, nothing could be further from the truth.

History provides a record of more than 1000 years of tremendous scientific advancement achieved only because of, not despite, the tireless work of Catholic men and women, many of them priests, religious brothers, and religious sisters. The amazing fruits of modern science and technology that we usually take for granted today would not exist if not for contribution of this hard work inspired by a love of God and humanity. To the extent our society returns to a suppression of Catholics and their work in the public square, we will be suppressing further advancement of authentic science and good technology Worse, such a course would set us back into a more barbaric and inhumane culture.

Since current events and interest involved the life sciences, I’ll give a few examples among the hundreds of devout Catholics who have greatly contributed to this field. Dr. George Agricola (d. 1555) is considered the father of mineral sciences and wrote extensively on geology, mining, and smelting. Closest to my specialty, Gabriello Fallopio (d. 1562) a medical doctor and Catholic priest whose anatomy research also included the head, ears, and sinuses, is most famous for describing the tube leading from the ovary to the uterus which still bears his name—the Fallopian tube, where conception occurs. I still remember my university studies about the fascinating work of the Augustinian friar named Gregor Mendel (d. 1884), whose clever experiments with pea plants established the foundation for our understanding of genetics and inheritance (commonly known as Mendelian inheritance or genetics). Interestingly, this humble priest is now considered the “Father of Genetics” even among the militant atheists who might object to this honourable title of “Father” if they knew that in his earthly life he was addressed as “Father” by the faithful to whom he administered the sacraments.

The Scottish biologist, Sir Alexander Flemming (d. 1955) whose discovery of penicillin in 1928 later helped him earn the Nobel Prize in Medicine, was also a devoted Catholic, member of the Pontifical Academy of Sciences, and husband of Sarah Marion McElroy of Killala, Ireland. It has been estimated that well over 200 million lives have been saved with penicillin. To this day, we regularly use penicillin in during labor to prevent live-threatening infections in newborns. Finally, let us remember that great French chemist and microbiologist, Louis Pasteur, the “Father of Microbiology” whose name lives on in the “pasteurization” process to prolong the shelf-life of beverages. His epitaph reads “ Happy the man who bears within him a divinity, an ideal of beauty and obeys it; and ideal of art, and ideal of science, an ideal of country, and ideal of the virtues of the Gospel,” (translated from French).

“Faith and reason are like two wings on which the human spirit rises to the contemplation of truth; and God has placed in the human heart a desire to know the truth—in a word, to know himself—so that, by knowing and loving God, men and women may also come to the fullness of truth about themselves (cf. Ex 33:18; Ps 27:8-9; 63:2-3; Jn 14:8; 1 Jn 3:2),” (Faith and Reason, B. John Paul II)

Additional information on Catholic scientists can be found at the following links:

en.wikipedia.org/wiki/List_of_Roman_Catholic_cleric-scientists

en.wikipedia.org/wiki/List_of_Catholic_scientists

www.catholiclab.net

Sincerely,

–Dr. Frank

 

What is the da Vinci Robot?

Today, we’ll shift gears slightly and talk about some of the great advances in gynecologic surgery. Lest anyone mistake my appeal to sound medical ethics as a rejection of technology and innovation, I’d like to discuss a few modern developments that help me to better care for my patients.

The Ob/Gyn specialty is unique in that it is the fusion of what was traditionally a medical specialty (obstetrics) and a surgical specialty (gynecology). As a surgeon, I sometimes find it necessary to use a scalpel to effect the necessary cure for my patients. However, I still believe strongly in that noble dictum of Hippocrates “Primum non nocere,” famously translated “first do no harm.” Therefore, when I do find a surgical procedure needed, I strive to perform the surgery in way that is least painful and scarring for the patient. Accordingly, I advocate a principle know as minimally invasive surgery.

In the last 30 years, laparoscopic surgery has revolutionized surgery for both general surgeons and gynecologists. In the last 5 years, the da Vinci Robot has revolutionized urologic surgery for men and gynecologic surgery for women is currently undergoing the same dramatic transition. For men, a prostatectomy for prostate cancer used to require a large (greater than 12 cm abdominal incision) laparotomy. Now with the assistance of robotic equipment, this procedure can be accomplished with a laparoscope through a few incisions (3-5) each less than 1 cm. In a similar way, gynecologic procedures such as hysterectomy, removal of fibroids (myomectomy), and even removal of advanced cancer can be more frequently be completed through the same type of small abdominal incisions.

How has the da Vinci robot system been so important? In the past, in order to perform may surgery, we needed to make an incision large enough for at least 2 sets of hands, the surgeon and the assistant. Such incisions ranged anywhere from 12-30 centimeters in length. Now, many if not most of these same procedures can be performed with laparoscopic equipment. These incisions only need be as large as the diameter of the laparoscopic instrument (approx 8mm or the size of a nice pen). While traditional laparoscopic instruments have been available for decades, they are much more difficult to use because of limitations with their maneuverability. The robotic tools on the other hand, are capable of performing hand-like movements in direct response to the surgeon’s precise movement using specialized hand controls. In other words, the robotic system is simply the most highly advanced set of tools available to perform laparoscopic surgery.

The benefits to the patient of such minimally invasive surgery are many. Less pain, less blood loss, fewer infections, and shorter convalescence are some of the most important benefits. Like many advances in medicine, however, such benefits do come at a significant upfront cost. The initial investment of the robotic equipment and the ongoing maintenance expenses has been criticized by some as being not affordable or worse—wasteful. Such criticism, though, is short-sited and fails to appreciate the whole picture in terms of cost. Good cost analysis studies are now coming forward that actually show monetary savings when all the factors are considered as a whole. For example, shorter hospital stay and fewer re-admissions for infectious complications alone are usually enough to more than make up for the initial higher equipment costs. When you factor in less use of pain medication and sooner return to work, the cost benefit analysis even more strongly favors the robot-assisted surgical approaches. Hence, sometimes, even the most utilitarian of arguments will support an approach that is not only best for society, but most importantly best for the individual person.

Sincerely,

Dr. Frank (gynecologic surgeon)

What exactly is endometriosis?

In this post, we’ll briefly discuss a fairly common yet enigmatic female pathology—endometriosis. A basic definition of endometriosis is the presence of endometrial cells in places outside of normal location on inner lining of the uterus. Some of the more common sites of endometriosis include the ovaries, uterine ligaments, and bowel. The most common symptoms of endometriosis are infertility, pelvic pain, and bladder pain. Most physicians are aware of endometriosis as a cause of pelvic pain, however, many do not fully appreciate the effect it has on a woman’s fertility. For example, up to 50% of infertile women have endometriosis, even though she may not have any pain symptoms.

The management options for endometriosis, like many gynecological conditions, can be grouped into three categories: 1) expectant (i.e. doing nothing and waiting to see if the problem improves without intervention), 2) medications, and 3) surgical treatment. Expectant management might be reasonable option in some situations, especially in light of the fact that about 25% of women will actually have spontaneous regression of their disease after 1 year. However, since the other 75% of women will have either persistent disease or progression of it, intervention in the form of medicines or surgery is usually recommended.

Most gynecologists today recommend medications and “birth control” pills in particular as the main stay of treatment for women whom they believe may have endometriosis. The problem with such an approach is threefold. First, birth control pills have not been clinically proven to be any more effective than simple pain relievers like ibuprofen for the relief of endometriosis related pain. Secondly, birth control pills do nothing to improve long-term infertility that is caused by endometriosis. In fact, the birth control pill actually contributes to the risk of infertility through its effect on cervical mucus function. Finally, the cumulative risks (especially of cancer) most pronounced in long-term use of the pill do not justify their use for this when much safer treatments are available. The second most commonly used type of medication for endometriosis is an intramuscular injection of a medication known as Lupron (leuprolide). While this medication is much more effective at relieving pain than any other medications, it is fraught with its own problems of annoying side-effects and health risks. The Lupron muscular injection acts by putting a woman’s body into a chemical menopause state—hence the source of both the most bothersome side-effects (hot flashes, night sweats, etc.) and the health risks such as osteoporosis.

The most effective and definitive treatment for pain and the only treatment that preserves or restores fertility in patients with endometriosis is surgical. The purpose of surgery in this setting is to either excise or destroy all endometriosis lesions. The trend of increasing laparoscopic surgery has been a particularly beneficial situation for women with endometriosis. Personally, I have found the robotic laparoscopic system effective enough for even the most severe forms of endometriosis that only a few years ago would have required a large abdominal incision and about 3-4 days in the hospital for recovery. Now, these same types of patients go home the same day. I truly believe that a good surgeon knows when not to operate; and believing strongly in the Hippocratic principle of “do no harm” I am cautious about recommending surgery for anyone. However, the medical science to date still shows that surgical treatment remains the “gold standard” in terms of treatment for this troublesome condition known as endometriosis.

–Dr. Frank

Is contraception only a Catholic issue?

The bulk of this article came from a good family practice doctor friend who stopped prescribing contraception after discovering how harmful it is to women.

Too frequently, contraception is dismissed as merely a Catholic issue and one that only the most serious and devoted of Catholics care about. The recognition of universal truths pertaining to matters of human dignity is not limited to faithful Catholics.

To millions around the world, Mahatma Gandhi is justifiably one of the 20th century’s exemplars of wisdom and compassion. Few people know, however, that he was an impassioned opponent of contraception who spent decades writing and speaking out against the artificial birth control movement that targeted his native India in the early 1900s. Convinced that contraception poised a grave threat to women, human dignity, and the good of society, Gandhi’s many arguments for his position are summed up in one paragraph he penned in 1925:

It is an insult to the fair sex to put up her case in support of birth-control by artificial methods. As it is, man has sufficiently degraded her for his lust, and artificial methods, no matter how well meaning the advocates may be, will still further degrade her. I urge the advocates of artificial methods to consider the consequences. Any large use of the methods is likely to result in the dissolution of the marriage bond and in free love…Birth control to me is a dismal abyss.

Forty years later on the other side of the globe, the opportunity arose to test Gandhi’s hypothesis. American scientists invented the birth control pill in the late 1950s, and the 1965 Supreme Court decision in Griswold vs. Connecticutmade contraception legal for the first time throughout the US. Within a decade natural sex became the exception in America and artificial methods the norm.

Evidence today suggests that Gandhi’s prediction could not have been more accurate. In a survey released in November 2010, the Pew Research Center reported that:


- in 2008, 52% of adults were married (vs. 72% in 1960)
- in 2008, 26% of adults in their 20s were married (vs. 68% in 1960)

- only 32% of Americans believe that premarital sex is wrong (vs. 68% in 1969)

-41% of babies born in 2008 were born to unmarried mothers (vs. 5% in 1960)

Gandhi was not alone in his prescient understanding of the harm contraception would bring. For almost its entire 2000 year history, all of Christianity (Protestants, Catholics and Orthodox) forbade artificial birth control, which existed in various forms, and warned of the danger it poised. Like Gandhi, this teaching was not based on religious dogma, but rather on a profound understanding of morality and human nature. How did we in less than 50 years almost completely forget this 2000 year old tenet?

As physicians whose mission is to serve broken families in a society where almost 30% of pregnancies are aborted, where over 40% of children are born into single parent households, and where over 50% of marriages end in divorce, we should have a strong professional as well as a personal interest in this issue.

The bulk of this article came from a good family practice doctor friend who stopped prescribing contraception after discovering how harmful it is to women.

 

Too frequently, contraception is dismissed as merely a Catholic issue and one that only the most serious and devoted of Catholics care about. The recognition of universal truths pertaining to matters of human dignity is not limited to faithful Catholics.

To millions around the world, Mahatma Gandhi is justifiably one of the 20th century’s exemplars of wisdom and compassion. Few people know, however, that he was an impassioned opponent of contraception who spent decades writing and speaking out against the artificial birth control movement that targeted his native India in the early 1900s. Convinced that contraception poised a grave threat to women, human dignity, and the good of society, Gandhi’s many arguments for his position are summed up in one paragraph he penned in 1925:

It is an insult to the fair sex to put up her case in support of birth-control by artificial methods. As it is, man has sufficiently degraded her for his lust, and artificial methods, no matter how well-meaning the advocates may be, will still further degrade her. I urge the advocates of artificial methods to consider the consequences. Any large use of the methods is likely to result in the dissolution of the marriage bond and in free love…Birth control to me is a dismal abyss.

Forty years later on the other side of the globe, the opportunity arose to test Gandhi’s hypothesis. American scientists invented the birth control pill in the late 1950s, and the 1965 Supreme Court decision in Griswold vs. Connecticut made contraception legal for the first time throughout the US. Within a decade natural sex became the exception in America and artificial methods the norm.

Evidence today suggests that Gandhi’s prediction could not have been more accurate. In a survey released in November 2010, the Pew Research Center reported that:

 

- in 2008, 52% of adults were married (vs. 72% in 1960)

- in 2008, 26% of adults in their 20s were married (vs. 68% in 1960)

- only 32% of Americans believe that premarital sex is wrong (vs. 68% in 1969)

-41% of babies born in 2008 were born to unmarried mothers (vs. 5% in 1960)

Gandhi was not alone in his prescient understanding of the harm contraception would bring. For almost its entire 2000 year history, all of Christianity (Protestants, Catholics and Orthodox) forbade artificial birth control, which existed in various forms, and warned of the danger it poised. Like Gandhi, this teaching was not based on religious dogma, but rather on a profound understanding of morality and human nature. How did we in less than 50 years almost completely forget this 2000 year old tenet?

As physicians whose mission is to serve broken families in a society where almost 30% of pregnancies are aborted, where over 40% of children are born into single parent households, and where over 50% of marriages end in divorce, we should have a strong professional as well as a personal interest in this issue.

 

–Dr. Frank (with help from a friend)

 

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