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BMJ 2011; 343 doi: (Published 14 December 2011) Cite this as: BMJ 2011;343:d8077

Hormonal contraceptives for nuns?

Two cancer researchers from Australia have urged the Catholic church to make oral contraceptive pills freely available to nuns to help protect them against reproductive cancers. Doctors first noticed a link between convent life and breast cancer in 1713, and by 1950 it was clear that nuns and other celibate women also had a high risk of ovarian and uterine cancers.

Catholic nuns have no children and no need to breast feed. They have more menstrual cycles between menarche and menopause than women who have children, write the researchers. We now know that menstrual cycles contribute to risk of breast cancer, uterine cancer, and ovarian cancer. We also know that women who use oral contraceptives have significantly fewer uterine and ovarian cancers than non-users, a protection that lasts for around two decades. The world’s 94 790 nuns should be encouraged to take advantage of this protection, say the experts. Oral contraceptive pills do not help prevent breast cancer but are associated with significant reductions in overall mortality in epidemiological studies. Pills can save lives.

Although the Catholic church explicitly bans all forms of contraception except abstinence, it does allow followers to take therapeutic agents to “cure organic diseases, even though they also have a contraceptive effect.” Hormonal contraceptives taken by celibate nuns would surely fall into this category, say the researchers. Nuns pay an unnecessarily high price for their childlessness, a fact that deserves wider recognition.

Little to choose between second generation antidepressants

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Doctors treating adults with major depression have a bewildering number of second generation antidepressant drugs to choose from. Meta-analyses have suggested that they all work equally well, and a new update confirms this. A close look at 234 studies, including 118 head to head trials, found a few differences between pairs …

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