Question 72

Dear Bill, 

Greetings in the Lord! I am a clinical specialist in NFP and a practicing cardiologist, having published also a number of researcharticles in the medical peer-reviewed literature dealing with thesubjects of contraception and sterilization from the medicalstandpoint. My main research interest has been the negative impactcontraception and sterilization have on sexuality, women's well-being,and marital happiness. I also am to my knowledge the only physician inthis country who has operated an NFP clinic solely and completely dedicated to working to help couples leave the contraceptive lifestyle.

I also have had a lot of experience answering these types of questions for the EWTN web site, and for the priests at NFP Outreach. 

Your symptoms sound very much like orchitis or prostatitis, the former being an infection or chronic inflammation of the testicles, and the latter being the same for the prostate gland. Either way, the approach you have taken to relieving your symptoms, besides as you say putting  you at odds with our Church's teaching and necessitating the sacrament of Reconciliation, is very likely contributing to making the problem even worse from a purely medical perspective. Very often, if there is genital stimulation or arousal in the setting of chronic orchitis or prostatitis, the increased secretions caused by the testicle and also by the prostate serve to worsen the pain and this will sometimes be partly relieved by ejaculation. But if the ejaculation takes place in a physiologically abnormal way (ectopic ejaculation outside the vagina) the secretions are not fully or physiologically emptied, and so they "sit around" in the affected gland, causing increased inflammation and what one might call a vicious cycle causing more pain in the end. So what you have come to associate with temporary relief of your symptoms might well be an exacerbating and contributing cause of the symptoms themselves -- in any event they are absolutely not medically helpful for your condition. 

One thing that I feel is too widely prevalent in average NFP instruction is the idea that during the days of abstinence it is good to cultivate intimacy in "non-genital" ways. However, often this is not a great idea, as this can put a great deal of tension and stress on a couple who for Godly and holy reasons has decided to prudently avoid pregnancy at least for a time. I think some of these couples would be better off, honestly, temporarily sleeping in separate beds, if only for that situation where physical proximity leads to at least some degree of arousal. This is especially the case when arousal leads to pain associated with orchitis or prostatitis. (Now you understand I am not here making this recommendation in a general way, for all couples). 

So to summarize: I see at least 2 problems complicating an otherwise laudable intent to follow the Church's teachings: first, there could be a degree of arousal occurring during the days of abstinence and this probably from a purely practical standpoint ought to be avoided; second, ejaculation should always be sought in the physiologically correct manner, with completed intercourse as the Church and due consideration for normal physiology would prescribe. Given the choice between risking a pregnancy and the risk of sin and the consequences of the aberrant sexual practice, long experience and wisdom with many couples would support normal intercourse as the best that could be chosen if true abstinence is not possible on days of fertility. At least this way, no moral or metaphysical norm is being violated, and no violence done to one's marriage and spouse. 

Finally, your condition needs the fairly urgent attention of a qualified urologist, because it is very likely that the syndrome will only be eradicated if properly diagnosed, and treated with probably six to eight weeks of antibiotics chosen by the urologist based on the results of urine culture, Gram stain, and analysis after prostate milking, which is a technique routinely used by urologists to properly diagnose these conditions. 

Sincerely yours, 
Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh
Clinical specialist in NFP
Associate Clinical Professor of Medicine, OU Health Sciences Center
Medical Director, The Oklahoma Vein and Endovascular Center
President, The Edith Stein Foundation