Question 85

Mike, a husband in your condition may not use the condom any more than an infertile couple or a couple beyond the childbearing age. The sperm must always be allowed to flow unimpeded. Dr. Martin's comments are attached. 

Fraternally, Fr. Dan

Dear Mike, 

Your question was forwarded to me by Fr. McCaffrey to answer. I am an NFP-only board certified obstretrician/gynecologist. While yeast infections during pregnancy can occur because of the decreased acidity of the vagina, intercourse is not associated with recurrences unless the husband is the one harboring the yeast. This is extremely unlikely for the following reasons: the ejaculate is actually very alkaline and helps to normalize the pH of the normally acidic vagina. Yeast may grow under a heavy foreskin in an uncircumcised male, but ordinarily has no reservoir in men. Yeast require a warm, wet environment with a plentiful source of glucose. 

It's likely that the vaginitis your wife has is not yeast, or is one of the non-candidal forms which are resistant to the over-the-counter medications. An immunoassay called Affirm, by Beckton Dickson, can diagnose yeast, bacterial vaginosis (an overgrowth of vaginal bacteria associated with preterm delivery) and trichomonas. The simple Q tip test takes 15 seconds and the results are available the same day. If yeast is confirmed, there are prescription meds which kill the resistant forms. Your wife's doctor should be able to request the test from the lab. If the test is negative for all three pathogens, then the likely diagnosis is either atrophy (decreased estrogen during pregnancy which causes irritation) or an overgrowth of normal lactobacilli in the vagina which lowers the pH too much leading to burning and irritation. This disorder is known as cytologic vaginosis (Doerderlein's Vaginosis) and can be treated by alkalinizing the vagina. Intercourse without a condom would be a great way to accomplish this. 

Finally, there is another medical concern with the use of condoms (I'll leave the theological comments to Fr. McCaffrey). The wife has a structure in the vagina which absorbs excess moisture, including seminal fluid, in order for her immune system to recognize "same." The marital act allows you to become "one flesh" in an immunologic sense. In doing so, a mother is less likely to recognize the child she is carrying as "other" and develop preeclampsia, a serious complication of pregnancy.

Fr. Matthew Habiger OSB 
mhabiger@kansasmonks.org