Women are curious about endometriosis because it is a curiosity. The causes of endometriosis are not precisely understood but we have a good working knowledge.
We do know that it involves endometrial tissue being extruded out of fallopian tubes and into the pelvis. There, in a subset of women, the tissue implants and becomes active. Then, in a subset of these patients, this tissue secretes inflammatory mediators. Finally, some of these women develop autoantibodies. Pain and infertility can result from all of the inflammation and the damage that it causes. Cysts full of liquid can form; scarring can block tubes and distort anatomy.
Treatments are of two types: medical and surgical. Medical therapy makes good sense because we know that endometriosis is hormonally responsive. Conservative surgical therapy is helpful to drain cysts, cauterize lesions, and release adhesions such as the ones in the photo. Definitive surgical therapy includes removal of the tubes, uterus and ovaries.
Recently I was asked to review a blog post posted on my Facebook page. (See blog post HERE) It was by a naturopathic doctor who was proposing a different approach to endometriosis. She was postulating endometriosis as an autoimmune disease. Apparently she had read a speculative literature review article, (Reference HERE) which noted an increased prevalence of inflammatory mediators and auto antibodies in those with endometriosis. Despite anything like a high level of evidence, (See levels of evidence HERE) she drew a causal relationship between these findings in the occurrence of endometriosis.
I think the authors of the study would consider these findings noteworthy associations, but would not feel entitled to draw any further conclusions such as causality. I myself would say her blog post thesis is a case of confusing eggs with chickens. In other words, endometriosis probably causes inflammatory mediators to arise and fosters the development of autoantibodies, not the other way around as she proposes. Some people are more immunologically reactive than others, and those that are will likely develop more autoimmunity of whatever type.
It is important to note that the author of the blog post draws a conclusion from this paper from which no conclusion can legitimately be drawn. She goes on to propose therapy, including modifications in diet, i.e. going off dairy and gluten. She then suggests her book which further discusses endometriosis and the "natural immune-modulating treatments" which she offers.
I see two main differences between legitimate medical websites and others. First, legitimate medical websites are evidence based. This means that not only must they cite medical research, but that they must cite it correctly, and not draw unfounded or speculative premature conclusions for associations which may be suggested. Secondly, legitimate medical websites are realistic. Others are boundlessly optimistic, offering readers and customers results that invariably surpass conventional treatments.
I say, follow the money. Also, if it seems too good to be true, then it probably is. Finally, the proof is in the pudding.
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