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Tampons, sex found protective against endometriosis 7/23/03 3:13 PM

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Tampons, sex found protective against


endometriosis

Last Updated: 2002-06-05 10:00:08 -0400 (Reuters Health)

By Amy Norton

NEW YORK (Reuters Health) - In what researchers call surprise findings,


a new study suggests that women who use tampons or have sex during
their menstrual periods could be less likely to develop endometriosis.

The study of women with and without endometriosis found that those
who exclusively used tampons were less likely to have the condition. The
results were similar for women who were at least sometimes sexually
active during their periods.

However, the findings only establish a relationship between these


behaviors and lower risk of endometriosis, rather than proof that they
can prevent the disorder.

"It's reasonable to say...(the findings) open the door to future studies,"


said Dr. Harvey J. Kliman of Yale University in New Haven, Connecticut.

Kliman, the senior author on the study, told Reuters Health that his
team's findings were "very surprising," given what researchers believe
about the development of endometriosis.

Endometriosis occurs when the tissue that lines the uterus (the
endometrium) exists outside the uterus--often in the ovaries and
fallopian tubes, and almost always staying within the pelvic region.
Normally, the endometrium breaks apart and is shed each month during
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Tampons, sex found protective against endometriosis 7/23/03 3:13 PM

a woman's menstrual period. But endometrial tissue outside the uterus


has no outlet, and the normal surrounding may become inflamed and
swollen, often leading to pain.

Experts believe that a back-flow of menstrual fluid--called retrograde


menstruation--contributes to endometriosis. So anything that might
enhance retrograde flow, including tampons and sex, could conceivably
raise the risk of endometriosis.

Going into this new study, Kliman said, "we were absolutely convinced
that sex during menstruation would be a bad thing."

But in their survey of more than 2,000 women, the researchers found
the opposite pattern. When asked about their sexual activity history,
women with endometriosis were less likely to say they "sometimes" or
"often" engaged in sexual activity during menstruation, compared with
women without the condition. They were more likely to have "never" or
"rarely" done so, according to findings published in the June issue of
Gynecologic and Obstetrical Investigation.

The same pattern emerged when women were asked specifically about
sexual activity leading to orgasm. The authors suggest that it is possible
that orgasm during menstruation might protect against endometriosis by
enhancing the uterine contractions that expel menstrual fluid.

As for tampon use, fewer women with endometriosis reported


exclusively using tampons currently and in the past--less than 12%,
compared with 21% among healthy women. Women who used only
pads had a more than twofold increase in endometriosis risk, the report
indicates.

This suggestion of a protective effect of tampons "really blew our


minds," Kliman said. He noted, as an explanation for the link, that
tampons may help draw out "debris" during menstruation, as opposed to
hindering its exit.

However, whether tampons truly ward off endometriosis is unclear. For


one, this study relied on women's recall of their menstrual and sexual
history. And because endometriosis symptoms include painful
menstruation and sex, women with the condition may be likely to avoid
sex during their periods--although, Kliman pointed out, the study asked
women about their practices throughout their reproductive years.

Regardless of whether there is a protective effect, Kliman said, the


findings should help "get rid of the fear" that tampons contribute to
endometriosis. He noted that some have speculated that tampons--which
until the mid-1980s contained dioxin--might promote endometriosis.

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Tampons, sex found protective against endometriosis 7/23/03 3:13 PM

"This (study) makes me think that tampons certainly don't promote


endometriosis," Kliman said. "I think I can say that with certainty."

Gynecological and Obstetrical Investigation 2002 June.

Copyright 2001-2002 Reuters Limited. All rights reserved. Republication


or redistribution of Reuters content is expressly prohibited without the
prior written consent of Reuters. Reuters shall not be liable for any errors
or delays in the content, or for any actions taken in reliance thereon.

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