Endometriosis (endo) affects an estimated half million women in Canada and five to ten million in the U.S.
To review, endometriosis means that tissue similar to that which normally lines the uterus occurs outside the uterus on ligaments, the bottom most part of the pelvis, bowels, bladder and other tissues in the abdomen and can cause women excruciating pain, chronic disability and infertility.
One of the most frequently mentioned theories originated in 1927. Back then, Dr. John Sampson maintained that endometriosis resulted from menstrual blood flowing backward through the uterus and out through the tubes. This endometrial tissue then implanted randomly on various structures in the pelvis and bled every month like the tissue that normally lines the uterus.
Another theory popular today is that endo may be the result of some type of auto-immune disease. This means that the body rejects the abnormal endometrial-like tissue that is located in the pelvis, with both local and generalized effects.
In recent years, it has become evident that the immune system of endometriosis patients is depressed. This includes dysfunction of T-cells, B-cells, and natural killer cells. The cause of this immune disorder is unknown.
However, thanks to the inquiring mind and meticulous research of a gynecologist in a small city in central Oregon, a new and intriguing theory has been advanced that may explain many aspects of endo that have so far been inexplicable. Dr. Redwine has made a major contribution to an understanding of endometriosis, and posed important questions.
This gynecologist has also developed a highly effective method of surgical treatment for endo and has treated over 1,500 patients. Thirty five percent of his patients are Canadians unable to receive comparable treatment in Canada. Many will pay part, if not all, the costs of surgery themselves.
Dr. David Redwine is Director of The Endometriosis Institute of Oregon and practices at the St. Charles Medical Center in Bend, Oregon.
Between 1979 and 1984, Dr. Redwine studied 143 consecutive patients. What he found surprised him and did not support the common cliches about the illness. Dr. Redwine calls these beliefs cliches because they have been handed down in the textbooks but not backed by scientifically valid studies. However, a lot of doctors still believe them.
"Much of the info we have on endo," says Dr. Redwine, "comes from untested theories. There's been almost no progress with the disease since John Sampson proposed his retrograde menstruation explanation of endo in 1927."
Five Common Cliches About Endo
In fact, endo can have many different appearances and colours and this can easily be proven by biopsy. Biopsy will show that these "atypical implants" are in fact typical endometriosis tissue. The fact of the myriad and subtle appearances of endo has been confirmed many times by other researchers in the fertility field.
Dr. Redwine found that endo was primarily a disease of fertile women.
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