The Bravis hospital, with branches in Roosendaal and Bergen op Zoom, is organizing an information evening on Monday 21 November with the theme: ‘Self-management in endometriosis’. The information evening, initiated by gynecologists from the Bravis hospital, will take place at the Roosendaal location.
Three of the four speakers come from the non-regular, alternative angle. They are non-BIG registered and promote treatments such as neurostimulation (TENS), acupuncture and Chinese herbs for which there is no evidence of effectiveness. The fourth speaker is Carolien Boomsma, one of the hospital’s gynaecologists. She worked – how spicy can it be – for her PhD at the Cochrane branch in New Zealand and should know the ins and outs of EBM (Evidenced Based Medicine).
Why promote alternative practitioners?
Board members of the Association against Quackery, Hans Vemer and Cees Renckens, expressed surprise at the information evening organized by the hospital. They wonder why the Bravis hospital allows alternative practitioners to promote treatments within its gates that only offer false hope. Both board members have some right to speak, they are retired gynaecologists. Hans Vemer has conducted research into endometriosis at the universities of Nijmegen and Leuven and has treated and operated on many women with this condition.
The Dutch Association for Obstetrics and Gynecology (NVOG) follows the recent guideline of the European Society for Human Reproduction and Embryology (ESHRE) in its guideline on endometriosis, Renckens and Vemer argue when asked. They have examined this European guideline for therapeutic possibilities and state: ‘For the control of pain in endometriosis, the guideline recommends adequate pain relief, for example with ibuprofen or other non-steroidal anti-inflammatory drugs. Treatment with an oral contraceptive pill or with hormones (progestogens) that prevent the production of ovarian hormones can also sometimes work well. If that does not help, heavier drugs are recommended to shut down your own hormone production, such as anti-progestogens or so-called GnRH antagonists. As a last resort or if there are large endometriosis cysts in the ovaries or severe adhesions in the abdomen, surgery should be considered. (Micro)surgery or rather IVF can also help with fertility problems where adhesions play a role.’
At most a placebo effect
Vemer and Renckens further write: ‘The guideline also discusses non-medical or non-regular treatments, also referred to as alternative treatments. These non-regular treatments, including nutritional supplements, are not recommended, as none of these treatments have been shown to have any positive effect. This applies to the treatment of pain as well as to the treatment of fertility problems. At most, some patients with pain complaints could experience a placebo effect.’
Both board members have specifically searched the scientific literature for the treatments that will be discussed at the information evening and conclude:
– Nothing can be found in PubMed about holistic coaching. At the information evening, marketing manager/holistic coach Margje Reijs-Schreijgrond, as an experience expert, will give a story about holistic lifestyle.
– At the information evening, physiotherapist Esther van Wifferen praises TENS as an aid to combat pain in endometriosis. The only article on PubMed about the effect of TENS on endometriosis was written in 2015 by some Brazilian gynecologists and retracted four years ago.
– Stephanie van Hulst, trained as an accountant, will speak at the info evening about the usefulness of Chinese herbs in endometriosis, under the working title ‘the healing effect of nutrition.’ She wrote a book about it.
No proven positive effect of Chinese herbs
Numerous articles have been published on the use of Chinese herbs for endometriosis. Most are observational studies and all without a good control group, so that no positive effect has been proven either.
Vemer and Renckens therefore conclude: ‘The program offered at the information evening does not fit in any way with the guidelines of the NVOG and the ESHRE. It seems to be purely about marketing quackery within the walls of a hospital. The women with endometriosis are being offered false hope, they will sooner experience relief from their wallets than from their complaints and the symposium’s alternative practitioners will proudly announce that they were welcome as speakers at the hospital.’
The hospital – faced with these objections from the association – responds succinctly: ‘We have taken note of this vision and will make our own assessment whether or not to organize an information evening, in consultation with the medical specialists involved’, the hospital said. responsible communications officer to inform the web editors by e-mail, after consultation with the supporters.
Quackery Adepts
It should not go unmentioned that the announcement for the information evening on the LinkedIn page of herbal expert Stephanie van Hulst has received twenty big thumbs up from satisfied people, patients, but especially fellow quackery adepts, including acupuncturists and fellow herbal practitioners. A foot reflexologist writes with her big thumb: ‘ Good to see that regular medicine works together with alternative medicine! Until next week!’
The alternative foot therapist hits the nail on the head with this: holding an information meeting by a hospital and in a hospital setting facilitates quackery and strengthens belief in it. It is regrettable that neither the hospital management nor the medical staff stopped this non-medical-scientific activity of the Bravis gynaecologists.