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Authors’ response to the Letters to the Editors concerning the article by Meaddough et al: Sexual Activity, Orgasm and Tampon Use Are Associated with a Decreased Risk for Endometriosis

We appreciate the opportunity to respond to the concerns raised by Mss. Guidone, Marvel, Ballweg and Quinn about our article which recently appeared in this journal [1]. As our introduction discussed, prior to our study the literature supported the notion that sexual activity during menses may lead to endometriosis and, as has been emphasized by these letters, tampons as a delivery vehicle for dioxin appeared to represent a risk factor for developing endometriosis. Therefore, if we were biased in any way prior to analyzing the responses to our questions, we would have leaned towards believing that early tampon use and/or orgasm during menses would have been more frequent in the respondents with endometriosis. We were as surprised as the authors of these letters to find that these opinions were not supported by our study.