For more than 70 years, thermal cures have been reimbursed by social security, as long as they are prescribed by doctors. But is it always justified? Are their benefits proven? L’Oeil du 20h tried to see things more clearly.
In France, there are today 89 thermal spas, frequented by 600,000 people. Some patients say they come out in better shape.
Reimbursement of these cures costs social security 265 million euros per year. They are prescribed in different fields: rheumatology, respiratory tract and even gynecology.
Treatments for infertility
In the list of numerous pathologies treated, one of them caught our attention: infertility. Several establishments claim to be able to treat it; on their websites, we can read: “A natural and effective alternative to infertility” or “Babies have been born after treatment in our walls…”
This is the case of a spa resort in the South-West of France, where we were able to go. She built her reputation on the treatment of infertility.
Each year, the establishment welcomes several hundred women. Patients who often see this treatment as their last hope for having a child. This is what a 43-year-old woman, who has a very difficult journey behind her, tells us:
I’m trying and I have nothing to lose. This is one of my last chances.
Patient undergoing thermal treatment for infertilityat the Eye of 8 p.m.
For 3 weeks, she received several treatments per day, including vaginal irrigations. They are done using a cannula that is inserted into the vagina. A treatment caregiver explains to us what this treatment is for: “the goal of the game is to drain the 2 liters of liquid in 20 minutes of bathing, so that we bathe the inside of the uterus, but without drowning it”.
Cost of the treatment: around 500 euros, reimbursed almost in full if the patient is in PMA, medically assisted procreation.
On its walls, the establishment is proud to display birth announcements sent by former patients. Testimonials which, according to management, would prove the effectiveness of the care.
A surprising medical speech
But the speech given to patients is sometimes surprising. We go to another establishment specializing in gynecology, presenting ourselves as an infertile couple.
Before accessing the baths, you must meet the spa doctor. The latter explains the treatment process to us. First, the “columnization” : it’s a “vaginal thermal water compress, which must be left in the vagina for at least 1 hour.
After a few minutes of conversation, we asked him about the effectiveness of the treatments, and his answer was astonishing:
We don’t know… We don’t know how it works. We know that we have an action, but it’s like when you go to Lourdes, that you are cured of something: we don’t know.
A spa doctorat the Eye of 8 p.m.
So is there any scientific evidence on the effectiveness of these gynecological cures? We contacted the National Council of Thermal Establishments, which represents these care structures. He acknowledges that there are no studies on the subject to date.
One of its representatives confirmed this to us by telephone. : “At the moment, there is nothing, there is nothing convincing. Today, I would not venture to tell you that thermal water cures infertility, it is not true. If it were true, I would love it, but it doesn’t work like that at all”
We showed the images of the care provided in these cures to the president of the National College of Gynecologists and Obstetricians of France, Joëlle Belaisch-Allart. She said to herself, stunned:“I don’t see how vaginal irrigation could change ovulation, it completely escapes me… In fact, seriously: it’s impossible.”
According to her, these treatments are not only useless… They are also not recommended.
Vaginal douching is not recommended in gynecology. I even wonder if it couldn’t have a harmful effect.
Joëlle Belaisch-Allart, National College of Gynecologistsat the Eye of 8 p.m.
An economic… and political lobby
But then, how can these infertility cures be reimbursed? We’ll explain it to you.
Today, for a treatment to be covered by health insurance, it must first be evaluated by the High Authority of Health. It rules on its effectiveness, which will determine its reimbursement.
But thermal cures are an exception. Their effectiveness has never been evaluated by the HAS; however, they are still reimbursed.
In recent years, several deputies have attacked without success what they consider to be an anomaly, by proposing, like Thomas Mesnier in 2022, an amendment on “conditioning the reimbursement of thermal treatments to their effectiveness”.
In 2008, this is what Yves Bur, now retired, had already tried to set up. According to him, there is an economic lobby led by elected officials from spa towns, which would prevent any reform.
Because the cures bring a lot to the local economy: up to 5 billion euros in benefits each year.
We first defend the economic model: these towns depend on hydrotherapy, an economy with hotels, restaurants, etc. It is social security which finances this local economic model.
Yves Bur, former MPat the Eye of 8 p.m.
Faced with these criticisms, defenders of hydrotherapy respond that reimbursement for thermal treatments only represents 0.15% of Health Insurance expenses.
Among our sources
The National Council of Thermal Establishments
Health insurance
The national college of gynecologists and obstetricians of France