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Menarche, Menopause, and Endocrine-Disrupting Chemicals

An increasing amount of research published over the past few years suggests that female reproductive health may be affected by a wide range of chemicals present both in the environment and within consumer products. Called endocrine-disrupting chemicals (EDCs), these substances have been linked to an increased incidence of early puberty, pregnancy length disorders, and other reproductive health abnormalities.1

EDCs can be grouped according to their origin as follows: industrial (i.e., dioxins, polychlorinated biphenyls [PCBs], and alkylphenols), agricultural (i.e., pesticides, insecticides, herbicides, phytoestrogens, and fungicides), residential (phthalates, polybrominated biphenyls, and bisphenol A [BPA]), and pharmaceutical (parabens); even heavy metals such as cadmium, lead, mercury, and arsenic may be included in the list of EDCs.2 The most common exposure pathways are through inhalation, food intake, and direct contact.2

In an analysis of National Health and Nutrition Examination Survey (NHANES) data, increased levels of phenolic 2,5-DCP from dichlorobenzene (DCB), a common fumigant, correlated with earlier menarche in girls aged 12-16.3 The researchers measured a single chemical, but there are hundreds of known endocrine disruptors in our everyday environment. In a different analysis of NHANES data, 15 known toxicants were identified as contributors to early menopause in women,4 while other EDCs have been linked to earlier menarche.3 Ovarian polycystic syndrome has also been associated to EDC exposure, particularly bisphenols.1,2

Toxins have been known to be endocrine disruptors, and what that means is that these toxins are estrogen mimetics—they act like estrogen, but they are dysfunctional hormones. As a result, they get in and they start changing things like metabolism; they start binding to receptors and upregulating things that perhaps shouldn’t be upregulated.

-IFM educator Deanna Minich, PhD, FACN, CNS.

In the following video, Dr. Minich discusses her concerns about endocrine-disrupting chemicals.

Deanna Minich, PhD, FACN, CNS, an IFM Certified Practitioner, is a Functional Medicine nutritionist, researcher, and author.

Bisphenols

In 2012 alone, the US produced 9.5 trillion pounds of EDCs, which are embedded in products such as pesticides, plastics, chemical drugs, and even personal hygiene products.1 The first endocrine-disrupting chemical identified in 1936 was BPA; later, in 1950, it was discovered that BPA could be polymerized for the manufacturing of plastics.5 Despite its association with adverse health effects in females, global production of BPA continues to grow, in part due to its multiple applications in the plastic and manufacturing industries.1 The United States Environmental Protection Agency has established a safe level of 50µg/kg/day, and the European Food Safety Authority has established a tolerable daily intake below 4µg/kg/day;1 however, data from the literature suggest that exposure to BPA, even at low doses, may result in adverse health effects, particularly among pregnant women.5

Personal care products, marketed uniquely to women, are a specific source of exposure and can include chemicals such as formaldehyde, phthalates, parabens, lead, mercury, triclosan, and benzophenone.6-8 Research suggests that women ages 18 to 34 are more likely to be heavy buyers of personal care products, purchasing more than 10 types of products a year.9 What’s more, these women and their children may experience heightened vulnerability to these environmental chemicals if the products are used during sensitive periods of development such as preconception or pregnancy.10

Because bisphenol molecules have an effect similar to estrogens, they may influence hormonal regulation and the activity of estrogen receptors.11 Bisphenols may also negatively influence oocyte maturation, spermatogenesis, and the development of the reproductive system. A 2019 review of the research literature suggests that bisphenol S (BPS), which has now been used to replace BPA in many products, may have comparable negative effects on reproduction and may cause severe fertility disorders.11

BPS is an industrial alternative to the endocrine disruptor BPA, and may be found in some products labeled “BPA-free.”12 Data on current human exposure levels of BPS and bisphenol F (BPF), which is also being used to replace BPA, is reflected in NHANES 2013-2014 data.13 BPA, BPS, and BPF were detected in 95.7, 89.4, and 66.5% of randomly selected urine samples, respectively, indicating that exposure of the general US population to BPA and its substitutes may be nearly ubiquitous. According to the European Chemical Agency, 1,000 to 10,000 million metric tons of BPS are manufactured or imported annually to the European Economic Area alone.13

An interesting 2018 study found that, in aquatic larvae of C. riparius midges, the general transcriptional profile of several genes were affected after 24-hour exposure to BPS, especially those involved in endocrine and biotransformation pathways.12 The study shows, for the first time in invertebrates, that BPS activated the transcription of genes encoding nuclear receptors, concomitant with an increase in expression levels of other genes involved in the hormonal pathway mediated by ecdysone, indicating that BPS may be acting as a hormone agonist.12 Further research is needed to substantiate any claims that BPS disturbs the endocrine system in humans.

Conclusions

Research in the area of EDCs continues to evolve. While evidence supports the hazardous effects of environmental EDCs on the endocrine system, further long-term studies are needed to verify and assess the hypothesized causal relationship between EDCs and endocrine pathology.

Educating women about EDCs, including guidance about potentially problematic ingredients in personal care products, may help reduce exposure. Improving biotransformation and aiding in the elimination of toxicants may also assist in fertility and possibly overall health. Functional Medicine clinicians can guide patients on how to reduce their exposure to EDCs and develop and organize individual treatment protocols to help the body deal with these toxicants using diet, nutraceuticals, botanicals, pharmaceuticals, and behavioral interventions.

LEARN MORE ABOUT RE-ESTABLISHING HORMONAL BALANCE>

To learn more, please continue reading the IFM-authored articles below.

What nutrients may aid detoxification and improve overall health? Learn more.

Read more about chemical exposures at home

References

  1. Piazza MJ, Urbanetz AA. Environmental toxins and the impact of other endocrine disrupting chemicals in women’s reproductive health. JBRA Assist Reprod. 2019;23(2):154-164. doi:5935/1518-0557.20190016
  2. Lauretta R, Sansone A, Sansone M, Romanelli F, Appetecchia M. Endocrine disrupting chemicals: effects on endocrine glands. Front Endocrinol. 2019;10:178. doi:3389/fendo.2019.00178
  3. Buttke DE, Sircar K, Martin C. Exposures to endocrine-disrupting chemicals and age of menarche in adolescent girls in NHANES (2003–2008). Environ Health Perspect. 2012;120(11):1613-1618. doi:1289/ehp.1104748
  4. Grindler NM, Allsworth JE, Macones GA, Kannan K, Roehl KA, Cooper AR. Persistent organic pollutants and early menopause in U.S. women. PLoS One. 2015;10(1):e0116057. doi:1371/journal.pone.0116057
  5. Miko?ajewska K, Stragierowicz J, Gromadzi?ska J. Bisphenol A – application, sources of exposure and potential risks in infants, children, and pregnant women. Int J Occup Med Environ Health. 2015;28(2):209-241. doi:13075/ijomeh.1896.00343
  6. Chow ET, Mahalingaiah S. Cosmetics use and age at menopause: is there a connection? Fertil Steril. 2016;106(4):978-990. doi:1016/j.fertnstert.2016.08.020
  7. Dodson RE, Nishioka M, Standley LJ, Perovich LJ, Brody JG, Rudel RA. Endocrine disruptors and asthma-associated chemicals in consumer products. Environ Health Perspect. 2012;120(7):935-943. doi:1289/ehp.1104052
  8. Pierce JS, Abelmann A, Spicer LJ, et al. Characterization of formaldehyde exposure resulting from the use of four professional hair straightening products. J Occup Environ Hyg. 2011;8(11):686-699. doi:1080/15459624.2011.626259
  9. Tabs Analytics. Millennial women key to growth in cosmetics industry. Published January 20, 2016. Accessed January 29, 2019. https://www.tabsanalytics.com/blog/millennial-women-key-to-growth-in-cosmetics-industry
  10. Di Renzo GC, Conry JA, Blake J, et al. International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals. Int J Gynaecol Obstet. 2015;131(3):219-225. doi:1016/j.ijgo.2015.09.002
  11. Ješeta M, Crha T, Žáková J, Ventruba P. Bisphenols in the pathology of reproduction. Ceska Gynekol. 2019;84(2):161-165.
  12. Herrero Ó, Aquilino M, Sánchez-Argüello P, Planelló R. The BPA-substitute bisphenol S alters the transcription of genes related to endocrine, stress response, and biotransformation pathways in the aquatic midge Chironomus riparius (Diptera, Chrionomidae). PLoS One. 2018;13(2):e0193387. doi:1371/journal.pone.0193387
  13. Lehmler HJ, Liu B, Gadogbe M, Bao W. Exposure to bisphenol A, bisphenol F, and bisphenol S in U.S. adults and children: the National Health and Nutrition Examination Survey 2013-2014. ACS Omega. 2018;3(6):6523-6532. doi:1021/acsomega.8b00824

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