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Common Chemicals and Endometriosis

Endocrine disruptors are in the news frequently nowadays. These are chemicals that interfere with the body's endocrine (or hormone) systems and can produce all sorts of negative health effects, including all sorts of reproductive problems in both males and females. Phthalates and parabens (both used in common everyday products) are examples of endocrine disruptors.

The latest is that a study conducted in Pakistan found that women with endometriosis had high levels of a common endocrine disruptor - a phthalate known as diethylhexyl phthalate (DEHP), which is used in many everyday products. Healthy women without endometriosis did not have detectable levels of DEHP in their serum (blood) in this study. The researchers say that these results suggest that the phthalate DEHP, which is used in plastics, has a contributing role in the development of endometriosis.

Endometriosis is an often painful condition in which tissue that normally lines the inside of the uterus (the endometrium) grows outside the uterus. Symptoms may include abdominal pain, heavy periods, and infertility.

Phthalates are used as plasticizers -  substances added to plastics to increase their flexibility, transparency, durability, and longevity. They are used in many consumer products, including in household furnishings, soft vinyl toys, flooring,medical equipment, air fresheners, cosmetics, perfumes, food packaging, medicine, and insecticides. Some ways humans are exposed to DEHP is from eating processed food (which contains some DEHP that has leached from food processing machines and packaging materials) and from applying personal care and cosmetic products to the skin.

Other studies have also found that DEHP levels are significantly higher in women with endometriosis compared to women without endometriosis. Interestingly, in this study - those with more advanced stages of endometriosis also tended to have the highest levels of DEHP. Excerpts from the study by  Sadia Nazir et al from the Journal of Human Reproductive Sciences:

Women Diagnosed with Endometriosis Show High Serum Levels of Diethyl Hexyl Phthalate

Abstract: Endometriosis is one of the common causes of infertility with very diverse etiology. In modern lifestyle, humans are exposed to several endocrine-disrupting chemicals (EDCs) which may lead to reproductive disturbances. Diethyl hexyl phthalate (DEHP) is one of the common EDCs to which women are exposed by the use of cosmetics, perfumes, food packaging, medicine, and insecticides.

Aim: The aim of this study was to measure the levels of DEHP in women diagnosed with endometriosis and healthy females and to compare these levels among different stages of endometriosis.

Subjects and methods: This study comprised of fifty women diagnosed with endometriosis, aged 20–40 years, and fifty age-matched healthy, fertile women without endometriosis. Females on any medication/comorbid conditions were excluded from the study. Serum DEHP concentrations were measured by high-performance liquid chromatography (HPLC). The results were expressed as means ± standard deviation (SD) (ng/ml of DEHP).

Results: The mean ± SD value of DEHP in cases was 65.29 ± 21.69 ng/ml; however, the mean ± SD value of DEHP in controls was undetectable. Comparison of DEHP among stages of endometriosis revealed an increasing trend with advanced stages (III and IV). The values were not different between the two age groups of women with endometriosis (20–30 and 31–40 years).

Conclusion: High levels of DEHP in women diagnosed with endometriosis suggest a role of phthalates in the etiology of endometriosis and permit careful use of such compounds.

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