Phthalates and risk of endometriosis
Open accessAbstract
Background Phthalates are ubiquitous environmental chemicals with endocrine disruptive properties. The impact of these chemicals on endocrine-related disease in reproductive-age women is not well understood. Objective To investigate the relationship between urinary phthalate metabolite concentrations and the risk of a hormonally-driven disease, endometriosis, in reproductive-age women. Methods We used data from a population-based case-control study of endometriosis, conducted among female enrollees of a large healthcare system in the U.S. Pacific Northwest. We measured urinary phthalate metabolite concentrations on incident, surgically-confirmed cases (n=92) diagnosed between 1996 and 2001 and population-based controls (n=195). Odds ratios (OR), and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusting for urinary creatinine concentrations, age, and reference year. Results The majority of women in our study had detectable concentrations of phthalate metabolites. We observed a strong inverse association between urinary mono-(2-ethyl-5-hexyl) phthalate (MEHP) concentration and endometriosis risk, particularly when comparing the fourth and first MEHP quartiles (aOR 0.3, 95% CI: 0.1-0.7). Our data suggested an inverse association between endometriosis and urinary concentrations of other di-2-ethylhexyl phthalate (DEHP) metabolites (mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP)) and ∑DEHP, however, the confidence intervals include the null. Our data also suggested increased endometriosis risk with greater urinary concentrations of mono-benzyl phthalate (MBzP) and mono-ethyl phthalate (MEP), although the associations were not statistically significant. Conclusions Exposure to select phthalates is ubiquitous among female enrollees of a large healthcare system in the U.S. Pacific Northwest. The findings from our study suggest that phthalates may alter the risk of a hormonally-mediated disease among reproductive-age women.
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A significant association between urinary concentrations of MBzP, MEHP, and MEP and increased risk of endometriosis was found in women.
“A significant association between urinary concentrations of MBzP, MEHP, and MEP and increased risk of endometriosis was found in women [206].”
From A Review of Biomonitoring of Phthalate Exposures (2019) · cites this paper as [206]
The Results report a statistically significant inverse association between urinary MEHP and endometriosis risk, not an increased risk. They suggest increased risk with MBzP and MEP, but explicitly state that those associations were not statistically significant. The supplied passages do not give page numbers. (LLM, conf=0.90)
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- Authors
- Upson, K., Sathyanarayana, S., De Roos, A. J., Thompson, M. L., Scholes, D., Dills, R., & Holt, V. L.
- Affiliations
- University of Washington (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Corresponding author
- Upson, Kristen
- Venue
- Environmental Research
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 126
- Pages
- 91-97
- ISSN
- 0013-9351 (ISSN-L)
- PMC
- PMC3905445
- OpenAlex
- W1987642282
- Cited by
- 157
- References
- 55
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 14 · 2023: 13 · 2022: 20 · 2021: 17 · 2020: 22 · 2019: 13 · 2018: 11 · 2017: 5 · 2016: 19 · 2015: 7 · 2014: 6
- FWCI
- 7.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Environmental Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5f31nr013092-02)
- National Institute of Nursing Research (F31NR013092, 1F31NR013092-01)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD033792, T32HD052462)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
- Keywords
- phthalates, endometriosis, urinary phthalate metabolites, di(2-ethylhexyl) phthalate metabolites, monobenzyl phthalate, monoethyl phthalate, endocrine disruptors, women of reproductive age, environmental chemical exposure
- MeSH terms
- Adolescent, Adult, Endometriosis, Environmental Exposure, Female, Humans, Middle Aged, Phthalic Acids, Northwestern United States, Case-Control Studies, Endocrine Disruptors, Young Adult
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