Chlorination by-products in drinking water and menstrual cycle function.
Open accessAbstract
We analyzed data from a prospective study of menstrual cycle function and early pregnancy loss to explore further the effects of trihalomethanes (THM) on reproductive end points. Premenopausal women ((italic)n(/italic) = 403) collected urine samples daily during an average of 5.6 cycles for measurement of steroid metabolites that were used to define menstrual parameters such as cycle and phase length. Women were asked about consumption of various types of water as well as other habits and demographics. A THM level was estimated for each cycle based on residence and quarterly measurements made by water utilities during a 90-day period beginning 60 days before the cycle start date. We found a monotonic decrease in mean cycle length with increasing total THM (TTHM) level; at > 60 microg/L, the adjusted decrement was 1.1 days [95% confidence interval (CI), -1.8 to -0.40], compared with less than or equal to 40 microg/L. This finding was also reflected as a reduced follicular phase length (difference -0.94 day; 95% CI, -1.6 to -0.24). A decrement in cycle and follicular phase length of 0.18 days (95% CI, -0.29 to -0.07) per 10 microg/L unit increase in TTHM concentration was found. There was little association with luteal phase length, menses length, or cycle variability. Examining the individual THMs by quartile, we found the greatest association with chlorodibromomethane or the sum of the brominated compounds. Incorporating tap water consumption showed a similar pattern of reduced cycle length with increasing TTHM exposure. These findings suggest that THM exposure may affect ovarian function and should be confirmed in other studies.
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A monotonic decrease in cycle length and follicular phase length was observed in association with total THM, stronger with brominated compounds.
“A monotonic decrease in cycle length and follicular phase length was observed in association with total THM, which was stronger with brominated compounds [63].”
From Overview of Disinfection By-products and Associated Health Effects (2015) · cites this paper as [63]
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- Authors
- Windham, G. C., Waller, K., Anderson, M., Fenster, L., Mendola, P., & Swan, S.
- Affiliations
- California Health and Human Services Agency (US)
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2003-06-01
- Volume
- 111
- Issue
- 7
- Pages
- 935-941
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC1241528
- OpenAlex
- W2163487484
- Semantic Scholar
- 9379fc7f7cf242ad78c20273606578d597d2a0ac
- Cited by
- 59
- References
- 44
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 2 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 2 · 2013: 4 · 2012: 2
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor, 5325 d)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- MOspace Institutional Repository (University of Missouri) (submittedVersion)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Keywords
- trihalomethanes, chlorination by-products, drinking water disinfection, menstrual cycle length, follicular phase length, ovarian function, early pregnancy loss, chlorodibromomethane, brominated trihalomethanes, tap water consumption, urinary steroid metabolites
- MeSH terms
- Abortion, Spontaneous, Adult, California, Chlorine, Enzyme-Linked Immunosorbent Assay, Female, Humans, Hydrocarbons, Chlorinated, Menstrual Cycle, Middle Aged, Pregnancy, Prospective Studies, United States, Water Supply, Maternal Exposure, Trihalomethanes
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