Study shows exposure to household chemicals can lower odds of getting pregnant
Findings from UMass Amherst researcher adds to evidence of the health impacts of endocrine-disrupting chemicals
IT ALSO IMPACTS WOMEN CLEANERS/JANITORS
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Carrie Nobles IS AN ASSISTANT PROFESSOR OF ENVIRONMENTAL HEALTH SCIENCES IN THE UMAS AMHERST School of Public Health and Health Sciences.
view moreCREDIT: UMASS AMHERST
Exposure to phthalates, a group of plasticizing and solvent chemicals found in many household products, was linked to a lower probability of getting pregnant, but not to pregnancy loss, according to research by a University of Massachusetts Amherst environmental and reproductive epidemiologist.
The study, published this week in the journal Environmental Health Perspectives, also noted an association between preconception exposure to phthalates and changes in women’s reproductive hormones, as well as increased inflammation and oxidative stress.
“Phthalates are ubiquitous endocrine disruptors and we’re exposed to them every day,” says lead author Carrie Nobles, assistant professor of environmental health sciences in the School of Public Health and Health Sciences.
Phthalates are found in such common products as shampoo, makeup, vinyl flooring, toys and medical devices. People are exposed primarily by ingesting food and liquid that has come in contact with products containing the chemicals, according to a Centers for Disease Control and Prevention fact sheet.
Nobles and team analyzed data from a “unique cohort” of women in the preconception time-to-pregnancy study known as EAGeR (Effects of Aspirin in Gestation and Reproduction), which evaluated the effect of low-dose aspirin on live-birth rates. The study includes detailed information on 1,228 participants during six menstrual cycles when they are attempting to get pregnant. The women who became pregnant were followed through pregnancy.
“We were able to look at some environmental exposures like phthalates and how that relates to how long it takes to get pregnant. There was detailed data for each menstrual cycle, so we had a good handle on the date of ovulation and the timing of pregnancy when that happened,” Nobles says.
The body breaks down phthalates into metabolites that are excreted in urine and can be analyzed. The researchers measured 20 phthalate metabolites in urine samples taken when the participants enrolled in the study.
“We found there were three parent compounds that seem to be most strongly associated with taking longer to get pregnant, although we saw a general trend toward it taking longer to get pregnant across the phthalates we looked at,” Nobles says. “As exposure got higher, we saw more and more of an effect.”
The researchers also looked at a global marker of inflammation, C-reactive protein, and found the women who had higher levels of phthalates exposure also had higher levels of inflammation and oxidative stress, which can lead to organ and tissue damage and ultimately to disease.
In addition, women who showed higher levels of phthalates had lower estradiol and higher follicle-stimulating hormone across the menstrual cycle, which play an important role in ovulation and the early establishment of pregnancy.
“This profile – estradiol staying low and follicle-stimulating hormone staying high – is actually something that we see in women who have ovarian insufficiency, which can happen with age as well as due to some other factors,” Nobles says. “Ovulation just isn't happening as well as it used to.”
While women can check consumer product labels and look for phthalate-free options, the ubiquitous nature of the chemicals makes it difficult for an individual to control their exposure.
In Europe, certain phthalates are banned or severely restricted in their use, but the U.S. has no formal prohibitions. Nobles says the research findings add to the evidence that phthalates exposures have a negative impact on women’s reproductive health and can be used to help inform policy making.
“Maybe we want to think differently about our regulatory system and how we identify important exposures that are having adverse effects on whether people can get pregnant and have a healthy pregnancy,” Nobles says.
JOURNAL
Environmental Health Perspectives
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Preconception Phthalate Exposure and Women’s Reproductive Health: Pregnancy, Pregnancy Loss, and Underlying Mechanisms
ARTICLE PUBLICATION DATE
13-Dec-2023
Endocrine-disrupting chemicals found in menstrual products including tampons, pads, and liners
Endocrine-disrupting chemicals can interfere with human hormones and cause medical issues
Peer-Reviewed PublicationThe average menstruator will use over 11,000 tampons or sanitary pads in their lifetime. Vaginal and vulvar tissue that touch pads and tampons is highly permeable. Through this permeable tissue chemicals are absorbed without being metabolized, which makes endocrine-disrupting chemicals potentially dangerous when found in menstrual products. Endocrine-disrupting chemicals can interfere with human hormones and cause medical issues, including gynecological conditions such as endometriosis and uterine fibroids.
Joanna Marroquin, a Mason PhD in Public Health student, and Associate Professor Anna Pollack, reviewed studies conducted since 2103 that measured chemicals in menstrual products and that measured human biomarkers of chemical exposure and determined that endocrine-disrupting chemicals were found in menstrual products including tampons, pads, and liners.
“Identifying chemicals in menstrual products that menstruators regularly use is important because exposure through these products can impact menstruators’ reproductive health,” said Marroquin, the paper’s first author.
The study found that menstrual products contain a variety of endocrine-disrupting chemicals including phthalates, volatile organic compounds, parabens, environmental phenols, fragrance chemicals, dioxins and dioxin-like compounds.
This issue is even more relevant thanks to the Robin Danielson Menstrual Product and Intimate Care Product Safety Act of 2023, which was introduced in the U.S. House of Representatives in October 2023. The Act would establish a program of research regarding the risks posed by the presence of dioxins, phthalates, pesticides, chemical fragrances, and other components in menstrual products and intimate care products.
This literature reviewed 15 papers published between 2013 and 2023 that tested menstrual products in the U.S., Japan, and South Korea. The researchers note that there are few publications available that measure chemicals in menstrual products.
Additionally, though forever chemicals (PFAS) have been found in menstrual underwear, there is a lack of peer-reviewed research on menstrual underwear and other newly-popular-in-the-U.S. products such as menstrual cups and discs.
Chemicals in menstrual products: A systematic review was published in BJOG, an international journal of obstetrics and gynecology in September 2023. Additional authors include Marianthi-Anna Kiomourtzoglou from Mailman School of Public Health, Columbia University and Alexandra Scranton from Women's Voices for the Earth.
The research was supported by Pollack's National Institute of Environmental Health Sciences R01ES31079 award.
JOURNAL
BJOG An International Journal of Obstetrics & Gynaecology
METHOD OF RESEARCH
Systematic review
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Chemicals in menstrual products: A systematic review
Menstrual cycles affect day-to-day suicide risk, UIC researchers find
Female patients with a history of suicidality experience an increased risk of suicidal ideation or suicidal planning in the days surrounding menstruation, according to a new study by researchers at the University of Illinois Chicago.
In the first longitudinal study of how suicidal thoughts and related symptoms fluctuate across the menstrual cycle, UIC researchers identified when some female patients are at the highest risk, offering new guidance for clinicians about when to focus interventions with suicidal patients.
“As clinicians, we feel responsible for keeping our patients safe from a suicide attempt, but we often don’t have much information about when we need to be most concerned about their safety,” said Tory Eisenlohr-Moul, associate professor of psychiatry at UIC and senior author of the paper in the American Journal of Psychiatry. “This study establishes that the menstrual cycle can affect many people who have suicidal thoughts, which makes it one of the only predictable recurring risk factors that has been identified for detecting when a suicide attempt might occur.”
The American Journal of Psychiatry study, which is co-led by postdoctoral researcher Jaclyn Ross and MD/PhD student Jordan Barone, followed 119 patients who completed a daily survey to track suicidal thoughts and other mental health symptoms over at least one menstrual cycle. The design allowed the researchers to collect detailed data on changes in patients’ mental health over the course of their cycle. Previous research did not have this sort of tracking and only worked to estimate the timing of a person’s menstrual cycle status with a single timepoint after a suicide attempt.
Those past studies observed a pattern where suicide attempts increased in the days just before or after the onset of menses — the “perimenstrual” phase. The new UIC study replicated this pattern, finding that suicidal ideation was more severe and suicidal planning was more likely to occur during this point in the cycle compared to other phases.
The daily data also allowed the researchers to delve deeper into differences between individuals in how the cycle affects symptoms and suicidality.
“Previously, there haven’t been good predictors for why or when Person A is likely to make a suicide attempt versus when Person B is going to make an attempt,” Barone said. “Not everyone is hormone sensitive to the cycle in the same way, and we were able to statistically show the value of including individual differences in our models.”
Most patients in the study reported significant elevation of psychiatric symptoms such as depression, anxiety and hopelessness in the premenstrual and early menstrual phases, while others reported emotional changes at different times of their cycle. Individuals also varied in the specific psychiatric symptoms that appeared alongside suicidal thoughts.
“People differed in which emotional symptoms were most correlated with suicidality for them,” Eisenlohr-Moul said. “Just because the cycle makes somebody irritable or have mood swings or feel anxious, it doesn’t necessarily mean that that’s going to have the same effect on creating suicidality for each person.”
That observation fits with the broader research focus of Eisenlohr-Moul’s group, the CLEAR lab. The laboratory also studies premenstrual dysphoric disorder, a condition associated with an increased risk of suicidal thoughts and behaviors. Observational studies and clinical trials led by Eisenlohr-Moul have found that PMDD may result from some people’s heightened sensitivity to the reproductive hormones estrogen and progesterone — and stabilizing those hormones may lessen symptoms.
Similar dynamics of hormone sensitivity may be at play in the influence of the menstrual cycle upon suicidal thoughts in people without PMDD, the authors said. But more research is needed to determine how these factors affect each other in individual patients, and how that information could best be used clinically to prevent suicide attempts.
One idea is for patients to keep track of their mental health symptoms over the course of their cycle — as subjects did in the current study — to enable their clinicians to make personalized recommendations about their care.
“We’re excited to use the best methods out there to try to create individual prediction models for each person, so that we’re not putting people into a box,” Eisenlohr-Moul said. “We want to really figure out: does the cycle matter for this person, and then exactly how does it matter and how we can best intervene based on that information.”
Written by Rob Mitchum
JOURNAL
American Journal of Psychiatry
ARTICLE TITLE
Predicting Acute Changes in Suicidal Ideation and Planning: A Longitudinal Study of Symptom Mediators and the Role of the Menstrual Cycle in Female Psychiatric Outpatients With Suicidality
ARTICLE PUBLICATION DATE
14-Dec-2023
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