Over the years there has been a steady
rise in women's health
conditions such as breast cancer, fibroids, endometriosis, miscarriage,
and infertility. There also has been a rise in conditions such as fibromyalgia,
chronic fatigue syndrome and hypothyroidism, which mostly affect women.
Studies show that human exposure to chemicals in our environment such
as pesticides, herbicides, insecticides, and manufacturing by-products,
can cause these endocrine disrupting conditions.
An endocrine disruptor is any substance that alters normal hormone levels or
activity in the body. Synthetic chemicals can disturb the normal activity of
estrogens, androgens, thyroid and other hormones.1 They do so by binding directly
to hormone receptors, activating it and causing the chain of events as if the
hormone itself were binding to the receptor.1-3 The toxic chemical may also
bind and occupy the receptor, blocking normal hormonal activity, or it may
interfere with proteins that regulate the activity of hormones.1-5 These effects
may be associated with the development of illness and disease.
We are exposed to endocrine-disrupting compounds in our everyday life, often
without knowing we are being exposed. Pesticide residues can be found on fruits
and vegetables sitting in the store to be sold.9 Animal products are tainted
with dioxins and dioxin-like compounds and often have hormones and antibiotics
added to them.9 Certain fish have high levels of mercury and pesticides.9,14
Chemicals used as plasticizers in flexible polyvinyl chloride products can
harm the female reproductive system. Polyvinyl chloride products include tablecloths,
shower curtains, soft-squeeze children's toys, plastic medical equipment
and plastic food wrappings.The plastic containers that food and condiments
are stored in can leach out harmful chemicals.10,26 Hormone disrupting compounds
can be found in both well water and city water providing yet another means
of exposure.9 Toxic compounds are also inhaled or absorbed through the skin
by contact with most household cleaning products, cosmetics, perfumes, dry
cleaning, carpet, vinyl floors, copy machines, furniture glues, air fresheners,
mattresses, shampoos, and the list goes on.11,12
Some of the most common endocrine disrupting compounds include dioxins, polychlorinated
biphenyls, bisphenol-A, phthalates, pesticides, formaldehyde and heavy metals.
All have been shown to cause adverse health effects in women.2,3,15 There are
many other chemicals, compounds and by-products in the environment that are
considered toxins as well.
Dioxins are a byproduct produced by industrial incineration and combustion.
They are produced by manufacturing of chlorine-containing products such as
pesticides, wood preservatives and the bleaching of paper. Dioxins persist
in the environment for years and accumulate in the food chain. Dioxins decrease
thyroid hormones, testosterone and have both estrogenic and anti-estrogenic
effects.26 Dioxins are linked to endometriosis and thyroid dysfunction in women,
as well as increased rates of stillbirths.16-21,35,37
Polychlorinated biphenyls (PCBs) are used as coolants, lubricants,
and insulation for electrical equipment, in paints, plastics, dyes, wood and
rubber. PCBs accumulate in human adipose, the food chain, and are found
in rivers and lakes. PCBs weaken the immune system, affect neurological
development, behave like estrogen and affect thyroid function in rats and humans.22,23,35,36
Bisphenol-A is a compound found in plastics. It is used in the manufacturing
of compact disks, plastic bottles, the lining of metal food cans, and dental
sealants. It leaches out of plastics into food and the environment. Bisphenol-A
has estrogen-like effects on estrogen receptor positive breast cancer cells.24
Phthalates are additives to plastics to make them strong, soft, and flexible.
Most supplements are packaged in plastics made with phthalates. It is used
in carpet backing, paints, glues, insect repellants, hair spray, and nail polish.
Phthalates are used in personal care products such as lotions, hair color,
shampoo and deodorants. Phthalates are also used in the manufacture of enteric
coated medications, like Asacol, for example.39 Phthalates have hormone disrupting
effects and can suppress ovulation, estradiol production and contribute to
polycytic ovarian syndrome.10,26,27 In rats phthalates cause spontaneous abortion
and birth defects.37
Harmful pesticides such as DDT and its metabolite DDE have been banned in this
country but their effects still linger in our environment. DDT was an insecticide
used in agriculture and for mosquitoes. It has estrogen effects and anti-androgen
effects as well as effects on cognition. Pesticides have been linked to infertility,
spontaneous abortion and breast cancer.37,38 DDT still persists in the environment,
accumulated in adipose tissue and in the food chain.9,28-31
Formaldehyde is a compound originally used in homes in the 1970s as
a form of insulation. The fumes caused depression, fatigue, poor memory, headaches,
asthma, cough, skin rashes, and much more.12 Formaldehyde is no
longer used in insulation but is found in shampoo, conditioners, cosmetics,
materials, cleaning supplies, carpet, paper products, plastics, and the list
goes on.12,32 It has been linked to reduced fertility, spontaneous abortion,
Various heavy metals can be considered endocrine disruptors and are linked
to many women's health conditions. Exposure to low levels of cadmium
is associated with an increased risk of osteoporosis and fractures.40,41 Low-to-moderate
lead exposures may increase the risk for spontaneous abortion.42,43 There is
also a link between mercury, manganese and lead exposure and reduced fertility.44,45
A recent study by Darbe PD, in the Journal of Applied
found a high concentration of parabens in human breast tumors. This is significant
due to the amount of parabens and methylparabens women are exposed to each
day. Parabens are used as preservatives in thousands of cosmetics, food and
pharmaceutical products including hormonal creams. Parabens are known endocrine
Evaluating whether or not a patient's health condition is due to environmental
exposure begins in the office with an in-depth exposure history. Start by making
a time-line of the patient's symptoms, where they were living and working
during these symptoms and when they last felt well. An in-depth history of
residence, occupation, hobbies and lifestyle can help narrow down what they
may have been exposed to over time. Testing can provide valuable information
on recent exposure as well as retention of compounds in the body. Testing for
heavy metals, pesticides, solvents, phthalates and other compounds is available
from various labs.
It is important to be familiar with the link between women's health
conditions and environmental toxins, in order to educate patients in ways to
minimize exposure to these compounds. Avoiding endocrine disrupting compounds
begins simply with choices made at home and at the store.
1. Buy organic fruits and vegetables grown without pesticides, herbicides,
synthetic fertilizer or hormones.
2. Buy fresh/frozen fruits and vegetables when possible, avoiding canned foods.
3. Buy organic hormone-free meats, eggs, and dairy products and avoid eating
the fat of the animal.
4. Buy grass fed and lower fat animal products.
5. Eat fish low in mercury and fat since toxins accumulate in the fat of fish.
6. Avoid: tilefish, tuna, swordfish, shark, king mackerel, red snapper, orange
roughy, moonfish, bass, marlin, and trout.
7. Drink filtered water out of glass jars or cups instead of plastic bottles.
8. Buy natural chemical and fragrance free soaps, detergents, and cleaning
9. Use natural pest control instead of pesticides and instead of herbicides
for your lawn. Change your mind on what looks beautiful.
10. When remodeling look into earth friendly or 'green' building
11. Remove shoes when entering the house to prevent tracking residues into
12. Use a high quality air purifier in the home.
13. Use natural/organic cosmetics and grooming products free of phthalates
14. Use a non-toxic 'green' dry cleaners.
15. Avoid plastics as much as possible.
a. Store food in glass or ceramic containers.
b. Do not heat food in plastic containers or with plastic wrap over
c. Buy condiments in glass containers instead of plastic.
d. Use an organic fiber shower curtain instead of plastic.
e. Carry cloth bags in your car for groceries instead of plastic
f. Replace vinyl miniblinds with linen curtains
g. Use metal hangers instead of plastic.
16. Visit www.ewg.org for a list of foods lowest in pesticides and
fish lowest in mercury.
It is important to educate ourselves and others about the links between environmental
toxins and women's health. It is equally important to get politically
involved in local and national organizations to help put an end to the manufacture
and use of toxic compounds. Physicians for Social Responsibility, www.psr.org,
is one group committed to informing practitioners and the public about endocrine
disrupting compounds. Many states have environmental organizations such as
The Oregon Environmental Council; that has lectures for health care providers
and the public.
When educating patients on how to avoid endocrine disrupting compounds, it
becomes obvious that the natural products industry needs to explore alternatives
to delivering foods and medicinal agents in plastic packaging. Despite cost
increases and shorter shelf life, hopefully we will see more glass bottles
for supplements, less products with parabens, and less plastics in packaging
of juices, foods and dairy products.
Marianne Marchese is a naturopathic physician practicing in Portland,
Oregon at A Woman's Time.
Correspondence can be addressed to Dr. Marchese at email@example.com
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2. Having Faith and Living Downstream by Sandra Steingraber
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