Perfluorochemicals and Endometriosis: the ENDO Study

Overview

Journal Epidemiology

Specialty Public Health

Date 2012 Sep 21

PMID 22992575

Citations 31

Authors

Germaine M Buck Louis

C Matthew Peterson

Zhen Chen

Mary L Hediger

Mary S Croughan

Rajeshwari Sundaram

Joseph B Stanford

Victor Y Fujimoto

Michael W Varner

Linda C Giudice

Anne Kennedy

Liping Sun

Qian Wu

Kurunthachalam Kannan

Affiliations

Soon will be listed here.

Abstract

Background: Environmental chemicals may be associated with endometriosis. No published research has focused on the possible role of perfluorochemicals (PFCs) despite their widespread presence in human tissues.

Methods: We formulated two samples. The first was an operative sample comprising 495 women aged 18-44 years scheduled for laparoscopy/laparotomy at one of 14 participating clinical sites in the Salt Lake City or San Francisco area, 2007-2009. The second was a population-based sample comprising 131 women matched to the operative sample on age and residence within a 50-mile radius of participating clinics. Interviews and anthropometric assessments were conducted at enrollment, along with blood collection for the analysis of nine PFCs, which were quantified using liquid chromatography-tandem mass spectrometry. Endometriosis was defined based on surgical visualization (in the operative sample) or magnetic resonance imaging (in the population sample). Using logistic regression, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) for each PFC (log-transformed), adjusting for age and body mass index, and then parity.

Results: Serum perfluorooctanoic acid (PFOA; OR = 1.89 [95% CI = 1.17-3.06]) and perfluorononanoic acid (2.20 [1.02-4.75]) were associated with endometriosis in the operative sample; findings were moderately attenuated with parity adjustment (1.62 [0.99-2.66] and 1.99 [0.91-4.33], respectively). Perfluorooctane sulfonic acid (1.86 [1.05-3.30]) and PFOA (2.58 [1.18-5.64]) increased the odds for moderate/severe endometriosis, although the odds were similarly attenuated with parity adjustment (OR = 1.50 and 1.86, respectively).

Conclusions: Select PFCs were associated with an endometriosis diagnosis. These associations await corroboration.

Citing Articles

Environmental Exposure to Per- and Polyfluorylalkyl Substances (PFASs) and Reproductive Outcomes in the General Population: A Systematic Review of Epidemiological Studies.

Haimbaugh A, Meyer D, Connell M, Blount-Pacheco J, Tolofari D, Gonzalez G Int J Environ Res Public Health. 2025; 21(12.

PMID: 39767456 PMC: 11675763. DOI: 10.3390/ijerph21121615.

Per- and Polyfluoroalkyl Substances (PFAS) Affect Female Reproductive Health: Epidemiological Evidence and Underlying Mechanisms.

Qu R, Wang J, Li X, Zhang Y, Yin T, Yang P Toxics. 2024; 12(9).

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Per- and Polyfluoroalkyl Substances (PFASs) and Their Potential Effects on Female Reproductive Diseases.

Yi Y, Feng Y, Shi Y, Xiao J, Liu M, Wang K Toxics. 2024; 12(8).

PMID: 39195641 PMC: 11358978. DOI: 10.3390/toxics12080539.

Effects of Per- and Polyfluoroalkylated Substances on Female Reproduction.

Gonzalez-Alvarez M, Antwi-Boasiako C, Keating A Toxics. 2024; 12(7.

PMID: 39058107 PMC: 11280844. DOI: 10.3390/toxics12070455.

Exposure to select PFAS and PFAS mixtures alters response to platinum-based chemotherapy in endometrial cancer cell lines.

Rickard B, Overchuk M, Tulino J, Tan X, Ligler F, Bae-Jump V Environ Health. 2023; 22(1):87.

PMID: 38098045 PMC: 10720226. DOI: 10.1186/s12940-023-01034-2.

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