Increased risk of endometriosis by long term exposure to xenoestrogens: A case control study in Iranian women

Abstract

Aims of the study: Endometriosis is a prevalent gynecologic disorder in young women at reproductive<br />age but the underlying risk factors have not identified yet in Iran and other neighboring<br />countries. Persistent exposure to environmental endocrine disrupting chemicals (EDCs) in particular<br />dioxins, PAHs and polychlorinated biphenyls (PCBs) with xenoestrogenic potentials have been<br />hypothesized in the etiopathogenesis of endometriosis .We aimed in the present study to investigate<br />the joint effects of endogenous and exogenous sources of estrogens on the incidence of endometriosis<br />in Iranian women who born and lived in Tehran .Methods: The age matched study population<br />consisted of 34 women with endometriosis and 100 healthy women who underwent surgery from<br />March 2009 to March 2012 . Results: Out of evaluated exogenous sources of estrogen exposure,<br />living near xenoestrogen producing factories (p<0.001*, OR= 16.8, CI 95%5-56.8) in women<br />with lower economical status (p= 0.001, OR=8.29 Cl95%, 3.37-20.37) was identified as the most<br />important risk factor of endometriosis. The prevalence of this phenomenon was higher in women<br />with histories of malignancy in their first degree family (P=0.014, OR=3.08, CI95% 1.23-8.53),<br />infertility (p<0.001, OR=13.07, Cl95%, 5.14-33.23), hormonal dysregulations (p=0.003, OR=8.38,<br />CI95%, 2.03-34.61) and bipolar disorders (p=0.046, OR=3.44, CI95%, 1.11-10.68). Conclusion:<br />Incidence and development of endometriosis is dependent on long term exposure to environmental<br />xenoestrogens especially in women with lower economical status which may affect the endogenous<br />levels of estrogen in women with background factors.