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A growing body of research is showing that our reproductive health may be affected by a range of chemicals present both in the environment and within consumer products.

These chemicals are known as endocrine-disrupting chemicals (EDCs) – substances that have been linked to an increased incidence of early puberty, pregnancy disorders, and other reproductive health abnormalities.

EDCs are relatively similar in structure to the female hormone estrogen.

The problem with this is that EDCs mimic real estrogen so well that they have the ability to bind to the body’s estrogen receptors, thus producing estrogenic effects.

They can also readily cross the placenta and mimic the action of estrogen in fetuses, which disrupts normal hormone response during fetal development.

During pregnancy, testosterone is the male sex hormone, or androgen, that is directly responsible for masculinizing the fetus during the first trimester.

Disruption from EDCs limits the effects of androgen and can result in abnormal fetal development.

Women should be particularly careful to avoid personal care products that might contain EDCs in their first trimester of pregnancy.

Our primary exposure to EDCs comes from the many consumer products that we use in our daily lives.

BPA (bisphenol A) is used to make things like plastic cups, plastic bottles, and food storage containers, and is also found in can lining.

DBP (dibutyl phthalate) is largely used in plastics to make them flexible, as well as in personal care products such as nail polish, perfumes, and lotions.

These chemicals can leach from plastics into your food following increased temperature exposure, such as through microwaving food.

DBP can also be absorbed through the skin when personal care products containing it are used.

EDCs are a lot more prevalent in our products than we might think, with a recent study from the University of Notre Dame in the United States revealing the extent.

The researchers conducted an analysis of more than 200 cosmetic products, including foundations, eye and eyebrow products, and various lip products.

The results indicate nearly 50% or more of these products likely contained a high level of per- and polyfluoroalkyl substances (PFAS) based on the presence of high levels of fluorine within the products.

Such products are being used around the mouth and eyes leading to a greater chance of ingestion or absorption.

“These results are particularly concerning when you consider the risk of exposure to the consumer, combined with the size and scale of a multibillion-dollar industry that provides these products to millions of consumers daily,” said study lead investigator and physics professor Dr. Graham Peaslee in a statement.

Effects of EDCs

Such chemicals are known to be endocrine disruptors as they are estrogen mimetics.

This means that they act like estrogen, but cause dysfunction instead as they are not being regulated by the body according to its needs as real estrogen hormones are.

As a result, when they get in the body, they start affecting processes like metabolism by binding to estrogen receptors and triggering pathways that perhaps shouldn’t be activated.

In an analysis of data from the US National Health and Nutrition Examination Survey (NHANES), 15 known toxicants were identified as contributors to early menopause in women, while other EDCs have been linked to earlier menarche.

Polycystic ovarian syndrome (PCOS) has also been associated to EDC exposure, particularly bisphenols.

EDCs have also been linked to neurodegenerative conditions like Parkinson’s disease and Alzheimer’s disease, obesity, attention deficit hyperactivity disorder (ADHD), metabolic disorders, and other reproductive disorders.

With reproductive disorders, it can manifest in the form of genital abnormalities.

Males in later adulthood may have low sperm count and impaired semen quality.

Together, these adverse disorders increase the risk for testicular germ cell cancer.

In a study published in The Journal of Clinical Endocrinology and Metabolism, the presence of di-n-octyl phthalate was associated with lower prenatal progesterone and greater postpartum depression months after delivery.

The study concluded that if phthalate exposure can be reduced through dietary and behavioral interventions, then “identifying prenatal exposure to phthalates is a potentially modifiable risk factor for postpartum depression”.

Avoiding EDCs

Products made out of PET (almost everything seen here) and PP (the red covers of the cookie jars) are generally safe to use for food storage.

EDCs can be categorized according to origin:

• Industrial, e.g. dioxins, polychlorinated biphenyls (PCBs), and alkylphenols
• Agricultural, e.g. pesticides, insecticides, herbicides, phytoestrogens, and fungicides
• Residential, e.g. phthalates, polybrominated biphenyls, BPA, and pharmaceutical (parabens)

Heavy metals such as cadmium, lead, mercury, and arsenic, should also be included in the list of EDCs.

The most common ways of exposure are through inhalation, food intake, and direct contact.

Pregnant mothers, in particular, should try to steer clear of harmful EDCs, especially during early pregnancy.

It is recommended pregnant women use personal care products that are labeled fragrance-free or phthalate-free during the first 12 weeks of pregnancy.

Another useful way to avoid contact with EDCs is to use glass containers for microwaving food.

Don’t leave canned or foods packaged in plastic containers in a hot car for long – plan your grocery days so that you go to and from the store without making any other stops.

Care should also be taken when choosing plastic food containers.

Check the bottom of your water bottles and plastic food storage containers for the resin identification code, which is usually indicated in a tiny triangle.

This code, ranging from one to seven, represents the type of plastic the container is made of:

• 1 is polyethylene terephthalate (PET)
• 2 is high-density polyethylene
• 3 is polyvinyl chloride (PVC)
• 4 is low-density polyethylene
• 5 is polypropylene (PP)
• 6 is polystyrene
• 7 contains different plastics, such as BPA.

The “safest” plastics are one, two, four, and five.

The American Academy of Pediatrics has cautioned against using plastics numbered three, six, and seven, as they are notoriously associated with endocrine disruption and other adverse outcomes.

It is important for pregnant mothers to understand the role that they play in protecting the future reproductive health of their children.

Educating women about EDCs, including guidance about potentially problematic ingredients in personal care products, may help reduce exposure.

Research in the area of EDCs continues to evolve with evidence supporting the hazardous effects of environmental EDCs on the endocrine system.

Still, we need further long-term studies to thoroughly verify and assess the causal relationship between EDCs and endocrine problems.

Improving biotransformation and aiding in the elimination of toxicants may also assist in fertility, and possibly overall health.

Functional medicine clinicians can guide patients on how to reduce their exposure to EDCs, and develop and organize individual treatment protocols to help the body deal with these toxicants, using diet, nutraceuticals, botanicals, pharmaceuticals, and behavioral interventions.

Datuk Dr. Nor Ashikin Mokhtar is a consultant obstetrician and gynecologist, and a functional medicine practitioner. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness, or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.