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Learn proven functional medicine strategies for treating toxic exposures at the upcoming Environmental Health Advanced Practice Module. See full program details

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Endocrine-disrupting chemicals (EDCs) are natural or human-made chemicals present both in the environment and within consumer products and have been associated with a range of health concerns, from reproductive issues to diabetes development.^1,2 Specific to women, a wide array of additional health issues associated with EDC exposure have been reported such as early menarche,³ early menopause,⁴ irregular menstrual periods,³ polycystic ovary syndrome development,⁵ and increased risk of uterine and breast cancers.^6,7

Endocrine-Disrupting Chemical Exposure

EDCs can be grouped according to their origin as follows: industrial (e.g., dioxins, polychlorinated biphenyls [PCBs], and alkylphenols), agricultural (pesticides, insecticides, herbicides, phytoestrogens, and fungicides), residential (phthalates, polybrominated biphenyls, and bisphenol A [BPA]), and pharmaceutical (parabens); heavy metals such as cadmium, lead, mercury, and arsenic may also be included in the list of EDCs.⁸ The most common exposure pathways are through inhalation, food intake, and direct contact.⁸

Personal care products, marketed uniquely to women, are a specific source of EDC exposure. Some of the most widely found EDCs in personal care products include:⁹

• Bisphenols
• Parabens
• Benzophenones
• Phthalates

Toxins have been known to be endocrine disruptors, and what that means is that these toxins are estrogen mimetics—they act like estrogen, but they are dysfunctional hormones. As a result, they get in and they start changing things like metabolism; they start binding to receptors and upregulating things that perhaps shouldn’t be upregulated.

-IFM educator Deanna Minich, PhD, FACN, CNS.

In the following video, Dr. Minich discusses her concerns about endocrine-disrupting chemicals.

Bisphenols & Female Health

Exposure to bisphenol A (BPA) is ubiquitous, with more than 95% of Americans having traces of BPA in their bodies,¹⁰ and recently, the European Food Safety Authority recommended to substantially lower the BPA daily exposure threshold deemed safe to humans.¹¹ However, research studies suggest that exposure to BPA, even at low doses, may result in adverse health effects.¹² These may include:³

• Endocrine disruption
• Tumors
• Adverse reproductive outcomes
• Transgenerational effects

A 2023 case-control study investigated the association between bisphenol analogs, including BPA, and odds of a PCOS diagnosis, as well as hormonal parameters among women (n=733 PCOS cases and controls).⁵ Researchers found that BPA and some analogs were significantly positively correlated with testosterone levels, and mixed exposure to several bisphenol analogs was significantly positively associated with odds of PCOS, with stronger associations among women with BMIs that indicated overweight or obese.⁵

BPS is an industrial alternative to the endocrine disruptor BPA and may be found in some products labeled “BPA-free.” Data on current human exposure levels of BPS and bisphenol F (BPF), which is also being used to replace BPA, is reflected in NHANES 2013-2014 data.¹⁰ BPA, BPS, and BPF were detected in 95.7, 89.4, and 66.5% of randomly selected urine samples, respectively, indicating that exposure of the general US population to BPA and its substitutes may be nearly ubiquitous. According to the European Chemical Agency, 1,000 to 10,000 million metric tons of BPS are manufactured or imported annually to the European Economic Area alone.¹⁰

Clinical Applications: Education & the Functional Medicine Approach

Educating women about EDCs, including guidance about potentially problematic ingredients in personal care products, may help reduce exposure. Research suggests that many people may be unaware of the sources of endocrine disruptors, and cumulative BPA exposure, for example, may be reduced using BPA-free cosmetics and glass food and water containers.¹³

In addition to education, the functional medicine model emphasizes the importance of supporting the body’s natural ability to eliminate toxicants. Optimizing a patient’s nutritional status, ensuring adequate fiber and water intake, eating more phytonutrient-dense and diverse foods, and supporting liver function through targeted, nutrient-dense diets are all dietary treatment approaches within the functional medicine model that may be implemented to help support the elimination of toxic compounds and alleviate toxic burden.

Individual intake assessments are integral in functional medicine care for helping identify and evaluate patterns of potential toxic exposures. Functional medicine clinicians guide patients on how to reduce their exposure to EDCs and develop and organize individual treatment protocols to help the body address these toxicants using a multi-pronged approach. Learn more about these clinical tools at IFM’s upcoming Environmental Health Advanced Practice Module (APM).

Related Articles

Endocrine Disruptors and Type 2 Diabetes

Exposure to Pesticides, Herbicides, & Insecticides: Human Health Effects

Pollutants and the Healthy Child

References

1. Di Nisio A, Foresta C. Water and soil pollution as determinant of water and food quality/contamination and its impact on male fertility. Reprod Biol Endocrinol. 2019;17(1):4. doi:1186/s12958-018-0449-4
2. Ahn C, Jeung EB. Endocrine-disrupting chemicals and disease endpoints. Int J Mol Sci. 2023;24(6):5342. doi:3390/ijms24065342
3. Gonsioroski A, Mourikes VE, Flaws JA. Endocrine disruptors in water and their effects on the reproductive system. Int J Mol Sci. 2020;21(6):1929. doi:3390/ijms21061929
4. Aydemir D, Ulusu NN. The possible role of the endocrine disrupting chemicals on the premature and early menopause associated with the altered oxidative stress metabolism. Front Endocrinol (Lausanne). 2023;14:1081704. doi:3389/fendo.2023.1081704
5. Zhan W, Tang W, Shen X, Xu H, Zhang J. Exposure to bisphenol A and its analogs and polycystic ovarian syndrome in women of childbearing age: a multicenter case-control study. Chemosphere. 2023;313:137463. doi:1016/j.chemosphere.2022.137463
6. Chang CJ, O’Brien KM, Keil AP, et al. Use of straighteners and other hair products and incident uterine cancer. J Natl Cancer Inst. 2022;114(12):1636-1645. doi:1093/jnci/djac165
7. Wan MLY, Co VA, El-Nezami H. Endocrine disrupting chemicals and breast cancer: a systematic review of epidemiological studies. Crit Rev Food Sci Nutr. 2022;62(24):6549-6576. doi:1080/10408398.2021.1903382
8. Lauretta R, Sansone A, Sansone M, Romanelli F, Appetecchia M. Endocrine disrupting chemicals: effects on endocrine glands. Front Endocrinol (Lausanne). 2019;10:178. doi:3389/fendo.2019.00178
9. Chan M, Mita C, Bellavia A, Parker M, James-Todd T. Racial/ethnic disparities in pregnancy and prenatal exposure to endocrine-disrupting chemicals commonly used in personal care products. Curr Environ Health Rep. 2021;8(2):98-112. doi:1007/s40572-021-00317-5
10.  Lehmler HJ, Liu B, Gadogbe M, Bao W. Exposure to bisphenol A, bisphenol F, and bisphenol S in U.S. adults and children: the National Health and Nutrition Examination Survey 2013-2014. ACS Omega. 2018;3(6):6523-6532. doi:1021/acsomega.8b00824
11.  Vom Saal FS, Antoniou M, Belcher SM, et al. The conflict between regulatory agencies over the 20,000-fold lowering of the tolerable daily intake (TDI) for bisphenol A (BPA) by the European Food Safety Authority (EFSA). Environ Health Perspect. 2024;132(4):45001. doi:1289/EHP13812
12.  Dueñas-Moreno J, Mora A, Kumar M, Meng XZ, Mahlknecht J. Worldwide risk assessment of phthalates and bisphenol A in humans: the need for updating guidelines. Environ Int. 2023;181:108294. doi:1016/j.envint.2023.108294
13.  Chung C, Park J, Song J-E, Park S. Determinants of protective behaviors against endocrine disruptors in young Korean women. Asian Nurs Res (Korean Soc Nurs Sci). 2020;14(3):165-172. doi:1016/j.anr.2020.07.002