Infertility and uncontrollable bleeding from uterine fibroids can be brought on by toxic chemicals called phthalates, which are found in everything from fast-food packaging to plastic water bottles.
We found substantially greater concentrations of the phthalate DEHP and its breakdown products in the urine of women who also happened to have symptomatic uterine fibroid tumours. Next, we considered whether this link was caused by something. And the answer was yes,” stated Dr. Serdar Bulun, the study’s corresponding author. He is the head of the obstetrics and gynaecology division at the Feinberg School of Medicine of Northwestern University in Chicago.
Up to 80% of women will experience the development of one or more fibroids at some point in their life; some will also suffer from bleeding, anaemia, miscarriages, and infertility. The majority are not malignant.
Researchers examined primary cells taken from women’s fibroids for the study. The researchers discovered that a particular cellular pathway that promoted tumour growth was activated by something known as MEHHP, a breakdown product of DEHP.
Although earlier research consistently linked phthalate exposure to the development of fibroid tumours, this discovery explains how it occurs.
Despite the consequences of DEHP’s use being questioned, it is still widely utilised in the US. It gradually dissipates into the air and dust before landing on different surfaces.
Dr. Nathaniel DeNicola, the environmental health expert for the American College of Obstetricians and Gynecologists, explained that fibroids can be identified accidentally during a C-section or imaging, as well as after symptoms manifest.
Uncertainty exists on the root cause of these cancers.
According to DeNicola, preprogrammed cell death is a typical process for cells to go through. Most adults have about 50 million cells go through this process daily. They can proliferate and produce cancer or fibroids if they don’t die.
DeNicola stated that he believes it is plausible that these chemicals are causing fibroids based on this study and prior research.
He pointed out that the study’s use of urine samples from real people as opposed to animal models is one of its strengths.
The biological material used to compare the link between fibroids and this exposure came directly from the patient, according to DeNicola. “That’s a plus, then.”
However, this was not the gold-standard for this type of research—a randomised, controlled experiment.
The researchers’ discovery of a u-shaped curve when examining the association is encouraging, according to DeNicola. Risk increased with some exposure levels.
However, he added, “on the low end, you might look to that for perhaps some grace with these exposures.” It’s really difficult to demand, example, zero exposure to something as pervasive as phthalates, a chemical found in plastic and personal care items.
But he pointed out that people might be able to reduce their exposure. In the same manner that they do with nutrition, doctors may be able to advise patients on how to reduce their exposure to phthalates.
In order to reduce racial inequities, policymakers could also regulate personal care items, particularly beauty products. DeNicola cited other studies showing that phthalate levels in items targeted at women of colour were disproportionately high.
He advised anyone looking for strategies to reduce exposure to phthalates in their personal care items to look for products that specifically state they are phthalate-free. Instead of purchasing “unscented” items, which may still include phthalates used to bind different odours to mask an overt perfume, look for fragrance-free products. DeNicola advised against heating meals in plastic containers.
Although DeNicola acknowledged that it would be “reasonably hard” to totally ban phthalates from consumer products, “we want as little as feasible,” she added.
Bulun advised utilising glass containers instead of plastic bottles or plastic food packaging. Additionally, he warned against using PVC items.
Additionally, Bulun said, legislators may support and fund additional research, pass new laws, and outlaw the use of plastic bottles and bags.
“In my view, this is the most important topic that warrants study in terms of human health. This area needs a lot more research, he said.
Bulun speculated that novel therapies for uterine fibroids may be able to target the mechanism the researchers uncovered.
Estrogen and progesterone are essential for the formation of uterine fibroids. He suggested that researchers and medical professionals keep looking for temporary alternatives with few side effects to help women reduce ovulation at times when they are not interested in getting pregnant.
Because, in essence, repeated ovulatory cycles are necessary for the development of uterine fibroids, Bulun said.
The Proceedings of the National Academy of Sciences published the findings online on November 14.
Uterine fibroids are covered in further detail by the US Office of Women’s Health.
Serdar Bulun, MD, chair of the department of obstetrics and gynaecology at Northwestern University Feinberg School of Medicine in Chicago; Nathaniel DeNicola, MD, environmental health specialist at the American College of Obstetricians and Gynecologists; and Proceedings of the National Academy of Sciences, published online on November 14, 2022.