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

Document Type : Short Communication


1 Department of Toxicology and Pharmacology, Islamic Azad University, Pharmaceutical Sciences Branch (IAUPS), Tehran - Iran

2 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences. Tehran, IR Iran


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