The Potential Relationship Between Environmental Endocrine Disruptor Exposure and the Development of Endometriosis and Adenomyosis

Abstract

Women with endometriosis, the growth of endometrial glands and stroma outside the uterus, commonly also exhibit adenomyosis, the growth of endometrial tissues within the uterine muscle. Each disease is associated with functional alterations in the eutopic endometrium frequently leading to pain, reduced fertility, and an increased risk of adverse pregnancy outcomes. Although the precise etiology of either disease is poorly understood, evidence suggests that the presence of endometriosis may be a contributing factor to the subsequent development of adenomyosis as a consequence of an altered, systemic inflammatory response. Herein, we will discuss the potential role of exposure to environmental toxicants with endocrine disrupting capabilities in the pathogenesis of both endometriosis and adenomyosis. Numerous epidemiology and experimental studies support a role for environmental endocrine disrupting chemicals (EDCs) in the development of endometriosis; however, only a few studies have examined the potential relationship between toxicant exposures and the risk of adenomyosis. Nevertheless, since women with endometriosis are also frequently found to have adenomyosis, discussion of EDC exposure and development of each of these diseases is relevant. We will discuss the potential mechanisms by which EDCs may act to promote the co-development of endometriosis and adenomyosis. Understanding the disease-promoting mechanisms of environmental toxicants related to endometriosis and adenomyosis is paramount to designing more effective treatment(s) and preventative strategies.

Bisphenol S Increases Cell Number and Stimulates Migration of Endometrial Epithelial Cells

“…50 However, some studies suggest a potential relationship between environmental exposures to toxicants and the risk of adenomyosis. 50,51 Hence, it is tempting to speculate that the BPS-induced migration in endometrial epithelial cells that was observed in this study may also be observed in humans, implicating the role of BPS on the development of adenomyosis. It is important to note that the sample size used in this study was not large enough to show a statistically significant increase in the appearance of adenomyosis-like lesions after BPS versus vehicle treatment.…”

Anemia-Associated Platelets and Plasma Prothrombin Time Increase in Patients with Adenomyosis

“…It is suggested that patients with adenomyosis tend to be younger in the early stage of the disease, while those in the advanced stage of the disease tend to be older, indicating that age may also reflect the progress of the disease. Adenomyosis often coexists with endometriosis [ 38 , 39 ], and endometriotic stroma cells can secrete thrombin and thromboxane A2, inducing platelet activation and aggregation [ 40 ]. Hence, endometriosis may affect the results if adenomyosis is comorbid with endometriosis.…”

Data-Driven Medicine in the Diagnosis and Treatment of Infertility

“…Other studies observed a link between BPA and increased risk of miscarriage [ 76 ], and semen quality in men [ 74 ]. The relationship between EDCs and endometriosis is also being studied [ 77 ].…”