Endometriosis and toxins

The number of women who are estimated to have endometriosis is between 10 and 15% of those of reproductive age. We are, therefore, facing a health problem that has a very significant incidence (and that it is likely that in many cases is being underestimated for a number of reasons).

The problem, in this case in the abdominal wall

The symptoms associated with endometriosis can be very diverse and range from severe pain in the lower abdomen (which is the most common symptom), especially intense before and during menstrual periods, to fatigue or bladder, intestinal or immune problems (such as allergies, eczema, food intolerance, …), for example. It should also not be overlooked that one of the most serious consequences of this disease is its link to female infertility. Between 30 and 50% of women with fertility problems have endometriosis, according to the sources consulted.

One of the most radical consequences is that it often forces the performance of a hysterectomy , depriving women of one of their most sacred organs. Thousands of women are forced to do so every year.

Moreover, as is often the case with other diseases for which, as with this one, there are more than likely environmental links (and it seems that with a very small weight of the genetic), the incidence of endometriosis seems to be growing. Only 20 reports of this disease had been published in the world’s scientific literature before 1921, and, regardless of the imperfection of the data that may have existed long ago, it seems clear that the disease has grown very considerably since the Second World War (when, incidentally, the expansion of the planetary chemical industry really began).

Disease occurs when, for a variety of reasons, tissue of the type that should only be found lining the interior of the uterus grows outside the place where it should naturally be found. For example, outside the uterus, on the ovaries, in the fallopian tubes, on the bladder, in the intestines,… or even in more distant areas such as an arm or the lungs. In the uterus this tissue will end up being expelled with the menstruation, but out of place this option does not exist and a series of problems are generated.

It is always complex to establish a cause for many diseases. Many illnesses do not have a single cause. But it is evident that, alone or in the company of other causes, according to a growing number of scientific studies that are being carried out, the presence of a series of chemical substances that can have serious effects of altering the hormonal balance of the female body, can be playing an important role in the initiation and subsequent development of the disease.

It is a scientifically proven fact that in the bodies of men and women in Western countries there are a vast number of chemical pollutants that did not exist in our bodies only a few decades ago. And more and more studies not only confirm this fact but also establish that these substances, at the “low” levels of concentration at which they are normally detected in a large part of the population, can have notable biological effects, causing a series of disorders. This has been seen for many diseases. And endometriosis need not be an exception, especially since many of the contaminants referred to have the quality of altering the hormonal balance, and endometriosis in a disease in which a malfunctioning of the immune and endocrine systems seem to have much to do with it.

There are several theories about the mechanics of endometriosis. One, for example, postulates that endometrial cells would migrate out of the endometrium through various possible pathways. Another one, aware that endometrial cells and cells lining the peritoneum (outside the uterus) come from the same precursor cells during embryonic development, postulates that an alteration of the precursor cells in very early stages may cause cells to be outside the uterus that have evolved in an inadequate way and then behave like endometrial cells by responding to the same hormonal stimuli. But none of these theses precisely closes the door to the fact that, in any case, a disruption of the chemical signals could favour what is happening. Especially if we take into account that, as already mentioned, many contaminants have hormonal alteration effects. Knowing the role of oestrogens in endometriosis, it is not so difficult to understand what can be represented by our bodies being full of artificial substances, some in one concentration, others in another which, for example, can have oestrogenic or anti-oestrogenic effects, depending on the substances or cases.

Nor does the incorrect functioning of the immune system help to remove the suspicion of the influence of polluting substances, as it is well known that one of the main effects of these substances, in some cases the same as those that various studies have associated with endometriosis, is precisely that of damaging the immune system in one way or another.

But apart from the speculations that could be made with more or less basis there are a series of clear and proven facts that we will now comment on.

Various scientific studies have established an association, in some cases very strong, between the presence of a series of toxic substances that are very common in the industrialised world, and endometriosis. The presence of these contaminating substances in people’s bodies is so frequent that it can be said that practically nobody is free from having them in their bodies.

These substances include dioxins, furans and PCBs. Dioxins, for example, are carcinogenic substances that act as a hormone disruptor and are released, inter alia, when certain types of plastics are incinerated. They are also emitted by certain industries or released into the atmosphere, water or soil (e.g. some plastics manufacturers, cement and paper mills). They are very persistent in the environment and accumulate in living beings, reaching humans especially through the diet.

PCBs are a very large group of substances -more than 200- that were widely used as refrigerants in electrical transformers, lubricants, hydraulic fluids, insulating oils, fireproofing products for wood, paints,… They are highly persistent and bioaccumulative substances so, in spite of having been banned in many countries, they are still present in living beings. So today, probably the greatest route of human exposure to these chemicals is through food. Among the PCBs there are substances that are neurotoxic, anti-thyroid and immunotoxic, especially when exposure occurs in the embryonic period.

Many of these toxins can reach us through the most diverse contaminated products (fish, meat, milk,…) and are known to cause effects at very low levels of concentration. A very general advice that could be given in the interest of prevention is to avoid excessive intake of animal fats since these types of toxins tend to accumulate in fatty tissue. In any case, as previously stated, almost everyone has the presence of these contaminants in their bodies.

The most diverse research has been carried out showing that these substances can contribute to the development of endometriosis, both in animals and in people.

In 1993, a study found that a group of macaques that had been fed a diet contaminated with low levels of dioxins for years showed a very high incidence of the disease, more than double that of those that had not been fed such a diet ( Rier S. et al. 1993. Endometriosis in Rhesus monkeys (Macaca mulatta) following chronic exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Fundams Appl Toxicology 21: 433-441 ). The study was prolonged in another one, years later, which showed that endometriosis also had a higher incidence among those animals that had had a higher exposure to dioxin-like PCBs ( Rier S. et al. 2001.Serum levels of TCDD and dioxin-like chemicals in Rhesus monkeys chronically exposed to dioxin: correlation of increased serum PCB levels with endometriosis. Toxicol Sciences 59: 147-159 )- It should be noted that the levels of contaminants in these monkeys are similar to those found in humans.

In addition, further experiments were carried out which showed that dioxin favoured the growth of endometrial cells outside the uterus in rodents or monkeys and various factors that could have an influence (such as those discussed in the article “Dioxins and endometriosis: a plausible hypothesis”) published in January 2002 in the journal Environmental Health Perspectives).

Similar results to those obtained in animals have been seen in women. For example, a study conducted on women who were exposed to dioxin contamination from the famous Seveso industrial accident in Italy had twice the incidence of endometriosis than those who were not exposed at that level. An Israeli study showed that women with endometriosis were much more likely to have detectable levels of dioxins (“Dioxin concentrations in women with endometriosis”. Human Reproduction (12) 1997)

Given the widespread exposure to dioxins in the world today, it is likely that in the interest of preventing the onset of the disease as well as reducing its expression once it has begun, efforts should be made to reduce the exposure of women to these contaminants. Dioxins are also a group of substances that have been linked, to a greater or lesser extent, as has already been said in part, to various other health problems ranging from suppression of the immune system to non-Hodgkin’s lymphoma, soft tissue sarcoma, hepatitis, altered sex ratios, diabetes, breast cancer, thyroid problems, low fertility, and a long list.

There have been some very compelling articles published on PCBs and their association with the disease. One of the clearest was the one published in the journal Human Reproduction , which showed a really considerable increase in risk , in the order of several times higher, depending on whether women had a certain presence of some of these substances in their bodies.

There are other studies that link endometriosis with certain other pollutants with effects similar to those of oestrogens. For example, diphenyl ether chloride or the pesticide methoxychloride has been shown to promote the growth of endometriosis cells in rodents.

But the fact is that the contaminants that can have more or less similar effects are many and are often found in the bodies of most Western women, forming complex chemical “cocktails”. They are alkylphenols present in detergents, pesticides that have been widely used in Spain such as endosulfan , plastic components and epoxy resins such as the famous bisphenol A,… and many other substances, whose possible contribution to endometriosis should be thoroughly studied (to determine whether the associations that have been found in other compounds exist).

One of these types of substances, widely used and present in countless products of daily use and, of course, detected in the blood of most Westerners, is phthalates.

Some scientific studies have been carried out on phthalates and endometriosis, finding an association between the presence of these substances and the disease ( Corbellis L et al (2003) High plasma concentrations of di-(2-ethyl-hexul)-phtalate in women with endometriosis.Hum Reproduction; 18 (7): 512-519 ). On phthalates and their effects in general, I recommend that you consult this article in this same space on the web, so that you can see how widespread exposure to these substances is.

Some data are curious, such as those that associate a slightly higher incidence of the disease with an early onset of the age of menstruation, if we take into account that there are various indications that would link in some case such signs of progress with exposure to various substances such as phthalates.

In addition, women with Endometriosis are at increased risk for other problems which, to a greater or lesser extent, have also been associated with exposure to a range of pollutants. We have already mentioned the increased risk of infertility, for example. Female infertility has been linked by countless scientific studies to various hormonal pollutants, glycol ethers, perfluorinated compounds, pesticides, PCBs, … and many other substances. Also other problems for which those affected by endometriosis are at greater risk, such as ovarian cancer, breast cancer, melanoma or non-Hodkinson lymphoma, have each been associated with exposure to various pollutants. The same goes for other problems to which those affected by endometriosis would be more prone, ranging from elasma, to chemical sensitivities, to auto-immune diseases. All of these things, interestingly enough, can have the common denominator of exposure to toxic chemicals.

In addition to chemical pollutants, there are other pollutants that have been associated with endometriosis. For example, radiation. It was also the macaques who suffered the consequences that should have served, but probably have not served properly until now, to warn women about the environmental risks associated with their disease. The experiments carried out showed how exposure to radiation dramatically increased the risk of developing this disease.

In short, as far as is known, it is likely that both to prevent the disease and to encourage the improvement of women who already have it, and in accordance with an inexcusable principle of precaution, all measures of awareness, research, legislation, etc., that result in guaranteeing the reduction of the exposure of the female population to a series of pollutants, will be taken.

IF YOU THINK IT IS IMPORTANT TO WORK TO RAISE AWARENESS OF THESE RISKS AND TO ENSURE THAT THEY ARE MINIMISED, JOIN US

LINK TO AN ENDOMETRIOSIS ASSOCIATION THAT REPORTS LINKS TO TOXINS:

http://www.endometriosisassn.org/environment.html

RECOMMENDED READING (because it is a good synthesis of what science knows about it): Endometriosis: Peer-Reviewed Analysis (CHE)

• Fodesam supports a manifesto for women with endometriosis, a disease that research links to toxic chemical exposure