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

Aims of the study: Endometriosis is a prevalent gynecologic disorder in young women at reproductiveage but the underlying risk factors have not identified yet in Iran and other neighboringcountries. Persistent exposure to environmental endocrine disrupting chemicals (EDCs) in particulardioxins, PAHs and polychlorinated biphenyls (PCBs) with xenoestrogenic potentials have beenhypothesized in the etiopathogenesis of endometriosis .We aimed in the present study to investigatethe joint effects of endogenous and exogenous sources of estrogens on the incidence of endometriosisin Iranian women who born and lived in Tehran .Methods: The age matched study populationconsisted of 34 women with endometriosis and 100 healthy women who underwent surgery fromMarch 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 womenwith lower economical status (p= 0.001, OR=8.29 Cl95%, 3.37-20.37) was identified as the mostimportant risk factor of endometriosis. The prevalence of this phenomenon was higher in womenwith 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 environmentalxenoestrogens especially in women with lower economical status which may affect the endogenouslevels of estrogen in women with background factors.