Bisphenol-A (BPA), BPA Glucuronide, and BPA Sulfate in Midgestation Umbilical Cord Serum
A new study in California found Bisphenol-A in all samples of umbilical cord blood obtained from pregnant women, suggesting universal fetal exposure. More than one-third of the samples had levels comparable to or higher than levels associated with health effects in animals.
Bisphenol-A (BPA) is an endocrine disrupting chemical used in numerous consumer products, resulting in universal exposure in the United States. Prenatal exposure to BPA is associated with numerous reproductive and developmental effects in animals. However, little is known about human fetal exposure or metabolism of BPA during midgestation. In the present study, we present a new liquid chromatography-tandem mass spectrometry method to directly measure concentrations of BPA and two predominant metabolic conjugates—BPA glucuronide and BPA sulfate—in umbilical cord serum collected from elective second trimester pregnancy terminations. We detected at least one form of BPA in all umbilical cord serum samples: BPA (GM 0.16, range <LOD-52.26 ng/mL), BPA glucuronide (GM 0.14, range <LOD-5.41 ng/mL) and BPA sulfate (GM 0.32, range <LOD-12.65 ng/mL). Levels of BPA ranged from less than 1/100th to over 400 times higher than levels of BPA in conjugated form. Although levels of BPA in conjugated form exceeded BPA levels in about 3/4 of the samples, BPA levels were higher in samples with total BPA above the median. Our findings suggest universal fetal exposure to BPA in our study population, with some at relatively high levels, and we provide the first evidence of detectable BPA sulfate in midgestation fetuses.
Model, actress and billboard recording artist Amy Weber opens up about her struggle to become a mother after undergoing treatment for cervical cancer, brought on by a now banned pregnancy drug called DES. In May 2009, Amy was finally able to fulfill her dream of becoming a mother. See what she went through during her high-risk pregnancy, and meet her family!
Ms. Denice Whalen-White is the Founder and President of the non-profit organization All Shades of Pink, Incorporated. Her passion is to help families and assist individuals in understanding the seriousness of breast cancer and how it is a disease that does not always mean lost of life.
” As individuals we must be willing to get to know our bodies and become aware of any change from yesterday, last week, last month or last year. So when women tell me they have a family history of breast cancer and are doing nothing to manage their breast health because they prefer not to know, I am left speechless. “
” I spent the first half century of my life searching for the reason I was assigned, reared, and living as a man even though I knew I was female. As a child it was utterly confusing, and when coming out to my parents led to threats of incarceration in the state mental hospital, being the smart little kid that I was, I went silent and focused on trying to determine the causes of my misery. I could never imagine, in my wildest dreams or fantasies, ever transitioning and living full-time as myself; I couldn’t even imagine spending even a day in public as a woman. So I focused my attention on an academic future, scouring all the major libraries in the northeast, reading everything I could about gender variant behavior, trying to understand how I became who I was.
My cover being near perfect, I could do this research without arousing suspicion. I could even ask my mother questions about her pregnancy with me, and my brother, and try to tease out some information that might help me. One day she mentioned having taken the drug, DES, or diethylstilbestrol, to prevent miscarriage. Having miscarried her first time around, and being the dutiful woman that most were back in the early 50’s, she took this drug which had come highly touted from the Harvard labs. She told me she was always concerned about her exposure, but could never really learn anything about it, and was afraid to speak out. I, however, as a medical student, was under no such constraints. So I learned that the drug had been banned by the FDA in 1971 after having been tied to a cluster of eight cases of vaginal adenocarcinoma in very young women. This been unheard of in the Boston area, epidemiologists eventually traced the tumor to DES exposure in utero, and the drug was pulled.
Eventually I learned about additional long-term consequences of DES exposure, but the vast majority of them were in those assigned female. Even female homosexuality was recognized as a complication, along with breast cancer in the mothers as well as daughters, and an epidemic of infertility. A group, DES Action, sprang up in the 1970’s, fueled by the young women’s movement and books such as “Our Bodies, Our Selves.” Lawsuits were filed and won, Congress got into the act, and DES was eventually recognized as the worst drug disaster in American history. 5 million women were poisoned, and while the vaginal tumor developed in only 1:1000, it was still a true tragedy.
But what about those assigned as male? Nothing. While males were part of the few long-term follow-up studies, nothing more than a whisper of testicular cancer or a variety of genito-urinary tract anomalies popped up. DES Action put a man with brain cancer as the front for a DES Sons group, yet he didn’t even have internet or email capabilities, effectively shutting down any effective advocacy for those men.
We all know men are uncomfortable with their bodies, and don’t like to talk about their medical problems. The DES researchers, generally men, were not investigating issues of human sexuality either, so it became very easy to announce that the drug has no effects on male offspring. This in spite of the fact that DES was a super-estrogen, capable of crossing the placental and blood-brain barriers, and bathing the developing male brain with an overdose of estrogen before neurodevelopment had progressed very far. Those dosages of estrogen sure seemed to be capable of overwhelming the testosterone produced by the fetus’s testes, but the possibility was not taken seriously. Except by basic science researchers, such as Professor John McLachlan of Tulane University, who studied DES’ effects on rodents.
At a Congressional hearing on DES in 2001 I bumped into the good Professor and recounted my personal history. He told me that my medical history was classic for DES exposure, referred me to his papers, and I finally had my answers. Funny thing, by that time I had decided I could no longer live as a male and had decided to transition, so it no longer mattered to me existentially. But I had the answer.
As the medical advisor to Dr. Scott Kerlin’s DES Sons International Listserve, I had been toying with outing myself as transgender. Finally, I came out, and that opened the door to hundreds of other exposed DES “Sons.” Strange how things happen. That flood inspired Scott to start collecting data online, leading to his presentation of a paper at the e.hormone conference at Tulane in 2004, and my presentation, along with the nationally renowned intersex expert, Dr. Milton Diamond, of an expanded version of the paper, at the International Behavioral Development Symposium in Minot, North Dakota, in 2005. All the heavy hitters were there – Bailey, Blanchard, Zucker, Meyer-Bahlburg – and while they were able to ignore the paper because of our lack of proof in medical histories which had been destroyed decades earlier, the younger and more open-minded researchers accepted our thesis. Shortly thereafter Shanna Swan published her paper proving, for the first time in humans, that endocrine disruptors, of which DES is the paradigmatic compound, caused feminization of male fetuses. This past summer Congress banned the importation and sale of children’s toys containing one of the more ubiquitous EDCs, a class of molecules called phthalates.
Progress may come slowly, in fits and starts, but it does come. It will come, if people will it to happen. ”
” The forthcoming article in JLME also presents systematic, quantitative evidence that since the industry started making large contributions to the FDA for reviewing its drugs, as it makes large contributions to Congressmen who have promoted this substitution for publicly funded regulations, the FDA has sped up the review process with the result that drugs approved are significantly more likely to cause serious harm, hospitalizations, and deaths. ”
Your fertility is mostly determined by genetics, which influences how many eggs you are born with
Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.
Regular menstrual cycles are a sign of regular ovulation
Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).
Basal temperature charting does not predict ovulation
An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).
Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection
About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected.
In most cases, stress does not cause infertility
Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.
By age 44, most women are infertile, even if they are still ovulating regularly
Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40’s with fertility treatment are using donated eggs from younger women.
Having fathered a pregnancy in the past does not guarantee fertility
Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!
For the most part, diet has little or nothing to do with fertility
Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.
Vitamin D may improve results of fertility treatments
A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.
Being either underweight or overweight is clearly linked with lowered levels of fertility
The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.
A new government study shows the percentage of married couples having trouble conceiving has actually dropped slightly in recent years. The percentage of married women aged 15–44 who were infertile fell from 8.5% in 1982 to 6.0% in 2006–2010. Among married, nulliparous women aged 35–44, the percentage infertile declined from 44% in 1982 to 27% in 2006–2010, reflecting greater delays in childbearing over this period.
In utero DES-exposure associated with vaginal adenosis in DES Daughters
Vaginal Adenosis (submucosal glands lined by mullerian-type epithelium) was rarely described in the past. It has been seen frequently in young women whose mothers took diethylstilbestrol and similar compounds during pregnancy. The adenosis can appear as a red granular lesion. Biopsy of these red areas as well as those that initially appear normal but fail to stain with Schiller’s iodine can usually be accomplished in the office. Although these glands appear to be benign, they have been observed in close proximity toclear cell adenocarcinomas that have also occurred in young females whose mothers took stilbestrol during pregnancy. Present estimates suggest that the carcinomas are rare among the exposed population while adenosis occurs frequently. Although adenosis has been treated by surgical excision and local destruction (cauterization), the natural history of stilbestrol-associated adenosis is unknown. Close follow-up of patients with vaginal adenosis is certainly indicated and in many instances might prove to be the most prudent approach.
This study describes the use of routine vaginal iodine staining and other screening procedures for the detection of vaginal adenosis in 3871 postpubertal female patients. Iodine staining identified 65 patients with nonstaining areas in the vagina. Colposcopy verified the presence of vaginal adenosis in 11 of the 65 patients. Directed biopsies confirmed the diagnosis in 10 patients. The iodine staining procedure detected vaginal adenosis in only 1 patient who did not have a positive history of DES exposure or coexisting physical findings. Iodine staining of the vagina has little value as a screening procedure for the detection of vaginal adenosis. Based on these findings, a careful medical history and vaginal examination are recommended as the most productive routine screening procedures for vaginal adenosis. Evaluation and followup of those patients with a history of DES exposure in utero or physical findings suggestive of vaginal adenosis should include vaginal Papanicolaou smears supplemented by colposcopy at 6-month to 1-year intervals. Colposcopically directed biopsies of all abnormal areas should be obtained.