Environmental dioxins and endometriosis

Period activists want pads and tampon makers to disclose ingredients

Who knows what chemicals and other ingredients are in (your) tampons? Many sanitary pads don’t list any ingredients at all on the package…

One longtime concern about menstrual products has been whether the process of purifying or bleaching cotton and rayon with chlorine compounds may leave worrisome traces of toxic dioxins behind. Some research in nonhuman primates has linked exposure to dioxins to endometriosis.


Endometriosis is a common gynecologic problem of unknown etiology. Estrogen dependence and immune modulation are established features of this disease, and environmental contaminants have been suggested to play a role in the pathobiology of this disease as well.

Previous work in nonhuman primates has shown that exposure to the dioxin 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is associated with an increased prevalence and severity of endometriosis. Further animal experiments have implicated dioxin and dioxin-like compounds in this disease. Rodent studies support the plausibility of a role of environmental contaminants in the pathophysiology of endometriosis, although a convincing mechanistic hypothesis has yet to be advanced.

Small hospital-based case-control studies have failed to provide compelling evidence for or against an association of environmental contaminants and endometriosis. Herein we review evidence that dioxin and dioxin-like compounds are potent modulators of immune and endocrine function critical to the pathobiology of endometriosis.

Furthermore, perspectives on the potential mechanism(s) of dioxin and dioxin-like compound-induced toxicity in endometriosis, important knowledge needs, potential animal models for endometriosis studies, and considerations integral to future human case-control studies are discussed.

Sources and Press Release
  • Environmental dioxins and endometriosis, Semin Reprod Med 2003; 21(2): 145-154, DOI: 10.1055/s-2003-41321.
  • Period Activists Want Tampon Makers to Disclose Ingredients, nytimes, MAY 24, 2017.
  • Image credit Al Drago/The New York Times – Representative Grace Meng, Democrat of New York, spoke Tuesday at a rally in Washington calling for makers of feminine hygiene products to disclose the ingredients used to make tampons and pads.

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