title: Bisphenol A and phthalates and endometriosis: the Endometriosis: Natural History, Diagnosis and Outcomes Study.
abstract: OBJECTIVE
  To explore the relation between bisphenol A and 14 phthalate metabolites and endometriosis.
  
  
  METHODS
  Matched cohort design.
  
  
  METHODS
  Fourteen clinical centers.
  
  
  METHODS
  The operative cohort comprised 495 women undergoing laparoscopy/laparotomy, whereas the population cohort comprised 131 women matched on age and residence.
  
  
  METHODS
  None.
  
  
  METHODS
  Surgically visualized or pelvic magnetic resonance imaging diagnosed endometriosis in the two cohorts, respectively.
  
  
  RESULTS
  Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using logistic regression adjusting for age, body mass index, and creatinine. In the population cohort, six phthalate metabolites-mono-n-butyl phthalate, mono-[(2-carboxymethyl) hexyl] phthalate, mono (2-ethyl-5-carboxyphentyl) phthalate, mono (2-ethylhexyl) phthalate, mono (2-ethyl-5-hydroxyhexyl) phthalate, and mono (2-ethyl-5-oxohexyl) phthalate-were significantly associated with an approximately twofold increase in the odds of an endometriosis diagnosis. Two phthalates were associated with endometriosis in the operative cohort when restricting to visualized and histologic endometriosis (monooctyl phthalate; OR 1.38; 95% CI 1.10-1.72) or when restricting comparison women to those with a postoperative diagnosis of a normal pelvis [mono (2-ethylhexyl) phthalate; OR 1.35; 95% CI 1.03-1.78].
  
  
  CONCLUSIONS
  Select phthalates were associated with higher odds of an endometriosis diagnosis for women with magnetic resonance imaging-diagnosed endometriosis. The lack of consistency of findings across cohorts underscores the impact of methodology on findings.
authors.affiliation: Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland 20852, USA. louisg@mail.nih.gov
authors.forename: Germaine M
authors.initials: GM
authors.lastname: Buck Louis
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Peterson
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.forename: Mary
authors.initials: M
authors.lastname: Croughan
authors.forename: Rajeshwari
authors.initials: R
authors.lastname: Sundaram
authors.forename: Joseph
authors.initials: J
authors.lastname: Stanford
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Anne
authors.initials: A
authors.lastname: Kennedy
authors.forename: Linda
authors.initials: L
authors.lastname: Giudice
authors.forename: Victor Y
authors.initials: VY
authors.lastname: Fujimoto
authors.forename: Liping
authors.initials: L
authors.lastname: Sun
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.forename: Kurunthachalam
authors.initials: K
authors.lastname: Kannan
mesh_terms: D000328:Adult; D001559:Benzhydryl Compounds / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D015331:Cohort Studies; D004715:Endometriosis / Q000175:diagnosis* / Q000601:surgery / Q000652:urine*; D004785:Environmental Pollutants / Q000652:urine*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D010636:Phenols / Q000652:urine*; D010795:Phthalic Acids / Q000652:urine*; D016896:Treatment Outcome; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D015415:Biomarkers; D004785:Environmental Pollutants; D010636:Phenols; D010795:Phthalic Acids; C006780:bisphenol A; D000098826:Bisphenol A Compounds