title: Environmental exposure to di-2-ethylhexyl phthalate is associated with low interest in sexual activity in premenopausal women.
abstract: Phthalates, a ubiquitous class of environmental chemicals, may interfere with typical reproductive hormone production both in utero and in adulthood. Although they are best known as anti-androgens, increasingly, evidence suggests that phthalates, particularly di-2-ethylhexyl phthalate (DEHP), may also suppress estrogen production. Given that both androgens and estrogens are essential for sexual function, particularly sexual interest, it is plausible that adult exposure to phthalates alters sexual function. To this end, we used data from 360 women participating in a pregnancy cohort study (the Study for Future Families) to examine whether urinary phthalate metabolite concentrations were associated with two dimensions of self-reported sexual dysfunction in the months prior to conception: lack of sexual interest and vaginal dryness. Women in the highest quartile of urinary concentrations of mono-2-ethyl-5-hydroxyhexyl phthalate, a DEHP metabolite, had 2.58 (95% CI 1.33, 5.00) times the adjusted odds of reporting that they almost always or often lacked interest in sexual activity, and results were similar for mono-2-ethyl-5-oxohexyl phthalate (aOR: 2.56, 95% CI 1.32, 4.95), another DEHP metabolite. Self-reported vaginal dryness was not associated with any phthalate metabolite concentration. This study is novel in its focus on sexual function in relation to environmentally relevant (rather than occupational) exposure to phthalates in adult women and these preliminary findings merit replication in a large, prospective study. Better understanding how adult exposure to phthalates may affect reproductive health, including sexual function, is of public health interest given that virtually all Westerners are exposed to phthalates.
authors.affiliation: Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. Electronic address: Emily_barrett@urmc.rochester.edu.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Barrett
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21215, USA. Electronic address: lauren.parlett@jhu.edu.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Parlett
authors.affiliation: UCLA Clinical and Translational Science Institute Los Angeles Biomedical Research Institute and Harbor-UCLA Medical Center; Professor of Medicine, David Geffen School of Medicine at UCLA Division of Endocrinology, Department of Medicine Harbor-UCLA Medical Center. Electronic address: wang@labiomed.org.
authors.forename: Christina
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO, USA. Electronic address: drobnisE@health.missouri.edu.
authors.forename: Erma Z
authors.initials: EZ
authors.lastname: Drobnis
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Department of Urologic Surgery, University of Minnesota, Minneapolis, MN, USA. Electronic address: redmo001@umn.edu.
authors.forename: J Bruce
authors.initials: JB
authors.lastname: Redmon
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. Electronic address: shanna.swan@mssm.edu.
authors.forename: Shanna H
authors.initials: SH
authors.lastname: Swan
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004051:Diethylhexyl Phthalate / Q000633:toxicity* / Q000652:urine; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D006801:Humans; D007989:Libido / Q000187:drug effects*; D010795:Phthalic Acids / Q000633:toxicity / Q000652:urine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000503:physiopathology / Q000523:psychology / Q000652:urine; D017697:Premenopause / Q000187:drug effects / Q000523:psychology; D011446:Prospective Studies; D012098:Reproduction / Q000187:drug effects; D012725:Sexual Behavior / Q000187:drug effects*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000523:psychology / Q000652:urine; D055815:Young Adult
chemical_list: D010795:Phthalic Acids; C479069:mono(2-ethyl-5-hydroxyhexyl) phthalate; C080276:mono(2-ethyl-5-oxohexyl)phthalate; C032279:phthalic acid; D004051:Diethylhexyl Phthalate
keywords: Endocrine disruptors; Environmental chemicals; Phthalates; Sexual dysfunction; Sexual interest