Association of genital talc and douche use in early adolescence or adulthood with uterine fibroids diagnoses

Ogunsina, Kemi; Sandler, Dale P.; Murphy, John D.; Harmon, Quaker E.; D’Aloisio, Aimee A.; Baird, Donna D.; O’Brien, Katie M.

doi:10.1016/j.ajog.2023.08.014

Cited by 3 publications

(5 citation statements)

References 45 publications

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“…We were unable to stratify by race in this study due to sample size, and instead controlled for it as a confounder in the final model. Other sources of chronic and acute inflammation in the reproductive tract may also contribute to uterine fibroids, such as intrauterine device (IUD), cesarean section, obesity, diet, aging, talc use, as well as environmental factors including reactive oxygen species and toxic metals [ 18 , 84 ]. We were not able to assess these factors.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiologic studies have identified a number of factors associated with a greater risk for fibroids, including older age, African American race, early age of menarche, nulliparity, and adolescent talc use (with or without douching) [12][13][14][15][16][17][18]. One theorized etiology of fibroids is that injury resulting from reproductive tract infections, such as Chlamydia trachomatis (CT), may contribute to fibroid risk as inflammation can promote increased smooth muscle cell proliferation and production of extracellular matrix, factors in tumor cell progression.…”

Section: Introductionmentioning

confidence: 99%

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Uterine fibroids and longitudinal profiles of the vaginal microbiota in a cohort presenting for transvaginal ultrasound

Robbins,

Brown,

Stennett

et al. 2024

PLoS ONE

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Bacterial vaginosis, characterized in part by low levels of vaginal Lactobacillus species, has been associated with pro-inflammatory cytokines which could fuel uterine fibroid development. However, prior work on the associations between uterine fibroids and vaginal bacteria is sparse. Most studies have focused on assessment of individual taxa in a single sample. To address research gaps, we sought to compare short, longitudinal profiles of the vaginal microbiota in uterine fibroid cases versus controls with assessment for hormonal contraceptives (HCs), a possible confounder associated with both protection from fibroid development and increases in Lactobacillus-dominated vaginal microbiota. This is a secondary analysis of 83 reproductive-age cisgender women who presented for transvaginal ultrasound (TVUS) and self-collected mid-vaginal swabs daily for 1–2 weeks before TVUS (Range: 5–16 days, n = 697 samples). Sonography reports detailed uterine fibroid characteristics (N = 21 cases). Vaginal microbiota was assessed by 16S rRNA gene amplicon sequencing and longitudinal microbiota profiles were categorized by hierarchical clustering. We compared longitudinal profiles of the vaginal microbiota among fibroid cases and controls with exact logistic regression. Common indications for TVUS included pelvic mass (34%) and pelvic pain (39%). Fibroid cases tended to be older and report Black race. Cases less often reported HCs versus controls (32% vs. 58%). A larger proportion of cases had low-Lactobacillus longitudinal profiles (48%) than controls (34%). In unadjusted analysis, L. iners-dominated and low-Lactobacillus profiles had higher odds of fibroid case status compared to other Lactobacillus-dominated profiles, however these results were not statistically significant. No association between vaginal microbiota and fibroids was observed after adjusting for race, HC and menstruation. Results were consistent when number of fibroids were considered. There was not a statistically significant association between longitudinal profiles of vaginal microbiota and uterine fibroids after adjustment for common confounders; however, the study was limited by small sample size.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Uterine fibroids and longitudinal profiles of the vaginal microbiota in a cohort presenting for transvaginal ultrasound

Robbins,

Brown,

Stennett

et al. 2024

PLoS ONE

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“…These differences heighten vulvar susceptibility to topical agents including chemicals in intimate care products, which have been reported sources of allergic contact dermatitis of the vulva ( 34 ). In addition to more acute conditions, menstrual and intimate care product use may be associated with increased cancer risk of sexual and reproductive organs (e.g., uterine cancer, cervical cancer, ovarian cancer) as well as other gynecologic conditions such as fibroids ( 39 , 41 , 68 – 70 ). These products could affect chronic health risks through several possible pathways, including inflammation response, microbiota changes, or endocrine disruption ( 70 ).…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiologic studies suggest that douching may be associated with pelvic inflammatory disease ( 37 ), ectopic pregnancy ( 23 ), bacterial and fungal vaginosis ( 24 , 25 , 38 ), and ovarian cancer ( 39 ), and genital use of talc-based powders may be a risk factor for ovarian cancer ( 40 ). Furthermore, women who reported both douching and genital talc powder use have increased risks of uterine leiomyoma (fibroids), ovarian cancer, and pelvic inflammatory disease than those who only reported using one product, suggesting that cumulative product use may be critical to understanding health risks ( 39 , 41 ). Despite the evidence of adverse health effects, these products remain poorly regulated with fragmented government oversight.…”

Section: Introductionmentioning

confidence: 99%

Examining differences in menstrual and intimate care product use by race/ethnicity and education among menstruating individuals

Zota,

Franklin,

Weaver

et al. 2023

Front. Reprod. Health

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IntroductionUnited States consumers spend over two billion dollars a year on intimate care products. These products, along with scented menstrual products, are marketed for odor control, perceived “freshness,” and vaginal/vulvar cleanliness. However, these scent-altering products may increase exposure to carcinogenic and endocrine-disrupting chemicals. Prior research has not adequately characterized demographic differences in product use. The objective of our study is to examine racial/ethnic and educational differences in menstrual and intimate care product use among people who menstruate.MethodsWe pooled data from two US-based cross sectional studies to examine demographic characteristics and product use in 661 participants aged 18–54 years. Participants reported use of scented and unscented menstrual products (tampons, sanitary pads, and menstrual cups) and intimate care products (vaginal douches, sprays, wipes, and powders). We examined differences by race/ethnicity and education using log-binomial regression and latent class analysis (LCA), which can identify groups based on product use patterns.ResultsOur sample was 33.4% Black, 30.9% Latina, 18.2% White, and 16.2% another identity. Approximately half the population had a bachelor's degree or more; 1.4% identified as transgender and 1.8% as non-binary. In adjusted models, scent-altering products (i.e., scented menstrual and intimate care products) were more likely to be used by those with less formal education (p < 0.05). Unscented menstrual products were more likely to be used by those with more formal education. Compared to Black participants, White participants were more likely to use unscented tampons and menstrual cups and less likely to use douches and wipes (p < 0.05). Using LCA we identified two groups: one more likely to use scent-altering products, and a second more likely to use unscented menstrual products. Less education and older age, but not race/ethnicity, was significantly associated with membership in the group more likely to use scent-altering products. While sex/gender composition did not statistically vary across groups, all non-binary participants fell in the unscented menstrual product group.DiscussionLower educational attainment was consistently associated with greater use of scent-altering menstrual and intimate care products. Future research should examine associations between body odor stigma, product use, and health risks at intersections of race, class, and gender.

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“…In vitro and in vivo studies have shown that BPA, NPH, DEHP, Cd, DES, Hg, and equol can cause DNA damage or impact epigenetic processes to fibroid pathogenesis, and early adolescence may be a window of susceptibility for fibroid development ( 53 ). These findings hold promise for the development of new prevention strategies for fibroids.…”

Section: Introductionmentioning

confidence: 99%

The adverse role of endocrine disrupting chemicals in the reproductive system

Pan,

Liu,

et al. 2024

Front. Endocrinol.

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Reproductive system diseases pose prominent threats to human physical and mental well-being. Besides being influenced by genetic material regulation and changes in lifestyle, the occurrence of these diseases is closely connected to exposure to harmful substances in the environment. Endocrine disrupting chemicals (EDCs), characterized by hormone-like effects, have a wide range of influences on the reproductive system. EDCs are ubiquitous in the natural environment and are present in a wide range of industrial and everyday products. Currently, thousands of chemicals have been reported to exhibit endocrine effects, and this number is likely to increase as the testing for potential EDCs has not been consistently required, and obtaining data has been limited, partly due to the long latency of many diseases. The ability to avoid exposure to EDCs, especially those of artificially synthesized origin, is increasingly challenging. While EDCs can be divided into persistent and non-persistent depending on their degree of degradation, due to the recent uptick in research studies in this area, we have chosen to focus on the research pertaining to the detrimental effects on reproductive health of exposure to several EDCs that are widely encountered in daily life over the past six years, specifically bisphenol A (BPA), phthalates (PAEs), polychlorinated biphenyls (PCBs), parabens, pesticides, heavy metals, and so on. By focusing on the impact of EDCs on the hypothalamic-pituitary-gonadal (HPG) axis, which leads to the occurrence and development of reproductive system diseases, this review aims to provide new insights into the molecular mechanisms of EDCs’ damage to human health and to encourage further in-depth research to clarify the potentially harmful effects of EDC exposure through various other mechanisms. Ultimately, it offers a scientific basis to enhance EDCs risk management, an endeavor of significant scientific and societal importance for safeguarding reproductive health.

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Association of genital talc and douche use in early adolescence or adulthood with uterine fibroids diagnoses

Cited by 3 publications

References 45 publications

Uterine fibroids and longitudinal profiles of the vaginal microbiota in a cohort presenting for transvaginal ultrasound

Uterine fibroids and longitudinal profiles of the vaginal microbiota in a cohort presenting for transvaginal ultrasound

Examining differences in menstrual and intimate care product use by race/ethnicity and education among menstruating individuals

The adverse role of endocrine disrupting chemicals in the reproductive system

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