“…It should also be noted that although chemicals are often classified as either estrogen agonists or anti-androgens, estrogen agonists also suppress androgen output from the testis. EDCs | Sources | Mechanism | Impact on urethra development | References |
Atrazine | Herbicide | ER agonist | Association with hypospadias | ( Agopian et al, 2013 , Garcia et al, 2017 , Govers et al, 2019a , Kraft et al, 2010 , Kristensen et al, 1997 , Morales-Suarez-Varela et al, 2011 ) |
BPA | Polycarbonate plastics, epoxy resins, plastic toys and bottles, lining of food cans | ER agonist Antiandrogen | Association with hypospadias | ( Choi et al, 2012 , Fernandez et al, 2016 , Liu et al, 2015 ) |
Clomiphene, progestins, oral contraceptives | Pharmaceuticals | ER agonist/antagonist | Mixed results -Moderate and severe hypospadias increased | ( Carmichael et al, 2005 , Meijer et al, 2006 , van Rooij et al, 2013 ) |
DES | Historical pharmaceutical | ER agonist | Hypospadias | ( Kalfa et al, 2011a , Klip et al, 2002 , Mahawong et al, 2014 , Palmer et al, 2005 , Vorherr et al, 1979 ) |
DDT | Contaminated water, soil, fish, crops | ER agonist Antiandrogen | Association with hypospadias | ( Bornman et al, 2010 , Fernandez et al, 2007 ) |
Genistein | Phytoestrogen in legumes and clover | ER agonist | Hypospadias | ( Michikawa et al, 2019 , Moule, 1961 , North and Golding, 2000 , Padilla-Banks et al, 2012 , Ross et al, 2011 , ... |
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