Phthalates and Your Reproductive Health
Ingredients in your make up bag may be impacting your fertility
Phthalates – often called plasticizers – are chemicals that have been used in many household products and have been found throughout the environment since the 1920s. They are widely used in cosmetics, personal care products, and many scented products since they make artificial scents last longer. In recent years, serious concerns about the effects of phthalates on reproduction and other health issues have called into question their widespread use. Phthalates have been linked to infertility, miscarriage, and more, but legislation can be slow to catch up with scientific evidence when it comes to protecting consumers. In the case of phthalates and your reproductive health, you need to be your own advocate – and the first step is learning more.
Tell me more about phthalates
Phthalates were developed in the 1920s as plasticizers – chemicals used to make plastics more flexible. They are water-insoluble, synthetic chemicals that are added to polyvinyl chloride (PVC) plastics, and they have widespread use in many plastic household items like flooring, furniture, toys, shower curtains, PVC pipes, and more. They stabilize artificial scents and are added to many scented products like perfume, cosmetics, shampoos, lotions, candles, nail polish, and hair spray. Since phthalates are not chemically bound to the plastics and products in which they are used, they can leach into the environment easily. It is estimated that over 18 billion pounds of phthalates are made each year, and the Centers for Disease Control found urinary levels of phthalates in most Americans tested. Since phthalates are broken down in the body and excreted in the urine relatively quickly, the findings from the CDC suggest a steady and constant exposure to phthalates.
How do phthalates affect reproductive health?
Phthalates are endocrine disruptors, which means they bind to hormonal receptors and interfere with the function of reproductive hormones like estrogen and testosterone. Higher levels of phthalates have been associated with disruption in menstruation, ovulation dysfunction, and increased risk of endometriosis (1, 2). Studies have shown that higher levels of phthalates in both men and women trying to conceive are associated with longer times to conception and eventual diagnosis of infertility (inability to conceive for one year) (3). Studies have shown that phthalate exposure has been associated with poor egg quality (4) and poor sperm quality (5).
Avoiding phthalates is not only important while you are trying to conceive but during pregnancy as well since phthalate exposure has been associated with higher risk of miscarriage (6). Concerns about phthalates continue into later pregnancy and beyond. Phthalates have been found in amniotic fluid, and high levels of phthalate exposure in pregnancy may result in poor obstetric outcomes like preterm delivery (7). Infants and children are especially vulnerable to environmental toxins, and early exposure to phthalates has been associated with early puberty, obesity, and other health issues later in life (8).
What is being done about phthalate exposure for consumers?
Legislation is slow to catch up to evidence when it comes to consumer products and industry. Phthalates are in a multitude of household products, but legislation is very limited. In 2008, Congress passed the Consumer Product Safety Improvement Act, which includes a permanent ban of three phthalates in any product made for children that can be placed in their mouths. Later, three more phthalates were banned on an interim basis, again for children’s toys designed to be used in children’s mouths (pacifiers, teething toys, etc.). This is a step in the right direction, but unfortunately, there are many more phthalates and very little regulation.
One area that is extremely unregulated in the United States is the cosmetics industry, which includes anything we place on our skin, like lotions, shampoos, makeup, and perfume. You may be surprised to know that of the over 10,000 cosmetic ingredients catalogued by the FDA, less than 11% have been reviewed. In the United States, 11 chemicals have been banned from use in cosmetics compared to over 600 in Canada and over 1,300 in Europe. The last time the US passed regulations in the cosmetic industry was in the 1930s. It’s no surprise, then, that the CDC’s evaluation of phthalate levels of Americans showed higher levels of phthalates used in soaps, body washes, shampoos, and cosmetics in adult women (who typically use more personal care products) compared to men.
The use of phthalates in products we use is a heated debate: one side saying research shows reproductive harm and more limitations on use are imperative and the other side saying use in limited quantities is safe. Even if small quantities are safe, though, how can consumers ensure that their personal exposure is ‘safe?’ Until manufacturers stop using phthalates in products, consumers need to educate themselves and consider limiting exposure on their own.
Reality check
This stuff is scary if you are first learning about it – take a deep breath, it will be okay. When I first started researching the impact of environmental toxins on reproductive health for my patients and for my books on infertility and recurrent miscarriage, I freaked out. I wrote about it and talked to patients about it, but I shut down a little and ignored it for myself for a while. At first, it’s sickening and overwhelming – the evidence is there, but no one seems to be doing anything about it. But actually, people are doing things, and the information is available. One company that is not only selling less toxic products but also pushing the US Congress for reform is Beauty Counter. Learn more about their #betterbeauty movement here. Start by being aware and take it one day at a time. When I run out of a product, I think and research before I replace it. I make choices and think more. Just by reading this, you’re more aware, and you can make choices for yourself that make a big difference!
Ways to limit phthalate exposure:
Eliminate plastic from your kitchen – phthalates can leak from plastic containers (like water bottles and food containers) exposed to heat and detergent (dishwashers, microwaves).
Exchange your phthalate-containing beauty products for safer ones (fragrance free is a good start since fragrance is considered a trade secret and companies do not have to list ingredients that are used for scent in cosmetic products).
Choose phthalate-free nail polish (bring your own to the nail salon).
Choose cleaning products and detergents that are fragrance free or scented with essential oils.
Skip synthetic air fresheners and candles.
If remodeling your house, choose natural materials like wood or bamboo and get blinds made of cloth or wood – skip the PVC plastics.
Skip soft plastic teethers, pacifiers, and toys for young kids – opt for natural rubber or silicone.
More resources:
Here’s a website with many tips on avoiding phthalates:
http://greenopedia.com/avoid-phthalates/
Here are two apps that review beauty products:
https://www.ewg.org/consumer-guides#.WpSyeWaZOCQ
Here's my blog post on BPA, another endocrine disruptor that impacts fertility, miscarriage risk, and overall health.
More blog posts at drlorashahine.com.
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References:
1. Davis BJ, Maronpot RR, Heindel JJ. Di-(2-ethylhexyl) phthalate suppresses estradiol and ovulation in cycling rats. Toxicol Appl Pharmacol 1994;128:216-223.
2. Smarr MM, Kannan K, Buck Louis GM. Endocrine disrupting chemicals and endometriosis. Fertil Steril. 2016 Sep 15;106(4):959-66.
3. Thomsen AM, Riis AH, Olsen J, et al. Female exposure to phthalates and time to pregnancy: a first pregnancy planner study. Hum Reprod 2017;32:232-238.
4. Machtinger R, Gaskins AJ, Racowsky C, Mansur A, Adir M, Baccarelli AA, Calafat AM, Hauser R. Urinary concentrations of biomarkers of phthlates and phthalate alternatives and IVF outcomes. Environ Int. 2018 Feb;111:23-31.
5. Broe A, Pottegard A, Hallas J, Ahern TP, Fedder J, Damkier P. Association between use of phthalate-containing medication and semen quality among men in couples referred for assisted reproduction. Hum Reprod 2018 Feb 7.
6. Toft G, Jonsson BA, Lindh CH, Jensen TK, Hjollund NH, Vested A, et al. Association between pregnancy loss and urinary phthalate levels around the time of conception. Environ Health Perspect 2012;120:458-463.
7. Marie C, Vendittelli F, Sauvant-Rochat MP. Obstetrical outcomes and biomarkers to assess exposure to phthalates: A review. Environ Tox. 2015 Oct;83:116-36.
8. Philips EM, Jaddoe VWV, Transande L. Effects of early exposure to phthalates and bisphenols on cardiometabolic outcomes in pregnancy and childhood. Reprod Toxicol. 2017 Mar;68:105-118.
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