Gourounti Kleanthi
Background: A possible association between endometriosis and exposure to organochlorines has been hypothesized. Dioxins can affect endometriosis via their weak estrogenic hormonal effect and via the induction of inappropriate estrogen production in the endometrium. Furthermore, dioxins can stimulate pro-inflammatory cytokines and induce the direct activation of genes involved in cell cycle and death. The purpose of this review is to summarize and present the existing evidence regarding the relationship between PCBs and/or dioxins and endometriosis. Material and Methods: The literature concerning the association between organochlorines and endometriosis was reviewed. Relevant studies were identified by searching the following databases: the Cochrane Library, Medline, Embase and PubMed. Results: Thirteen epidemiological studies that have assessed the relationship between endometriosis and organochlorine exposure were included in this review. The majority of examined studies have not demonstrated an association between organochlorines and endometriosis but only trends or non significant odds ratios. The evidence to date concerning the association between the levels of organochlorines and endometriosis is not entirely consistent and there is accumulative evidence from the individual studies that high concentrations of organochlorine compounds are not important predictors of endometriosis. Conclusion: In conclusion, the majority of studies dealing with endometriosis did not observe a significant association with organochlorines. However, there is not always possible to identify causal relationships between organochlorine exposure and deleterious health effects. The role of health care professionals, and specifically the role of midwives, should be focused on the education of the public in order to minimize their exposure to organochlorines and other harmful substances.
