THE ROLE OF ENDOCRINE DISRUPTORS IN EARLY PUBERTY AND HORMONAL IMBALANCES IN WOMEN
Abstract
In recent decades, puberty has been occurring at younger ages, particularly among girls. While genetics and nutrition are well-known influences, increasing evidence suggests that endocrine-disrupting chemicals (EDCs) also play a role. EDCs are compounds that interfere with hormones by mimicking, blocking, or altering their activity. Found in plastics, cosmetics, pesticides, and processed foods, they represent widespread, unavoidable exposures in modern life.
Early puberty carries significant health risks beyond physical changes. Girls who mature earlier are more likely to develop hormonal imbalances, menstrual irregularities, metabolic disorders, and reproductive conditions such as polycystic ovary syndrome, endometriosis, and infertility. Prolonged estrogen exposure is also linked to hormone-sensitive cancers. Metabolic disruptions may further increase risks of obesity, insulin resistance, and cardiovascular disease.
Evidence on EDCs remains mixed: some studies associate higher levels of bisphenol A, phthalates, and parabens with early puberty, while others report inconsistent effects. Variability may stem from genetic susceptibility, metabolism, or cumulative exposure to environmental factors.
This review explores how EDCs may influence pubertal timing and long-term hormonal health, emphasizing the need to recognize environmental contributors to female reproductive development and to strengthen the regulation of endocrine-disrupting chemicals.
References
Ahmed, M. L., Ong, K. K., & Dunger, D. B. (2009). Childhood obesity and the timing of puberty. Trends in Endocrinology & Metabolism, 20(5), 237–242. https://doi.org/10.1016/j.tem.2009.02.004
Birnbaum, L. S. (2012). Environmental chemicals: Evaluating low-dose effects. Environmental Health Perspectives, 120(4), A143–A144. https://doi.org/10.1289/ehp.1205179
Biro, F. M., Greenspan, L. C., & Galvez, M. P. (2018). Puberty in girls and the environment. Journal of Pediatric and Adolescent Gynecology, 31(6), 557–565. https://doi.org/10.1016/j.jpag.2018.08.010
Boas, M., Feldt-Rasmussen, U., Skakkebæk, N. E., & Main, K. M. (2006). Environmental chemicals and thyroid function. European Journal of Endocrinology, 154(5), 599–611. https://doi.org/10.1530/eje.1.02128
Boseley, S. (2012, October 21). Onset of puberty in girls has fallen by five years since 1920. The Guardian. https://www.theguardian.com/society/2012/oct/21/puberty-adolescence-childhood-onset
Carel, J. C., & Léger, J. (2023). Precocious puberty. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544313/
Caserta, D., Ciardo, F., Bordi, G., Marci, R., La Rocca, C., Tait, S., Bergamasco, B., Stecca, L., Mantovani, A., Guerranti, C., Fanello, E. L., Perra, G., Borghini, F., Focardi, S., & Moscarini, M. (2021). The influence of endocrine disruptors on female fertility: A systematic review. Journal of Endocrinological Investigation, 44(6), 1123–1145. https://doi.org/10.1007/s40618-020-01455-8
Cleveland Clinic. (2025). Precocious puberty – Early puberty: Symptoms & causes. https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty
Cohn, B. A., La Merrill, M. A., Krigbaum, N. Y., Yeh, G., Park, J. S., Zimmermann, L., & Cirillo, P. M. (2015). DDT exposure in utero and breast cancer. Journal of the National Cancer Institute, 107(10), djv218. https://doi.org/10.1093/jnci/djv218
Darbre, P. D., & Harvey, P. W. (2014). Parabens can enable hallmarks and characteristics of cancer in human breast epithelial cells: A review of the literature. Journal of Applied Toxicology, 34(9), 925–938. https://doi.org/10.1002/jat.3027
Diamanti-Kandarakis, E., Bourguignon, J. P., Giudice, L. C., Hauser, R., Prins, G. S., Soto, A. M., & Gore, A. C. (2009). Endocrine-disrupting chemicals: An Endocrine Society scientific statement. Endocrine Reviews, 30(4), 293–342. https://doi.org/10.1210/er.2009-0002
Dodson, R. E., Nishioka, M., Standley, L. J., Perovich, L. J., Brody, J. G., & Rudel, R. A. (2012). Endocrine disruptors and asthma-associated chemicals in consumer products. Environmental Health Perspectives, 120(7), 935–943. https://doi.org/10.1289/ehp.1104052
Elsen, C., Fini, J. B., Reynaud, C., & Demeneix, B. A. (2022). Endocrine disruption and early puberty: Mechanisms and epidemiological evidence. Environmental Health Perspectives, 130(3), 036002. https://doi.org/10.1289/EHP9532
Endocrine Society. (2025). Endocrine-disrupting chemicals. https://www.endocrine.org/advocacy/position-statements/endocrine-disrupting-chemicals
Endocrine Society. (2025). What EDCs are. https://www.endocrine.org/topics/edc/what-edcs-are
Eskenazi, B., Warner, M., Marks, A. R., Sjödin, A., Fenster, L., Rubin, C., & Needham, L. (2018). Dioxin exposure and age of pubertal onset among Seveso women. Environmental Health Perspectives, 126(9), 097002. https://doi.org/10.1289/EHP3420
Gely-Pernot, A., Hao, C., Becker, E., Stéphan, L., Kervarrec, C., Chalmel, F., Primig, M., Smagulova, F., Martin, J., Weber, M., Tevosian, S., & Jégou, B. (2017). Male fertility impairment following peripubertal exposure to the herbicide atrazine. Journal of Endocrinology, 234(1), 35–49. https://doi.org/10.1530/JOE-16-0417
Goodarzi, M. O., Dumesic, D. A., Chazenbalk, G., & Azziz, R. (2011). Polycystic ovary syndrome: Etiology, pathogenesis, and diagnosis. Nature Reviews Endocrinology, 7(4), 219–231. https://doi.org/10.1038/nrendo.2010.217
Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., Toppari, J., Zoeller, R. T., & Endocrine Society. (2015). EDC-2: The Endocrine Society’s second scientific statement on endocrine-disrupting chemicals. Endocrine Reviews, 36(6), E1–E150. https://doi.org/10.1210/er.2015-1010
Gore, A. C., Heindel, J. J., Zoeller, R. T., & others. (2010). Mechanisms of endocrine disruption. In Environmental impacts on reproductive health and fertility. Cambridge University Press. https://doi.org/10.1017/CBO9780511674686.007
Harley, K. G., Kogut, K., Madrigal, D. S., Cardenas, M., Vera, I. A., Meza-Alfaro, G., Sheth, S. S., Bradman, A., Eskenazi, B., & Sagiv, S. K. (2019). Prenatal and early-life exposure to parabens and development of obesity and puberty in girls. Environmental Health Perspectives, 127(8), 087001. https://doi.org/10.1289/EHP5135
Hayes, T. B., Khoury, V., Narayan, A., Nazir, M., Park, A., Brown, T., Adame, L., Chan, E., Buchholz, D., Stueve, T., & Gallipeau, S. (2010). Atrazine induces complete feminization and chemical castration in male African clawed frogs (Xenopus laevis). Proceedings of the National Academy of Sciences, 107(10), 4612–4617. https://doi.org/10.1073/pnas.0909519107
Jain, R. B. (2018). Association between thyroid profile and perfluoroalkyl substances among US adolescents. Environmental Pollution, 243, 98–106. https://doi.org/10.1016/j.envpol.2018.08.057
Kahn, L. G., Philippat, C., Nakayama, S. F., Slama, R., & Trasande, L. (2020). Endocrine-disrupting chemicals: Implications for human health. The Lancet Diabetes & Endocrinology, 8(8), 703–718. https://doi.org/10.1016/S2213-8587(20)30129-7
Kaplowitz, P. (2025). Definition, etiology, and evaluation of precocious puberty. UpToDate. https://www.uptodate.com/contents/definition-etiology-and-evaluation-of-precocious-puberty
Kassotis, C. D., Tillitt, D. E., Lin, C. H., McElroy, J. A., & Nagel, S. C. (2020). Endocrine-disrupting chemicals and reproductive disorders. Nature Reviews Endocrinology, 16(6), 341–355. https://doi.org/10.1038/s41574-020-0334-9
Kay, V. R., Chambers, C., & Foster, W. G. (2022). Endocrine disruption and female reproductive health: Impacts of phthalates and mechanisms of action. Reproductive Toxicology, 108, 52–64. https://doi.org/10.1016/j.reprotox.2022.07.003
Kim, M. J., Moon, S., Oh, B. C., Jung, D., Park, Y. J., & Choi, K. (2020). Endocrine-disrupting chemicals and their role in gynecological cancers. Environmental Research, 182, 109081. https://doi.org/10.1016/j.envres.2019.109081
Kortenkamp, A. (2017). Low dose mixture effects of endocrine disruptors. Environment International, 104, 151–162. https://doi.org/10.1016/j.envint.2017.01.013
Kumar, V., Chawla, S., Garg, S., Arora, S., & Singh, N. (2021). Emerging biosensor technologies for detecting endocrine-disrupting chemicals. Biosensors and Bioelectronics, 194, 113569. https://doi.org/10.1016/j.bios.2021.113569
La Merrill, M. A., Emond, C., Kim, M. J., Antignac, J. P., Le Bizec, B., Clément, K., Birnbaum, L. S., Barouki, R., Cravedi, J. P., & Fernandez, M. F. (2020). Toxicological function of AhR in carcinogenesis and endocrine disruption. Biochemical Pharmacology, 177, 113910. https://doi.org/10.1016/j.bcp.2020.113910
Machtinger, R., Gaskins, A. J., Mansur, A., Adir, M., Racowsky, C., & Baccarelli, A. A. (2018). Association between preconception urinary phthalate metabolite concentrations and outcomes of assisted reproductive technologies. Fertility and Sterility, 109(5), 897–905. https://doi.org/10.1016/j.fertnstert.2018.01.029
Mahoney, M. M., & Padgett, E. L. (2021). Disruption of female reproductive endocrinology by dioxins and dioxin-like compounds. Frontiers in Endocrinology, 12, 667221. https://doi.org/10.3389/fendo.2021.667221
Martínez-Pacheco, H. M., Castro-Mora, J. A., Sánchez-Gutiérrez, M., & González-Ortiz, L. J. (2021). The role of endocrine disruptors in polycystic ovary syndrome: A review of the literature. Environmental Toxicology and Pharmacology, 88, 103705. https://doi.org/10.1016/j.etap.2021.103705
Mayo Clinic Staff. (2025). Precocious puberty – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811
Meeker, J. D., Sathyanarayana, S., & Swan, S. H. (2009). Phthalates and other endocrine-disrupting compounds in plastics and personal care products: Implications for human health. Environmental Health Perspectives, 117(3), 309–315. https://doi.org/10.1289/ehp.1002727
Mimura, J., & Fujii-Kuriyama, Y. (2003). Functional role of AhR in the expression of toxic effects by TCDD. Biochimica et Biophysica Acta – Molecular Cell Research, 1619(3), 263–268. https://doi.org/10.1016/S0304-4165(02)00485-3
NHS. (2025, April 15). Early or delayed puberty. NHS. https://www.nhs.uk/conditions/early-or-delayed-puberty
Patisaul, H. B., & Adewale, H. B. (2009). Long-term effects of environmental endocrine disruptors on reproductive physiology and behavior. Frontiers in Behavioral Neuroscience, 3, 10. https://doi.org/10.3389/neuro.08.010.2009
Rattan, S., Zhou, C., Chiang, C., Mahalingam, S., Brehm, E., & Flaws, J. A. (2021). Exposure to endocrine-disrupting chemicals during adulthood: Consequences for female fertility. Endocrinology, 162(10), bqab133. https://doi.org/10.1210/endocr/bqab133
Rier, S. E., & Foster, W. G. (2002). Environmental dioxins and endometriosis. Toxicological Sciences, 70(2), 161–170. https://doi.org/10.1093/toxsci/70.2.161
Rochester, J. R. (2013). Bisphenol A and human health: A review of the literature. Reproductive Toxicology, 42, 132–155. https://doi.org/10.1016/j.reprotox.2013.06.004
Rochester, J. R., & Bolden, A. L. (2015). Bisphenol S and F: A systematic review and comparison to BPA. Environmental Health Perspectives, 123(7), 643–650. https://doi.org/10.1289/ehp.1408989
Rudel, R. A., Gray, J. M., Engel, C. L., Rawsthorne, T. W., Dodson, R. E., Ackerman, J. M., Rizzo, J., Nudelman, J. L., & Brody, J. G. (2011). Food packaging and bisphenol A and bis(2-ethylhexyl) phthalate exposure: Findings from a dietary intervention. Environmental Health Perspectives, 119(7), 914–920. https://doi.org/10.1289/ehp.1003170
Sadeghi-Nejad, A., Amiri, P., Omrani, G. H. R., Khamseh, M. E., Malek, M., Agha-Hosseini, M., & Gharibzadeh, S. (2014). Etiology of precocious puberty: 10 years’ study in Endocrine Research Center. International Journal of Endocrinology and Metabolism, 12(4), e16796. https://doi.org/10.5812/ijem.16796
Sharma, A., Arora, S., & Ghosh, J. (2019). Endocrine disruptors and their role in endometriosis. Indian Journal of Clinical Biochemistry, 34(1), 19–27. https://doi.org/10.1007/s12291-018-0762-5
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