Cosmetic and personal care product use, urinary levels of parabens and benzophenones, and risk of endometriosis: results from the EndEA study

F M Peinado, Peinado FM, Francisco M. Peinado, O Ocón-Hernández, Olga Ocón‐Hernández, Ocón-Hernández O, Luz M. Iribarne-Durán, L M Iribarne-Durán, F Vela-Soria, Fernando Vela-Soria, A Ubiña, Ubiña A, C Padilla, Padilla C, Carmencita D. Padilla, Mora JC, J C Mora, J.C. Santos Mora, J Cardona, Juan de la Cruz Cardona, Cardona J, Josefa León, León J, J León, M F Fernández, Fernández MF, Mariana F. Fernández, N Olea, Nicolás Olea, F Artacho-Cordón, Francisco Artacho‐Cordón
Environmental research · 2020 · vol. 196 , pp. 110342 · doi:10.1016/j.envres.2020.110342 · PMID:33069703 · W3093108100
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

Cosmetic and personal care product use correlates with urinary paraben and benzophenone levels, and higher levels of certain parabens and benzophenones are linked to increased endometriosis risk.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This case-control study from the EndEA project examined whether cosmetic and personal care product (PCP) use and urinary concentrations of benzophenone and paraben congeners are associated with endometriosis risk, and whether oxidative stress modifies any associations. It included 124 women (35 laparoscopically confirmed endometriosis cases and 89 laparoscopy-confirmed controls) and quantified urinary BP-1, BP-3, 4-OH-BP, MeP, EtP, PrP, and BuP, along with oxidative stress biomarkers (TBARS and total antioxidant power), while collecting frequency of cosmetics/PCP use; associations were tested using multivariable regression, with oxidative stress assessed for effect modification. After adjustment, increased endometriosis risk was reported across higher urinary terciles for MeP, BP-1, BP-3, and total benzophenones (with ORs around 3.34–5.63), and there were near-significant TBARS and significant inverse TAP associations, while oxidative stress did not modify the benzophenone/paraben–endometriosis links. This paper is centrally about endometriosis—specifically, it analyzes urinary parabens/benzophenones and oxidative stress in relation to endometriosis risk in the EndEA study.

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Abstract

AimTo explore the relationship of urinary concentrations of different congeners of benzophenones and parabens with the utilization of cosmetics and personal care products (PCPs) and their impact on the risk of endometriosis, and to evaluate the influence of oxidative stress on associations found.MethodsThis case-control study comprised a subsample of 124 women (35 cases; 89 controls). Endometriosis was confirmed (cases) or ruled out (controls) by laparoscopy, with visual inspection of the pelvis and biopsy of suspected lesions (histological diagnosis). Urinary concentrations of benzophenone-1 (BP-1), benzophenone-3 (BP-3), 4-hydroxibenzophenone (4-OH-BP), methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butyl-paraben (BuP), and biomarkers of oxidative stress [lipid peroxidation (TBARS) and total antioxidant power (TAP)] were quantified. Information was gathered on the frequency of use of cosmetics and PCPs. Associations between the frequency of cosmetics/PCP use, urinary concentrations of benzophenones and parabens, oxidative stress, and endometriosis risk were explored in logistic and linear multivariable regression analyses.ResultsThe frequency of utilization of certain cosmetics and PCPs was significantly associated with urinary concentrations of benzophenones and parabens. After adjustment for potential confounders, the risk of endometriosis was increased in women in the second versus first terciles of MeP (OR = 5.63; p-value<0.001), BP-1 (OR = 5.12; p-value = 0.011), BP-3 (OR = 4.98; p-value = 0.008), and ƩBPs (OR = 3.34; p-value = 0.032). A close-to-significant relationship was observed between TBARS concentrations and increased endometriosis risk (OR = 1.60, p-value = 0.070) and an inverse association between TAP concentrations and this risk (OR = 0.15; p-value = 0.048). Oxidative stress results did not modify associations observed between benzophenone/paraben exposure and endometriosis risk.ConclusionsOur findings indicate that the frequency of cosmetics and PCP utilization is a strong predictor of exposure to certain benzophenone and paraben congeners. These compounds may increase the risk of endometriosis in an oxidative stress-independent manner. Further studies are warranted to corroborate these findings.
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Methods

This case-control study comprised a subsample of 124 women (35 cases; 89 controls). Endometriosis was confirmed (cases) or ruled out (controls) by laparoscopy, with visual inspection of the pelvis and biopsy of suspected lesions (histological diagnosis). Urinary concentrations of benzophenone-1 (BP-1), benzophenone-3 (BP-3), 4-hydroxibenzophenone (4-OH-BP), methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butyl-paraben (BuP), and biomarkers of oxidative stress [lipid peroxidation (TBARS) and total antioxidant power (TAP)] were quantified. Information was gathered on the frequency of use of cosmetics and PCPs. Associations between the frequency of cosmetics/PCP use, urinary concentrations of benzophenones and parabens, oxidative stress, and endometriosis risk were explored in logistic and linear multivariable regression analyses.

Results

The frequency of utilization of certain cosmetics and PCPs was significantly associated with urinary concentrations of benzophenones and parabens. After adjustment for potential confounders, the risk of endometriosis was increased in women in the second versus first terciles of MeP (OR = 5.63; p-value<0.001), BP-1 (OR = 5.12; p-value = 0.011), BP-3 (OR = 4.98; p-value = 0.008), and ƩBPs (OR = 3.34; p-value = 0.032). A close-to-significant relationship was observed between TBARS concentrations and increased endometriosis risk (OR = 1.60, p-value = 0.070) and an inverse association between TAP concentrations and this risk (OR = 0.15; p-value = 0.048). Oxidative stress results did not modify associations observed between benzophenone/paraben exposure and endometriosis risk.

Conclusions

Our findings indicate that the frequency of cosmetics and PCP utilization is a strong predictor of exposure to certain benzophenone and paraben congeners. These compounds may increase the risk of endometriosis in an oxidative stress-independent manner. Further studies are warranted to corroborate these findings.

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Condition tags

endometriosis

MeSH descriptors

Benzophenones Cosmetics Endometriosis Endometriosis Endometriosis Parabens Benzophenones Case-Control Studies Female Humans Parabens

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