Presence of metalloestrogens in ectopic endometrial tissue

Background: Heavy metals with estrogenic effects are termed as metalloestrogens which are implicated in the etiology of endometriosis; an estrogen dependent disease. Aim: To demonstrate the presence of metalloestrogens in ectopic endometrial tissue. Settings: A gynaecology unit of a tertiary care hospital and two national level laboratories. Design: Descriptive study Methods: In fifty patients with endometriosis confirmed by laparoscopy or laparotomy, ectopic endometrial tissue samples (n=50) were collected. Tissue samples were digested using supra pure 65% HNO3 and levels of metalloestrogens were measured using Total Reflection X-ray Fluorescence (TXRF) and graphite furnace atomic absorption spectroscopy (GFASS). Results: Three metalloestrogens, namely cadmium, nickel and lead were detected in the ectopic endometrial tissue with geometric mean (95% CI) levels of 2.861 (2.126-3.596), 17.547(13.152-21.942) and 25.785(18.490-33.080) μg/Kg respectively. Conclusion: In this study, metalloestrogens viz. cadmium, nickel and lead were present in the ectopic endometrial tissue.