Association Between Endometriosis and Environmental Disruptors: A Literature Review and Meta-Analysis

Donatella Caserta, Fernando Ficarola, Francesco Branda, Andrea Giannini, Aris Raad Besharat, Angela Musella
In: Women · 2026 · vol. 6(3) , pp. 49 · doi:10.3390/women6030049 · W7169883085
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This systematic review and meta-analysis found a statistically significant association between exposure to endocrine-disrupting chemicals, particularly polychlorinated biphenyls, and endometriosis.

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Abstract

Endometriosis is a chronic gynecological disease affecting about 10% of reproductive age women, with a significant impact on socio-economic sphere and quality of life. It is a multifactorial phenomenon, in which genetic predisposition, immunologic malfunction, hormone imbalance, and environmental insult play an important role in disease development and progression. The aim of this review is to report the current evidence from the literature related to the association between endometriosis and endocrine disruptors. This study was designed as a systematic review and meta-analysis investigating the association between exposure to endocrine disruptors and the risk of endometriosis. The review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The systematic search identified 428 records from national and international scientific databases. The included studies were published between 2001 and 2020, with most studies classified as fair-to-good quality. The overall random-effects meta-analysis demonstrated a statistically significant association between exposure to endocrine-disrupting chemicals and endometriosis. This systematic review and meta-analysis provides evidence of a significant association between exposure to endocrine-disrupting chemicals and endometriosis, with the strongest and most consistent association observed for polychlorinated biphenyls.

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