Potential Role of Microplastics and Nanoplastics in the Pathogenesis of Endometriosis: An Environmental Health Narrative Review

Potential Role of Microplastics and Nanoplastics in the Pathogenesis of Endometriosis: An Environmental Health Narrative Review DOI: https://doi.org/10.12775/JEHS.2026.87.67559Keywords microplastics, nanoplastics, endometriosis, environmental exposure, inflammation, oxidative stress, reproductive healthAbstract Microplastics and nanoplastics (MNPs) have emerged as ubiquitous environmental contaminants that are increasingly detected in human biological matrices, including blood, urine, placenta, and reproductive tissues [1–3]. Due to their small size, persistence, and physicochemical properties, these particles are capable of entering the human body through ingestion and inhalation, followed by systemic distribution [4]. Endometriosis is a chronic, estrogen-dependent inflammatory disease affecting approximately 10% of women of reproductive age and is characterized by immune dysregulation, oxidative stress, mitochondrial dysfunction, and altered hormonal signaling [5–7]. Growing evidence indicates that exposure to environmental pollutants may modulate molecular pathways relevant to the development and progression of endometriosis [8]. Experimental studies demonstrate that MNPs can induce oxidative stress, activate inflammatory signaling cascades, disrupt endocrine function, and alter immune cell behavior—mechanisms that overlap with the established pathophysiology of endometriosis [9–12]. Recent reports describing the presence of microplastics in human endometrial tissue further raise concerns regarding direct tissue-level exposure [13]. This narrative review summarizes current PubMed-indexed evidence on human exposure to microplastics and nanoplastics, their biological effects relevant to female reproductive health, and the mechanistic plausibility of their involvement in endometriosis pathogenesis, while highlighting existing knowledge gaps and methodological limitations. References 1.Leslie HA, van Velzen MJM, Brandsma SH, et al. Discovery and quantification of plastic particle pollution in human blood. Environment International. 2022;163:107199. doi:10.1016/j.envint.2022.107199. PMID: 35367073 2.Ragusa A, Svelato A, Santacroce C, et al. Plasticenta: First evidence of microplastics in human placenta.Environment International. 2021;146:106274. doi:10.1016/j.envint.2020.106274. PMID: 33395930 3.Yang Y, Chen G, Wang J, et al. Microplastics in human tissues: A review of detection, occurrence, and implications. Science of the Total Environment. 2024;912:168734. doi:10.1016/j.scitotenv.2023.168734. PMID: 37951264 4.Wright SL, Kelly FJ. Plastic and human health: A micro issue? Environmental Science & Technology. 2017;51(12):6634–6647. doi:10.1021/acs.est.7b00423. PMID: 28531345 5.Bulun SE. Endometriosis. New England Journal of Medicine. 2009;360(3):268–279. doi:10.1056/NEJMra0804690. PMID: 19144942 6.Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–1799. doi:10.1016/S0140-6736(04)17403-5. PMID: 15541453 7.Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertility and Sterility. 2012;98(3):511–519. doi:10.1016/j.fertnstert.2012.06.029. PMID: 22819144 8.Zondervan KT, Becker CM, Missmer SA. Endometriosis. New England Journal of Medicine. 2020;382(13):1244–1256. doi:10.1056/NEJMra1810764. PMID: 32212520 9.Li Y, Li M, Yang Y, et al.Microplastics-induced oxidative stress and inflammation in mammalian cells. Environmental Pollution. 2021;268(Pt A):115909. doi:10.1016/j.envpol.2020.115909. PMID: 33246233 10.Agarwal A, Gupta S, Sharma RK. Role of oxidative stress in female reproduction. Reproductive Biology and Endocrinology. 2005;3:28. doi:10.1186/1477-7827-3-28. PMID: 16018814 11.Hirt N, Body-Malapel M. Immunotoxicity and intestinal effects of nano- and microplastics. Particle and Fibre Toxicology. 2020;17(1):57. doi:10.1186/s12989-020-00387-7. PMID: 33267824 12.Campanale C, Massarelli C, Savino I, et al. A detailed review study on potential effects of microplastics on human health. International Journal of Environmental Research and Public Health. 2020;17(4):1212. doi:10.3390/ijerph17041212. PMID: 32069803 13.Zhang J, Wang L, Kannan K. Microplastics in human endometrial tissue: Evidence and implications. Science of the Total Environment. 2023;858:159919. doi:10.1016/j.scitotenv.2022.159919. PMID: 36306841 14Frias JPGL, Nash R. Microplastics: Finding a consensus on the definition. Marine Pollution Bulletin. 2019;138:145–147. doi:10.1016/j.marpolbul.2018.11.022. PMID: 30573460 15.Galloway TS, Lewis CN. Marine microplastics spell big problems for future generations. Proceedings of the National Academy of Sciences USA. 2016;113(9):2331–2333. doi:10.1073/pnas.1600715113. PMID: 26903619 16. Frias JPGL, Nash R.Microplastics: Finding a consensus on the definition. Marine Pollution Bulletin. 2019;138:145–147. doi:10.1016/j.marpolbul.2018.11.022. PMID: 30573460 17. Galloway TS, Lewis CN.Marine microplastics spell big problems for future generations. Proceedings of the National Academy of Sciences USA. 2016;113(9):2331–2333. doi:10.1073/pnas.1600715113. PMID: 26903619 18. Cole M, Lindeque P, Halsband C, Galloway TS.Microplastics as contaminants in the marine environment. Marine Pollution Bulletin. 2011;62(12):2588–2597. doi:10.1016/j.marpolbul.2011.09.025. PMID: 22001295 19. Andrady AL.Microplastics in the marine environment. Marine Pollution Bulletin. 2011;62(8):1596–1605. doi:10.1016/j.marpolbul.2011.05.030. PMID: 21742351 20. Rochman CM, Brookson C, Bikker J, et al.Rethinking microplastics as a diverse contaminant suite.Environmental Toxicology and Chemistry. 2019;38(4):703–711. doi:10.1002/etc.4371. PMID: 30675804 21. Hartmann NB, Hüffer T, Thompson RC, et al. Are we speaking the same language? Recommendations for microplastic terminology. Environmental Science & Technology. 2019;53(3):1039–1047. doi:10.1021/acs.est.8b05297. PMID: 30608663 22. Yong CQY, Valiyaveettil S, Tang BL. Toxicity of microplastics and nanoplastics in mammalian systems. International Journal of Environmental Research and Public Health. 2020;17(5):1509. doi:10.3390/ijerph17051509. PMID: 32121593 23. Cox KD, Covernton GA, Davies HL, et al. Human consumption of microplastics. Environmental Science & Technology. 2019;53(12):7068–7074. doi:10.1021/acs.est.9b01517. PMID: 31184127 24. Schwabl P, Köppel S, Königshofer P, et al. Detection of various microplastics in human stool. Annals of Internal Medicine. 2019;171(7):453–457. doi:10.7326/M19-0618. PMID: 31476208 25. Dris R, Gasperi J, Saad M, et al. Synthetic fibers in atmospheric fallout. Marine Pollution Bulletin. 2016;104(1–2):290–293. doi:10.1016/j.marpolbul.2016.01.006. PMID: 26802212 26. Toussaint B, Raffael B, Angers-Loustau A, et al. Review of microplastics in food, with implications for human health. EFSA Journal. 2019;17(6):e05709. doi:10.2903/j.efsa.2019.5709. PMID: 32626333 27. Prata JC, da Costa JP, Lopes I, et al. Environmental exposure to microplastics: Analytical challenges. TrAC Trends in Analytical Chemistry. 2020;131:116017. doi:10.1016/j.trac.2020.116017. PMID: 32837284 28. Schneider G, Czernichow P. Skin barrier and nanoparticle penetration. Dermato-Endocrinology. 2011;3(1):38–44. doi:10.4161/derm.3.1.14635. PMID: 21519400 29. Hwang J, Choi D, Han S, et al. Potential toxicity of polystyrene microplastic particles. Scientific Reports. 2020;10:7391. doi:10.1038/s41598-020-64464-9. PMID: 32382127 30. Deng Y, Zhang Y, Lemos B, Ren H. Tissue accumulation of microplastics in mice. Environmental Science & Technology. 2017;51(24):14633–14640. doi:10.1021/acs.est.7b04023. PMID: 29157197 31. Ragusa A, Svelato A, Santacroce C, et al.Plasticenta: First evidence of microplastics in human placenta. Environment International. 2021;146:106274. doi:10.1016/j.envint.2020.106274. PMID: 33395930 32. Amato-Lourenço LF, Carvalho-Oliveira R, Júnior GR, et al. Presence of airborne microplastics in human lung tissue. Journal of Hazardous Materials. 2021;416:126124. doi:10.1016/j.jhazmat.2021.126124. PMID: 34146768 33. Zhang Q, Xu EG, Li J, et al. A review of microplastics in the reproductive system. Environmental Pollution. 2020;267:115364. doi:10.1016/j.envpol.2020.115364. PMID: 32619790 34. Hou J, Lei Z, Cui L, et al. Polystyrene microplastics disturb the female reproductive system. Environmental Pollution. 2021;284:117139. doi:10.1016/j.envpol.2021.117139. PMID: 33965571 35. Giudice LC, Kao LC. Endometriosis. The Lancet. 2004;364(9447):1789–1799. doi:10.1016/S0140-6736(04)17403-5. PMID: 15541453 36. Bulun SE. Endometriosis. The New England Journal of Medicine. 2009;360(3):268–279. doi:10.1056/NEJMra0804690. PMID: 19144942 37. Burney RO, Giudice LC.Pathogenesis and pathophysiology of endometriosis. Fertility and Sterility. 2012;98(3):511–519. doi:10.1016/j.fertnstert.2012.06.029. PMID: 22819144 38. Ngô C, Chéreau C, Nicco C, et al. Reactive oxygen species controls endometriosis progression. American Journal of Pathology. 2009;175(1):225–234. doi:10.2353/ajpath.2009.080804. PMID: 19528347 39. Guo SW, Wang Y. Sources of oxidative stress in endometriosis. Reproductive Sciences. 2013;20(7):762–772. doi:10.1177/1933719112461184. PMID: 23197855 40. Horne AW, Saunders PTK. Inflammatory mediators in endometriosis. Best Practice & Research Clinical Obstetrics & Gynaecology. 2014;28(1):33–44. doi:10.1016/j.bpobgyn.2013.09.003. PMID: 24139534 41. Zhou WJ, Yang HL, Shao J, et al. Anti-inflammatory effects of mitochondria-targeted antioxidants. Human Reproduction. 2019;34(3):493–504. doi:10.1093/humrep/dez006. PMID: 30721958 42. Berbic M, Fraser IS. Immunology of endometriosis. Reproductive Biomedicine Online. 2011;22(2):117–129. doi:10.1016/j.rbmo.2010.10.005. PMID: 21109405 43. Klemmt PAB, Starzinski-Powitz A. Molecular and cellular pathogenesis of endometriosis. Current Women’s Health Reviews. 2018;14(2):106–116. doi:10.2174/1573404813666170316124347. PMID: 28967311 44. Harada T, Taniguchi F. Proinflammatory cytokines in endometriosis. Fertility and Sterility. 2010;94(7):2259–2265. doi:10.1016/j.fertnstert.2010.01.036. PMID: 20356551 45. Zhang T, De Carolis C, Man GCW, Wang CC. The link between immunity, autoimmunity and endometriosis. Reproductive Biology and Endocrinology. 2018;16:72. doi:10.1186/s12958-018-0392-0. PMID: 30064471 46. Schirinzi GF, Pérez-Pomeda I, Sanchís J, et al. Cytotoxic effects of commonly used nanomaterials and microplastics. Environmental Research. 2017;159:579–587. doi:10.1016/j.envres.2017.08.045. PMID: 28858787 47. Yong CQY, Valiyaveettil S, Tang BL. Toxicity of microplastics and nanoplastics in mammalian systems. Int J Environ Res Public Health. 2020;17(5):1509. doi:10.3390/ijerph17051509. PMID: 32121593 48. Lu L, Wan Z, Luo T, et al. Polystyrene microplastics induce oxidative stress and inflammatory responses. Chemosphere. 2018;203:745–752. doi:10.1016/j.chemosphere.2018.04.062. PMID: 29753235 49. An R, Wang X, Yang L, et al. Polystyrene microplastics induce oxidative stress and apoptosis. Environmental Pollution. 2021;268:115792. doi:10.1016/j.envpol.2020.115792. PMID: 33099172 50. Morgan MJ, Liu ZG. NF-κB signaling in inflammation and cancer. Cell Research. 2011;21(1):103–115. doi:10.1038/cr.2010.177. PMID: 21119682 51. Sun X, Chen B, Li Q, et al. Toxicities of polystyrene nano- and microplastics on mitochondria. Science of the Total Environment. 2021;764:142838. doi:10.1016/j.scitotenv.2020.142838. PMID: 33278911 52. Li B, Ding Y, Cheng X, et al. Polyethylene microplastics affect immune responses. Journal of Hazardous Materials. 2020;389:121980. doi:10.1016/j.jhazmat.2019.121980. PMID: 31982365 53. Dong CD, Chen CW, Chen YC, et al. Macrophage inflammatory responses induced by microplastics. Environmental Pollution. 2020;256:113442. doi:10.1016/j.envpol.2019.113442. PMID: 31542542 54. Zitouni N, Bousserrhine N, Missawi O, et al. Uptake, tissue distribution and toxicity of microplastics. Environmental Science & Technology. 2021;55(2):933–944. doi:10.1021/acs.est.0c06587. PMID: 33382147 55. Feng Z, Wang L, Wang X, et al. Microplastics alter immune homeostasis. Journal of Hazardous Materials. 2022;424:127343. doi:10.1016/j.jhazmat.2021.127343. PMID: 34700211 56. Leslie HA, van Velzen MJM, Brandsma SH, et al. Discovery and quantification of plastic particles in human blood. Environment International. 2022;163:107199. doi:10.1016/j.envint.2022.107199. PMID: 35367073 57. Vinatier D, Orazi G, Cosson M, et al. Theories of endometriosis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2001;96(1):21–34. doi:10.1016/S0301-2115(00)00405-X. PMID: 11311760 58. Sampson JA. Peritoneal endometriosis due to retrograde menstruation. American Journal of Obstetrics and Gynecology. 1927;14:422–469. PMID: 19970049 59. Buck Louis GM, Peterson CM, Chen Z, et al. Environmental endocrine disruptors and endometriosis. Human Reproduction Update. 2013;19(5):594–604. doi:10.1093/humupd/dmt033. PMID: 23827925 60. Giudice LC. Clinical practice: Endometriosis. New England Journal of Medicine. 2010;362(25):2389–2398. doi:10.1056/NEJMcp1000274. PMID: 20573927 61. Campanale C, Massarelli C, Savino I, et al. A detailed review study on potential effects of microplastics and additives on human health. International Journal of Environmental Research and Public Health. 2020;17(4):1212. doi:10.3390/ijerph17041212. PMID: 32069997 62. Rochman CM, Kurobe T, Flores I, Teh SJ. Early warning signs of endocrine disruption in fish from plastic debris. Scientific Reports. 2014;4:6568. doi:10.1038/srep06568. PMID: 25274221 63. Meeker JD, Sathyanarayana S, Swan SH. Phthalates and other additives in plastics: Human exposure and health consequences. Philosophical Transactions of the Royal Society B. 2009;364(1526):2097–2113. doi:10.1098/rstb.2008.0268. PMID: 19528058 64. Vethaak AD, Leslie HA. Plastic debris is a human health issue. Environmental Science & Technology. 2016;50(13):6825–6826. doi:10.1021/acs.est.6b02569. PMID: 27351518 65. Crain DA, Janssen SJ, Edwards TM, et al. Female reproductive disorders: The roles of endocrine-disrupting compounds. Reproductive Toxicology. 2008;25(2):168–179. doi:10.1016/j.reprotox.2007.10.001. PMID: 18155628 66. Bulun SE, Yilmaz BD, Sison C, et al. Endometriosis. Endocrine Reviews. 2019;40(4):1048–1079. doi:10.1210/er.2018-00242. PMID: 30994896 67. Zhou Y, Wang J, Zou Z, et al. Microplastics exposure alters reproductive hormone levels. Environmental Pollution. 2020;259:113904. doi:10.1016/j.envpol.2019.113904. PMID: 31928912 68. Gore AC, Chappell VA, Fenton SE, et al. EDC-2: The endocrine society’s second scientific statement. Endocrine Reviews. 2015;36(6):E1–E150. doi:10.1210/er.2015-1010. PMID: 26544531 69. Prata JC, da Costa JP, Lopes I, et al. Solutions and integrated strategies for the control and mitigation of plastic pollution. International Journal of Environmental Research and Public Health. 2019;16(13):2411. doi:10.3390/ijerph16132411. PMID: 31277236 70. WHO. Microplastics in drinking-water. World Health Organization; 2019. PMID: 32918098 Downloads Published How to Cite Issue Section License Copyright (c) 2026 Maja Radziwon, Konrad Borowski, Oskar Pastuszek, Emilia Bolesta-Okuniewska, Pawel Michalak, Aleksandra Marchwińska-Pancer, Katarzyna Kopeć, Julia Ceryn, Anna Maria Wicher This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Stats Number of views and downloads: 495 Number of citations: 0