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Endocrine disruptors (EDs), chemicals in the environment that can affect human endocrine function, are increasingly becoming a prominent concern for the public as well as professionals.

Experts at the 2nd International Congress on Endocrine Disruptors and Women’s Health reported exposure to EDs during pregnancy may affect not only children but also future generations through epigenetic changes.

EDs interfere with hormonal signaling through multiple mechanisms, including mimicking hormones, and binding to their receptors, blocking natural hormonal signals, and altering hormone synthesis, transport, and metabolism, according to Sonia Almela, Ph D, founder and CEO, ME AND ME Cosmetics in Barcelona, Spain. Her work focuses on cutaneous endocrinology, cosmetic safety, and women’s health.

Speaking with El Médico Interactivo, part of the Medscape Professional Network. Almela explained that these substances are particularly concerning because they can act at extremely low concentrations, accumulate over time, and remain undetected for years or even decades.

“When an endocrine disruptor interferes with the endocrine system, it disrupts the signaling that coordinates many processes simultaneously,” Almela said. She noted that the potential consequences included thyroid disorders, metabolic abnormalities, reproductive difficulties, persistent inflammation, precocious puberty, early menopause, endometriosis, and accelerated aging.

Epigenetic Changes

Almela also highlighted EDs can induce epigenetic changes, particularly during vulnerable developmental periods such as pregnancy, breastfeeding, and puberty.

“These are times when the body is during hormonal development, and any interference can leave a lasting mark — much deeper than we imagine. It’s not just a one-time exposure; it’s an exposure that leaves a lasting impression,” said Almela.

She explained that the best-documented epigenetic mechanisms include DNA methylation, histone modification, and regulation by noncoding RNA. EDs may alter these processes in sperm and oocytes, allowing modified epigenetic information to be transmitted to the offspring.

Experimental models have shown that progenies of mothers exposed to EDs during pregnancy develop metabolic, reproductive, and immune abnormalities despite no direct exposure. In some cases, these effects persisted until the third generation.

Diagnosis and Prevention

In Almela’s view, applying this knowledge in clinical practice requires a broader diagnostic approach. She explained that cumulative exposure to EDs should be considered in patients presenting with unexplained chronic fatigue; weight gain; anxiety or depression resistant to treatment; hair loss; irregular menstrual cycles; endometriosis; polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome (PCOS); fertility problems; precocious puberty in children; or subclinical hypothyroidism despite otherwise normal laboratory findings. She argued that clinicians should assess ED exposure as routinely as they evaluate diet, sleep, or stress.

About prevention, Almela stated that the most urgent priority is reducing exposure during critical stages of hormonal development, including pregnancy, breastfeeding, and puberty. “These are periods when the endocrine system is still developing, and the effects of disruption can be permanent and transgenerational,” she said.

She also highlighted education of healthcare professionals as another major priority “We are responsible for educating ourselves, and that also means understanding all routes of exposure — such as food, air, water, what is inhaled, and what is applied to the skin — and assessing each patient’s actual cumulative exposure,” she said.

The second major concern she noted was the gap between the scientific evidence and current regulations. “Today, there is a huge gap between what research shows and what regulations require.”

According to her, the fourth priority is research. “We need studies that link chronic exposure to endocrine disruptors with transmissible epigenetic changes, with observable clinical markers, and with the conditions we are seeing on the rise, such as endometriosis, PCOS, hypothyroidism, infertility, precocious puberty, and hormone-dependent cancers.”

This article was translated from El Médico Interactivo, part of the Medscape Professional Network.