estrogens

BPA and Other Gender Bending Plastics

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An oft repeated theme in this journal is that measurement matters. From the basic concept that one cannot manage what is not measured to the more specific notion that research protocols in the lab should attempt to mimic real life as much as reasonably possible, we believe measurement is critical. In matters of health and hormones where complex systems with a myriad of ever-changing variables are the norm, this is difficult at best. Sometimes, however, the simple act of measuring these variables opens a world of insight. This is the case with BPA and other estrogenic plastics.

BPA and Estrogens

Bisphenol-A (BPA), the estrogenic activator leaching sperm from our men and damaging the ovaries of women came to the world’s attention several years ago after a vocal and strident outcry from moms. The FDA subsequently remitted, prohibiting BPA from baby bottles and sippy cups and a slew of newer ‘safer’ BPA-Free plastic products emerged, but are they really safer? Maybe not.

Simulating Real Life Usage: Measurement Matters

Until recently, no one had measured the estrogenic activity of the other compounds used to plasticize our food containers. Nor had anyone measured these compounds under real-world stressors, such as UV-radiation (sunlight), microwave radiation or in the dishwasher or with different types of solvent (to represent the food/drinks contained by these plastics). Indeed, as is often the case, we were lulled into a false sense of safety.  We believed that since BPA was removed from plastics, the endocrine disruptors were also removed, when in fact the other compounds had simply not been measured.

As one might expect, once those tests were conducted, researchers found that most plastic products on the market today release chemicals that are estrogenic – even those marketed as BPA-Free. Baby bottles, where much of the BPA outcry began, can leech as many as 100 different chemicals especially when exposed to real-life stressors, sunlight, microwaves and dishwashers, all estrogenic in nature.

Sunlight, in particular, was especially adept at maximizing the release of estrogenic chemicals into the solvent. Who hasn’t left their water bottle in the car? And when the plastics were tested in both polar and non-polar solvents (most foodstuffs/drinks are a combination of both), the majority showed reliably detectable estrogenic activity.

What to Do With All of These Estrogens

Not to worry, according to the authors of the study, there are ways to create plastics that don’t elicit estrogenic activity and they don’t cost any more or require different manufacturing than those that do. It’s simply matter of choosing to utilize those plasticizers and associated chemicals instead of what we currently use. The question is whether major plastics manufacturers will pay heed to these warnings and make the switch. Did I mention the man-boobs and infertility from the extra estrogens?

The study:  Most Plastic Products Release Estrogenic Chemicals: A Potential Health Problem That Can Be Solved 

Postscript

The article above was published originally in October 2012. Over two years later, I am sad to say that not much has changed. Industry has repeatedly denied the safety issues with BPA and the other, presumably safe, BPA-free plastics. The current campaigns, much like those of the tobacco industry, proffer industry financed research as proof of product safety while discrediting any scientist who brings evidence to the contrary. It’s a common script followed by all chemical manufacturers; one that has yet to be successfully curtailed.

 

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Controversy, GMO Research & Women’s Health

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If you’ve been on the internet at all over the last several weeks, you’ve likely come across these pictures- the white rats with grotesquely large mammary tumors warning of the dangers of GMO foods. A controversial and not yet even officially published study out of France on the Long term toxicity of Roundup herbicide and a Roundup-tolerant genetically modified maize is responsible.

In this 2 year study (compared to the 90-120 days for most previous protocols) researchers purportedly demonstrated the ill-effects of glyphosate (active ingredient in Roundup herbicide) and its adjuvants (putatively inactive ingredients that enhance the absorption, distribution or metabolism of the active ingredient), but also inadvertently, and despite the rampant criticism of the study, may have identified a mechanism of action for the growth of these tumors; a disruption of the estrogen pathway perhaps linked to primary kidney and liver damage. Moreover, and again perhaps inadvertently, the research points to a possible player in the development of fibroid type tumors.

How GMO Research is Conducted

There is great debate over the safety of herbicide rendered or engineered, genetically modified organisms (GMO) within the food and water supply. Studies on the side of industry, suggest no major ill-effects, while those on the side of environmentalist indicate differently.  Research design likely contributes to the disparate findings. Much research to date has been short-term (90-120 days) and/or has limited the analysis to testing or manipulating only the active ingredient in the herbicide (glyphosate) and not the variety adjuvants found in the total herbicide formulation and that would be dispersed into the natural environment (food, water) post herbicide use.

The current study sought to remedy some of those short-comings and approximate what humans might be exposed to with current regulatory standards in place and in an ‘natural environment’ where exposure rates and types would necessarily vary. (Whether lab rats can approximate human physiology or the lab can be considered a ‘natural environment’  are debates for another day).

The Seralini GMO Study

Using healthy male and female Sprague-Dawley rats, the researchers evaluated the long-term (two years), across a life-span effects, of eating Roundup treated foods (maize) and water with Roundup residue at levels below the currently parts per billion standard and consistent with what humans might be exposed to in the current environment. Control rats were fed non-GMO diets and the test rats were fed varying levels of GM maize (11%, 22% and 33% of the total diet) and water with Roundup – well below the approved levels found in the environment.

Tumors, Toxicity, Death and the GM Diet

Compared to control rats fed a non-GM diet, those fed the GM-maize and Roundup water, died five times sooner and developed huge tumors, often greater than 25% of their body weight and requiring euthanasia to reduce suffering. There were distinct differences between the male and female treated animals. The females died more quickly and developed primarily mammary tumors, followed by a lower percentage of pituitary tumors and kidney and liver toxicity. While the males, demonstrated more severe kidney and liver disease along with skin tumors. The females were more susceptible to the Roundup in the water and both groups were equally susceptible to both the lower and higher percentage (11% and 33%) exposure to GM food, suggesting a threshold effect for disease initiation rather than a cumulative or additive effect.

Endocrine Disruption

The endocrine effects were also telling and pointed to sex-dependent differences in the tumor and disease expression. The ratio of testosterone to estradiol was disrupted in both males and females. Males in the highest Roundup treatment group (33% of total feed maize), demonstrated double the levels of circulating estradiol (see Evolution or Extinction of Men for details on male endocrine disruption) when compared to the control group. Whereas the exposed females showed increased testosterone levels.

Potential Fibroid Connection

The explosive growth of tumors in the female treated rats is notable both because of the large size and location of the tumors (mammary and pituitary) but more so perhaps because of the nature and physiology of the tumors themselves. In all but two cases, the tumors were non-cancerous, non-infective or non-metastatic.  The tumors were benign adenomas and fibroadenomas, those commonly found in human women as they age (also common in this strain of lab rat as it ages). Fibroadenomas are comprised of fibrous and glandular tissue located in the breast. Fibroids are similar in tissue composition, but are found in the uterus.  In the present study, fibroadenomas were found in the mammary tissue and adenomas in the pituitary gland. There was no mention of uterine fibroids or adenomas in other female reproductive regions. Similarly, although, the authors make no such claim regarding the expression of fibroid type tumors, relative to hormone changes and concurrent liver dysfunction (where the enzymes and proteins involved in the hormone regulation reside), I surmise that perhaps there is a connection there as well.  It is conceivable that the combined insult of aging and environmental toxins on liver function alters hormone pathways sufficiently to promote this type of tumor growth.

Controversy and Criticism

As this study was released both pro- and anti-GMO factions got their pants in a bunch. On the anti-GMO side, this study represented proof-positive that GMO foods were bad. The results of this study, and in particular, the pictures of the tumor-ridden rats went viral on the internet. On the pro-GMO side, the criticism was as swift as it was vitriolic, with claims ranging from poor methodology, to outright scientific fraud.  I suspect the truth lay somewhere in between.

My Take

Releasing to press first. This merited all sorts of criticism, most of which has no bearing on the actual study but does suggest a less than forthright approach to media relations. However, given the politics surrounding this topic, one can understand this PR approach.

Sprague-Dawley rats are prone to tumors. Yes, they are and as they age, tumors become more frequent. But here we have a little pot and kettle action going on. Sprague-Dawley and other outbred strains of rats and mice, all have predilections for certain diseases and tumors, but are nevertheless what is used in all industry supported (even the studies supporting the safety of GMO) and academic research. The choice of lab rat/mice is important, but even within specific strains there is huge variability. Nullifying the study because the researchers used the same strain of lab rats that other researchers also use, is a weak criticism at best and more than a little disingenuous. Perhaps a better criticism would be the use of lab rats in general to extrapolate human physiology.

Sprague-Dawley rats are prone to tumors as they age. Well guys, so are women. By the time a woman reaches age 50, upwards of 70% of women have fibroid type tumors. And frankly, aging, whether in animals or humans, increases disease expression. Our bodies just don’t work as well when we are older. Simply measuring the effects of a toxin for a short period of time in youthful animals does not, in any way, mirror the real life of the animal or a human, where effects are cumulative over time and sometimes even multiplicative and synergistic.

The study was too long and the control rats were dying too. Life is longer than adolescence. If one wants to evaluate how a treatment or toxin affects an organism over time and as it ages, one has to evaluate across that life span. This study compared tumor progression, disease and death rates between the non-GM controls and the GM fed groups, across the rodent’s life span, which is about 2+/- years. As the rodents aged, both groups developed tumors and some died, but there were more tumors and earlier deaths in the experimental group.

Failure to observe or measure is not synonymous with non-existence. Neglecting to measure a particular toxin or analyte, a specific symptom or disease process, or failing to evaluate long term effects does not mean that the toxin, analyte, symptom or disease process in question did not happen or does not exist. It simply means that you chose not to measure it. So claiming that a 3-month study in youthful rodents nullifies results from a longer study, regardless of any other methodological issues with either study, is an utterly false, and more than a little dishonest argument.

The dose response-curve was not linear. Damn it, how dare our complex physiology not conform to the simplicity of linear statistics. A common dose-response reaction is highly linear, where a small dose elicits a similarly small response and a larger dose increase the response size. This is not case when dealing with endocrine disruptors. Hormone systems are complex and highly non-linear. Hormone reactions occur at extremely low doses and often interact synergistically with other factors and respond differently over time and with cumulative exposures. This was the case in the current study.

In spite of the flaws with this study and contrary to the criticism, the Seralini study represents one of the only, if not the only, long term evaluation of the effects of Roundup and GM feeding on health. Long term studies, even in rodents, are not common place. They should be.

The next long term study (and there should be many more) should include different strains of rodent, measure additional hormones and steroidogenic proteins altered with liver disease and if they want to be really ingenious, look at the estrogen, androgen and progesterone receptor densities in the tumors.

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Vaginal Atrophy – The Great Wall of the Vagina

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Does it hurt when you have sex? What about when you pee? Maybe just riding a bike is uncomfortable. This pain or discomfort may be attributed to vaginal atrophy.

Vaginal atrophy, or atrophic vaginitis, is a medical condition that refers to the thinning, drying and inflammation of the vaginal walls. This change in the vagina is due to a loss of endogenous estrogens and may account for discomfort and pain that women feel during everyday activities, such as sex, urination, or exercise.

This condition causes the vaginal walls to become fragile, and good bacteria in the vagina are often replaced by harmful bacteria and fungi. Since the vaginal wall is more susceptible to small tears, the possibility for infection increases.

Endogenous Estrogens

Our bodies naturally make a variety of estrogens. The most common endogenous estrogen is estradiol, which is produced in a woman’s ovaries. The remaining endogenous estrogens include estriol, which is produced by the placenta during pregnancy; and estrone, which is made by the ovaries and the adipose tissue – which is just a nice term for body fat.

Turns out, thin women are more susceptible to vaginal atrophy, which makes sense. Thinner women don’t have as much adipose tissue, so they don’t produce as much estrone. Women with more meat on their hips, however, have more fat tissue, which means they have another means of producing endogenous estrogens should they ever need backup.

Where Did the Endogenous Estrogen Go?

A woman’s endogenous estrogens can be impacted a number of ways. The simple joys of womanhood can affect hormone levels: Estradiol and especially estriol, decline dramatically following childbirth. Estradiol also declines while breastfeeding, and at menopause. In fact, the Harvard School of Medicine reported that within a few years of menopause, 50% of women have symptoms of vaginal atrophy.

Cesarean. Think you’re out of the woods because you haven’t had a child? Studies show that women who have never given birth vaginally are also more likely to have vaginal atrophy, according to Mayo Clinic. This means women who have only had cesarean sections are prone to vaginal atrophy, also.

Smoking. Don’t light up in frustration just yet: Women who are smokers are also prone to vaginal atrophy, which may be due to reduced blood circulation in the vaginal walls.

Cancer. Various cancer treatments can also decrease the production of endogenous estrogens. An oophorectomy, or the surgical removal of the ovaries, is performed to reduce the risk of ovarian cancer, and undoubtedly impacts the production of estradiol. Women undergoing pelvic radiation and chemotherapy can also experience lower endogenous estrogen levels.

Certain breast cancers are sensitive to endogenous estrogens, especially estrone, which encourage the growth of breast cancer tumors. In order to deter tumor growth, breast cancer patients may be given drugs that suppress endogenous estrogens. Sexuality, Reproduction and Menopause published a study that found 90% of breast cancer survivors report sexual problems and symptoms of vaginal atrophy.

Communicate Your Concerns

Although 50% of postmenopausal women and 90% of breast cancer survivors have symptoms of vaginal atrophy, Dr. Deborah Coady, who is the co-authored of Healing Painful Sex, said studies show only 10 to 20% of women discuss vaginal discomfort and pain with their doctors.

In the past, doctors linked vaginal dryness and dyspareunia, or painful intercourse, to emotional problems, discarding the possibility of a physical or hormonal change occurring. Now, however, more doctors are being educated on vaginal atrophy and are in a better position to discuss changes to the vaginal wall.

Oncosexology is developing to properly educate oncologists and patients alike, so they can prepare for the hormonal and vaginal changes that are likely to occur as a result of various cancer treatments.

If your doctor doesn’t bring it up first, though, don’t hesitate to speak up. Dr. Coady recommends talking about any vaginal discomfort, dryness, or pain right away. The longer the pain persists, the more likely it will result in nerve pain and dysfunction of the pelvic floor, so it’s best to diagnose the problem right away.

Treating Vaginal Atrophy

There are a slew of over-the-counter and prescriptions treatments available for women, such as vaginal moisturizers, lubricants, and low-dose vaginal estrogen. A list of these can be found on the Harvard School of Medicine website.

As for natural remedies, Dr. Coady found the application of natural oils, such as vitamin E, safflower, olive, or coconut oil effectively hydrates the vaginal wall when used three or four times a day for a month or two. A friend of mine uses coconut oil as a lubricant during intercourse, and says it works well.

As it turns out, the Harvard School of Medicine notes that sexual intercourse and/or masturbation is also good for your vaginal walls. This sexual activity stimulates blood flow to the vaginal walls, promotes vaginal elasticity, and, when aroused, increases lubrication. The Journal of the American Medical Association published a study that found women who are sexually active report less vaginal atrophy than those who are not, so feel free to get the blood flowing.

If you think you are suffering from vaginal atrophy, don’t suffer in silence. There are ways to improve this condition, and it starts by consulting your doctor and tending to your vaginal wall.

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