Cross-sectional Study of Urinary Levels of Endocrine Disrupting Chemicals and Premenopausal Symptom Severity in a College-Aged Population

Background: Endocrine-disrupting chemicals (EDCs) are suggested to affect premenstrual syndrome (PMS) symptom severity through dysregulation of sex steroid hormones like estrogen and progesterone and interference with the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes. Two cross-sectional studies have investigated the association between EDC exposure and PMS symptom severity using self-reported behaviors as a proxy for estimating EDC exposure. Methods: We evaluated whether urinary levels of bisphenol-A (BPA), methylparaben (MP), and monoethyl phthalate (MEP) were associated with a higher prevalence of PMS symptoms using data from the UMASS Breast Density Study, which included 98 nulliparous women aged 18–22 from the University of Massachusetts Amherst. Participants rated symptom severity on a 4-point scale for 26 physical and affective symptoms associated with PMS based on a modified version of the Calendar of Premenstrual Experiences (COPE) questionnaire. Associations between urinary EDC levels and PMS symptom severity were examined using multivariable linear regression. Results: Among 98 participants, the mean total PMS score was 42.7 and mean physical and affective scores were reported as 29.9 and 14.2, respectively. The top five symptoms reported were bloating, irritability, breast tenderness, abdominal cramping and emotional hypersensitivity, with approximately 30% of individuals reporting these symptoms as moderate to severe. No significant associations were observed between total PMS scores and tertile levels of BPA, methylparaben, or monoethyl phthalate. However, a suggestive positive trend was noted for BPA, with total PMS scores increasing by 2.97 points (β = 2.97, SE = 2.66, p = 0.27) and 3.46 points (β = 3.46, SE = 2.58, p = 0.18) in the second and third tertiles, respectively, compared to the lowest tertile. Similarly, affective PMS scores increased by 1.42 points (β = 1.42, SE = 1.31, p = 0.28) and 2.36 points (β = 2.36, SE = 1.27, p = 0.07) across the second and third tertiles of BPA exposure, respectively. Conclusion: This study observed no significant associations between urinary EDC concentrations and PMS symptom score severity. Future research should focus on assessing these associations in a larger, more diverse sample, as only 98 college-age women were included from the University of Massachusetts Amherst.