Environmental Exposures and Reproductive Health

Abstract

This dissertation focuses on environmental impacts on reproductive and gynecological health. Because women’s health outcomes rely on tightly regulated hormone axes, women are especially vulnerable to the harmful effects of environmental exposures through endocrine disruption and other mechanisms throughout the life course. The first chapter investigates whether exposure to various air pollutants in utero and during childhood is associated with earlier age at menarche. The second chapter explores urinary measures of benzophenone-3, an ultraviolet filter and endocrine disruptor found in sunscreens, plastics, and cosmetics, and their association with ovarian reserve during reproductive years among those presenting for care at a fertility clinic. Lastly, the third chapter highlights how individual-level and spatial levels of social vulnerability are related to the probability of receiving a diagnosis of polycystic ovary syndrome (PCOS), an ovulation disorder that increases risk of reproductive and metabolic comorbidities including infertility. Overall, we observe that environmental exposures and social determinants of health affect reproductive and gynecological outcomes at various points during the life course. The goal of this work is to contribute evidence of the harmful effects of air pollution and endocrine disruptors on women’s health and to highlight current shortcomings of our healthcare systems in properly diagnosing PCOS, with the hope that future interventions to reduce harmful exposures and improve diagnoses of gynecological disease will improve women’s health equity.