The Impact of Endocrine Disruptors on the Female Genital Tract Microbiome: A Narrative Review.

BACKGROUND/OBJECTIVES: Endocrine disruptors (EDs) are xenobiotic chemicals that disrupt hormone signaling and homeostasis within the human body. Accumulative evidence proposes that EDs could affect systemic hormone balance and local microbial communities, including the female genital tract (FGT) microbiome. The FGT microbiome, and especially the vaginal microbiota, contributes significantly to reproductive health maintenance, defense against infection, and favorable pregnancy outcomes. Disruption of the delicate microbial environment is associated with conditions like bacterial vaginosis, infertility, and preterm birth.

METHODS

The present narrative review summarizes the existing literature on EDs' potential for changing the FGT microbiome. We discuss EDs like bisphenol A (BPA), phthalates, and parabens and their potential for disrupting the FGT microbiome through ED-induced hormone perturbations, immune modulation, and epithelial barrier breach, which could lead to microbial dysbiosis.

RESULTS

Preliminary evidence suggests that ED exposure-microbial composition changes relationships; however, robust human evidence for EDs' changes on the FGT microbiome remains scarce.

CONCLUSIONS

Our review addresses major research gaps and suggests future directions for investigation, such as the necessity for longitudinal and mechanistic studies that combine microbiome, exposome, and endocrine parameters. The relationship between EDs and the FGT microbiome could be critical for enhancing women's reproductive health and for steering regulatory policies on exposure to environmental chemicals.