Exposure to harmful chemicals has long been linked to disease, but the specifics surrounding gynecological conditions are largely unknown. A study published in Environmental Health Perspectives by Joanna Marroquin, PhD in Public Health, Epidemiology student, is the first to evaluate Per- and polyfluoroalkyl substances () in endometrial (uterine) tissue. PFAS are commonly referred to as forever chemicals due to their resistance to breakdown and how long they remain in the environment or human body.
The study investigates exposure in relation to risk, staging, and subtypes of endometriosis. They found:
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PFAS were widely detected in endometrial tissue of women with and without endometriosis. This means there was no association found between PFAS and the overall risk of endometriosis.
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However, among those with endometriosis, higher levels of select PFAS were associated with a higher risk for more advanced endometriosis.
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Findings additional research on forever chemical exposure in reproductive tissues and its link to disease progression.
Results can further support scientists studying PFAS and endometriosis, patient advocates, and policymakers working to reduce exposure to harmful environmental chemicals.
Per- and polyfluoroalkyl substances (PFAS), also known as “forever chemicals,” are endocrine-disrupting compounds used for their oil and water-repellent properties in a wide range of products. Endometriosis occurs when uterine tissue grows outside the uterus, causing pain, abnormal menstruation, and in severe cases, infertility. T the National Institute of Environmental Health Sciences (R01031079: Investigating Mixtures of Pollutants and Endometriosis in Tissue (IMPLANT) study) and the Intramural Research Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (contract numbers: NO1-DK-63428, NO1-DK-6-3427, and 10001406-02).
Per- and Polyfluoroalkyl Substances in Eutopic Endometrium Tissue and Risk of Endometriosis: Findings from the Investigating Mixtures of Pollutants and Endometriosis in Tissue (IMPLANT) Study was published in Environmental Health Perspectives in April 2025. It is the college’s first R01-funded project.
Professor Anna Pollack and Associate Professor Jenna Krall in the Department of Global and Community Health served as contributing authors.
About the authors
Joanna Marroquin is a PhD student in Public Health with a concentration in Epidemiology in the Department of Global and Community Health. Her research focuses on women’s health across the life course, examining how environmental chemical exposures affect gynecologic conditions. She is especially interested in the role of endocrine-disrupting chemicals in shaping health outcomes and addressing disparities in exposure. Prior to pursuing her PhD, Joanna worked as a diagnostic medical sonographer, where her experiences in clinical care inspired her to contribute to research that improves health equity for women throughout their lives.
Jenna Krall is an associate professor in the Department of Global and Community Health. Krall is a biostatistician with research interests in air pollution and environmental epidemiology. Her work has been focused on developing methods for estimating sources of air pollution and their associations with health. She is also interested in statistical computing (R, SAS, Stata) and collaborative work related to chemical mixtures, spatial statistics, and missing data.
Anna Pollack’s research focuses on the relationship between environmental chemical exposures and fertility, pregnancy, and gynecologic health. Pollack was trained in reproductive and environmental epidemiology and epidemiologic methods. She investigates biological mechanisms underlying these processes, such as biomarkers of oxidative stress, inflammation, and endocrine disruption. Pollack’s research is based in and addresses disparities in exposure, which stem from environmental and occupational sources. She seeks to apply methods to examine complex mixtures to better understand their impact on women’s reproductive health.