Endometriosis: What if endocrine disruptors play a role we are only beginning to understand?
Laboratoire AiméeThere are figures that alone tell a silent emergency. Today, endometriosis affects about 10% of women of reproductive age worldwide, nearly 190 million people. Behind these statistics lie life journeys marked by profound medical wandering: it takes an average of 7 years for a diagnosis to be made. Seven years of doubts, normalized pain, and questions about the origin of an ailment that seems to take root.
Faced with this invisible epidemic, science no longer only seeks to manage symptoms; it traces back to the causes. Among them, one hypothesis gains more weight each year: that of our environment. What if the chemical substances around us contribute to the development of this pathology? This is not about providing a definitive answer but about taking a clear look at avenues that international research now takes very seriously.
This article does not claim that endocrine disruptors cause endometriosis. It presents the current state of research on the links studied by science, as well as the choices we make in our formulation practice.
Understanding endometriosis: a hormonally influenced disease
Endometriosis is a complex gynecological disease. It is characterized by the presence of tissues similar to the endometrium (the uterine lining) outside the uterine cavity. These cells are found on the ovaries, fallopian tubes, peritoneum, and sometimes even on neighboring organs like the bladder or intestines.
The problem lies in the behavior of this "exiled" tissue: during each cycle, under the influence of hormones, it reacts exactly like normal endometrium. It thickens, then bleeds. But having no outlet to the outside, these micro-bleeds cause chronic inflammation, adhesions, and internal lesions.
The consequences are often disabling: extremely painful periods, chronic fatigue, and pain during sexual intercourse. For many affected women, the struggle also involves fertility: in 30 to 40% of cases, endometriosis is associated with difficulties conceiving. It is all the more important to look into the link between endocrine disruptors and fertility.
One point is fundamental here: endometriosis is an estrogen-dependent pathology; the growth of the endometrium is stimulated by estrogens. It is precisely this hormonal sensitivity that places the disease at the heart of the debate on environmental chemical substances.
Endometriosis and endocrine disruptors: what research is exploring today
A hormone-dependent disease that raises questions about the environment
If the growth of the endometrium is conditioned by estrogens, then any substance capable of "mimicking" this hormone becomes a potential suspect in the onset, progression, or worsening of endometriosis.
This is precisely the mode of action of endocrine disruptors: these substances can interfere with the hormonal system by mimicking, blocking, or altering the body's natural signals. In the case of endometriosis, an estrogen-dependent disease, this interference raises a central question: can these environmental exposures amplify the mechanisms already at work?
What studies currently say about the link between EDs and endometriosis
For several years, international research has been closely examining this hypothesis. A convergence of epidemiological studies highlights a association between exposure to certain endocrine disruptors — notably bisphenols (BPA), phthalates (such as DEHP), dioxins, and PCBs — and endometriosis.
A review published in Reproductive Toxicology (Sirohi et al., 2022) suggests that these substances could play a role in the pathophysiology of the disease, by affecting several key biological pathways.
More recently, a 2025 review (International Journal of Molecular Sciences) confirms this trend: available data show a positive association between the levels of these compounds in the body and the risk of endometriosis.
A case-control study published in 2024 in Environmental Research, involving more than 500 women, notably observed that high urinary levels of bisphenols and phthalate metabolites were associated with an increased risk of endometriosis.
These results do not establish direct causality. However, they highlight a convergence of scientific clues that research continues to explore.
Increasingly documented biological mechanisms
Several plausible mechanisms now help explain why these substances are closely studied:
- Xeno-estrogenic activity
Some molecules act as "hormonal impostors." They bind to estrogen receptors and trigger inappropriate cell growth signals. This artificial stimulation could increase the estrogen exposure of tissues and promote lesion development;
- Oxidative stress
Exposure to persistent organic pollutants (such as dioxins or PCBs) causes an imbalance between free radicals and antioxidants. This cellular stress promotes a chronic inflammatory environment, characteristic of endometriosis;
- Immune system disruption
Normally, the immune system eliminates endometrial cells present outside the uterus. Some toxins could weaken this ability, allowing these cells to implant and persist;
- Epigenetic modifications
Some substances can alter the expression of genes involved in hormonal and inflammatory regulation, without changing the DNA itself. These changes could contribute to establishing a lasting environment favorable to the disease.
A scientific coherence, without absolute certainty
Taken individually, each of these mechanisms remains under study. But together, they outline a biological coherence: by simultaneously acting on hormones, inflammation, and immunity, endocrine disruptors could create an environment conducive to the implantation and progression of endometriosis.
It is this convergence of clues — rather than a single proof — that today leads the scientific community to consider environmental factors as a serious avenue, still under investigation.
Where do we encounter these substances in daily life?
Exposure to endocrine disruptors does not result from a single event, but from a widespread and continuous presence in our environment:
- Food: through pesticides (organochlorines) or plastic containers;
- Housing: cleaning products, brominated flame retardants, or candles made from paraffin derived from petrochemicals.
- Hygiene and cosmetics: phthalates are still frequently used as fixatives in endocrine disruptors found in conventional perfumes. Special caution is needed regarding industrial sanitary products due to the high permeability of the vaginal mucosa;
- Work environment: long-term exposure in the workplace is a major concern. A Canadian study notably highlighted an increased risk of gynecological diseases, including a 40% increase in ovarian cancer risk, among beauticians and hairdressers. This finding also applies to the clothing industry, construction, and agriculture.
The real health challenge lies in the cocktail effect, in other words, the accumulation of multiple low-dose exposures from various everyday sources. Indeed, each source alone may seem harmless. But we are exposed to a daily accumulation of micro-exposures. Safety thresholds are calculated substance by substance, product by product, and do not take into account repeated, almost chronic exposure.
Faced with the omnipresence of sources and the inadequacy of current regulatory thresholds, the only immediate action is to reduce the exposures we can directly control.
This observation justifies increasing precautions during pregnancy, as well as for women whose hormonal balance is already weakened by a condition (endometriosis, PCOS…).
The precautionary principle, an obvious choice for Aimée de Mars
Faced with this omnipresence, what stance should be taken? For Valérie Demars, founder of the Aimée de Mars Laboratory, the answer lies in a deep conviction born from 30 years of formulation experience.
Her experience reflects the slow response time of health authorities. She has observed the successive questioning of substances (chlorphenesin, parabens, phenoxyethanol, or PFAS), once considered safe before being banned or restricted, often 15 years after initial doubts. This clinical experience led her to a conclusion: "we didn't know" can no longer be used as an excuse.
"The precautionary principle doesn't mean we're perfect. It means that when there is doubt, we don't take the risk," she explains.
This requirement led to the shift from 98% to 100% naturally sourced. This choice, which took 5 years of R&D, perfectly illustrates our manifesto for a perfume that protects life. Today, it is entirely possible to choose cosmetics without endocrine disruptors without sacrificing sensory pleasure. A natural concentrate costs ten times more than its synthetic equivalent, but this is an accepted extra cost to guarantee respectful care.
Conclusion
Endometriosis is a complex disease, with roots that are both genetic and environmental. The 190 million women affected deserve that the issue of pollutants be addressed transparently by health authorities.
It's not about living in fear, but adopting a cautious approach. Reducing synthetic content in your home and favoring healthy products are levers everyone can activate. By choosing care over chemical risk, we not only protect our skin, we protect our most intimate balance.
Sources
- WHO (2023): "Report on the global impact of endometriosis."
- Sirohi et al., (2022): "Endocrine disruptors and endometriosis, Reproductive Toxicology."
- Environmental Research (2024): "Case-control study on bisphenols and phthalates."
- International Journal of Molecular Sciences (2025): "Unraveling the Core of Endometriosis."
- Biomedicines (2024): "Epidemiological review on phthalate exposure."