Menstrual Irregularities in Adolescent Girls and Correlation with the Extent of Exposure to Plastics: A Case-Control Study

Abstract

Introduction: Menstrual irregularities in adolescent girls are rapidly increasing worldwide. Exposure to endocrine-disrupting chemicals such as plastics including Bisphenol A (BPA), Phthalates and Polyvinyl chloride (PVC) are potential environmental toxins contributing to hormonal imbalance and irregular menstrual cycles. Aim/Objectives: We examined the association between plastic usage and menstrual cycle characteristics among Adolescent girls aged 15–19 years who were participating in a questionnaire-based cohort study under the program on reproductive health awareness in adolescent girls. Materials and Methods: A case-control study of 360 girls was conducted in 2016 and 2019 in a school in Rajasthan, India. We used self-reported information through a questionnaire to assess the association of irregular menstrual cycles (≤25 days and ≥35 days) with extent of plastic usage categorized here as medium and high. Results: The study cohort had a high prevalence of irregular menstrual cycles (40.8%). Heavy plastic exposures increased the chances of getting irregular periods significantly. Girls with irregular menstrual cycles had more prevalence of hair fall, acne, acanthosis nigricans, and abnormal hair growth/hirsutism. Girls with family history of diabetes and CVD were more susceptible to develop irregular menstrual after heavy usage of plastics. Both medium and high exposures to plastics were associated with abnormal hair growth/hirsutism (p <0.026) indicating a role of androgen imbalance in these girls. Most girls with irregular cycles had no history of obesity or diabetes and CVD, indicating the association of plastics use with menstrual irregularities in adolescent girls. Conclusion: These results suggest that exposure to plastics increases the chances of having irregular menstrual cycle and the characteristics of PCOS. Due to its endocrine disruptive actions, plastics may influence neuroendocrine functions during the preadolescent period and cause imbalance in the levels of endogenous hormones essential for optimal menstrual function.