Midlife Urinary Phthalate Metabolite Concentrations and Prior Uterine Fibroid Diagnosis

Diana C. Pacyga, Brad A. Ryva, Romana A. Nowak, Serdar E. Bulun, Ping Yin, Zhong Li, Jodi A. Flaws, Rita S. Strakovsky

Research output: Contribution to journalArticlepeer-review


Fibroid etiology is poorly understood but is likely hormonally mediated. Therefore, we evaluated associations between midlife phthalates (hormone-altering chemicals) and prior fibroid diagnosis, and considered differences by weight gain status. Women (ages: 45–54; n = 754) self-reported past fibroid diagnosis. We pooled 1–4 urines collected after fibroid diagnosis over the consecutive weeks to analyze nine phthalate metabolites and calculate relevant molar sums (e.g., di(2-ethylhexyl) phthalate, ΣDEHP; anti-androgenic phthalates, ΣAA; all metabolites, ΣPhthalates). Using Poisson regression, we evaluated associations between phthalate biomarkers and the risk of having fibroid diagnosis. We explored if associations differed by weight gain from age 18 to 45–54 or in women diagnosed with fibroids within 5 years of phthalate assessment. Our major finding was that women had a 13% (RR: 1.13; 95%CI: 1.02, 1.26) and 16% (RR: 1.16; 95% CI: 1.03, 1.31) greater risk of prior fibroid diagnosis for each two-fold increase in ΣDEHP or ΣAA, respectively. These associations were strongest in women who became overweight/obese from age 18 to 45–54 and in those diagnosed <5 years before phthalate assessment. Based on these results, prospective studies should corroborate our findings related to associations between phthalates and fibroids, and may consider evaluating the role that weight gain may play in these associations.

Original languageEnglish (US)
Article number2741
JournalInternational journal of environmental research and public health
Issue number5
StatePublished - Mar 1 2022


  • Endocrine disruptors
  • Fibroids
  • Leiomyoma
  • Midlife
  • Phthalates
  • Women

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'Midlife Urinary Phthalate Metabolite Concentrations and Prior Uterine Fibroid Diagnosis'. Together they form a unique fingerprint.

Cite this