{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T18:22:19Z","timestamp":1771266139782,"version":"3.50.1"},"reference-count":70,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CICS-UBI","award":["2020.07020.BD"],"award-info":[{"award-number":["2020.07020.BD"]}]},{"name":"CICS-UBI","award":["2020.06616.BD"],"award-info":[{"award-number":["2020.06616.BD"]}]},{"name":"Foundation for Science and Technology","award":["2020.07020.BD"],"award-info":[{"award-number":["2020.07020.BD"]}]},{"name":"Foundation for Science and Technology","award":["2020.06616.BD"],"award-info":[{"award-number":["2020.06616.BD"]}]},{"name":"FCT","award":["2020.07020.BD"],"award-info":[{"award-number":["2020.07020.BD"]}]},{"name":"FCT","award":["2020.06616.BD"],"award-info":[{"award-number":["2020.06616.BD"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomedicines"],"abstract":"<jats:p>Endometriosis is a chronic gynecological disease, primarily associated with pelvic pain and infertility, that affects approximately 10% of the women of reproductive age. Estrogen plays a central role in endometriosis, and there is growing evidence that endocrine disruptors, such as phthalates, may contribute to its development. This review aimed to determine whether there is a causal relationship between phthalate exposure and the development of endometriosis, as well as the possible effects of phthalates on fertility, by analyzing epidemiological data. After a literature search with a combination of specific terms on this topic, we found that although there are limitations to the current studies, there is a clear association between phthalate exposure and endometriosis. Phthalates can interfere with the cellular processes of the endometrium; specifically, they can bind to PPAR and ER-\u03b1 and activate TGF-\u03b2, promoting different signaling cascades that regulate the expression of specific target genes. This may lead to inflammation, invasion, cytokine alteration, increased oxidative stress, and impaired cell viability and proliferation, culminating in endometriosis. Nevertheless, future research is important to curb the progression and development of endometriosis, and strategies for prevention, diagnosis, and treatment are a priority. In this regard, public policies and recommendations to reduce exposure to phthalates and other endocrine disruptors should be promptly implemented.<\/jats:p>","DOI":"10.3390\/biomedicines12081932","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T11:14:41Z","timestamp":1724325281000},"page":"1932","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between the Exposure to Phthalates and the Risk of Endometriosis: An Updated Review"],"prefix":"10.3390","volume":"12","author":[{"given":"B\u00e1rbara","family":"Ribeiro","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences (FCS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1875-0144","authenticated-orcid":false,"given":"Melissa","family":"Mariana","sequence":"additional","affiliation":[{"name":"Health Sciences Research Centre (CICS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"},{"name":"Faculty of Sciences (FC), University of Beira Interior (UBI), 6201-001 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-6398","authenticated-orcid":false,"given":"Margarida","family":"Lorigo","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences (FCS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"},{"name":"Health Sciences Research Centre (CICS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"}]},{"given":"Denise","family":"Oliani","sequence":"additional","affiliation":[{"name":"Assisted Reproduction Laboratory, Academic Hospital of Cova da Beira, 6200-251 Covilh\u00e3, Portugal"},{"name":"S\u00e3o Jos\u00e9 do Rio Preto School of Medicine, Gynaecology and Obstetrics, S\u00e3o Jos\u00e9 do Rio Preto 15090-000, Brazil"},{"name":"Cova da Beira Local Unit of Health, 6200-251 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4783-665X","authenticated-orcid":false,"given":"Ana Cristina","family":"Ramalhinho","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences (FCS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"},{"name":"Health Sciences Research Centre (CICS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"},{"name":"Cova da Beira Local Unit of Health, 6200-251 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4823-5701","authenticated-orcid":false,"given":"Elisa","family":"Cairrao","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences (FCS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"},{"name":"Health Sciences Research Centre (CICS), University of Beira Interior (UBI), 6200-506 Covilh\u00e3, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bonavina, G., and Taylor, H.S. 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