{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:34Z","timestamp":1787071234569,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n Mid-life women are increasingly recognized as a vulnerable population for endocrine disruption due to chronic environmental exposures. Among emerging contaminants, per- and polyfluoroalkyl substances (PFAS) and microplastics have been implicated in reproductive health risks, yet focused evaluations in mid-life populations remain limited.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n The to systematically review human studies assessing the association between chronic exposure to PFAS and microplastics with reproductive health outcomes in mid-life women.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We conducted a systematic review adhering to PRISMA 2020 guidelines. Databases searched included PubMed, Scopus, Web of Science, and EMBASE up to April 2025. Inclusion criteria were original human studies evaluating PFAS or microplastics in association with at least one reproductive health outcome (e.g., menopause, hormone levels, fertility metrics, and gynecologic conditions) in mid-life women. Study quality was appraised using the Newcastle\u2013Ottawa Scale. Publication bias was qualitatively assessed. PROSPERO Registration ID: CRD42025446217.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Eighteen human studies were included (16 PFAS-related, 2 microplastic-related). PFAS exposure was consistently linked with earlier menopause, elevated FSH, reduced fertility, and higher odds of endometriosis and polycystic ovarian syndrome. Limited studies on microplastics demonstrated their presence in human ovarian follicular fluid and placental tissues, with preliminary evidence of altered ovarian reserve. However, no large-scale epidemiological outcomes for microplastics were available.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n PFAS are significantly associated with adverse reproductive outcomes in mid-life women. Although microplastics have been detected in reproductive tissues, outcome-based evidence is insufficient. Further longitudinal studies are warranted to clarify these emerging environmental risks.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmh.jmh_93_25","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T07:01:22Z","timestamp":1775199682000},"page":"5-15","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Reproductive Health Consequences of Per- and Polyfluoroalkyl Substances and Microplastics in Mid-life Women: A Systematic Review of Emerging Evidence"],"prefix":"10.4103","volume":"17","author":[{"given":"Nani Gopal","family":"Das","sequence":"first","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, Tripura Medical College and Dr. BRAM Teaching Hospital, Agartala, Tripura, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amitava","family":"Baidya","sequence":"additional","affiliation":[{"name":"Department of Peadiatrics, Agartala Government Medical College and GBP Hospital, Agartala, Tripura, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmalendu","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Health and Family Welfare, Government of Tripura, Agartala, Tripura, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satabdi","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Physiology, Agartala Government Medical College and GBP Hospital, Agartala, Tripura, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"R1-20260414","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40695-015-0006-7","article-title":"Women's midlife health:Why the midlife matters","volume":"1","author":"Harlow","year":"2015","journal-title":"Womens Midlife 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Saf"},{"key":"R5-20260414","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1097\/EDE.0b013e31826cc0cf","article-title":"Perfluorochemicals and endometriosis:The ENDO study","volume":"23","author":"Louis","year":"2012","journal-title":"Epidemiology"},{"key":"R6-20260414","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1093\/aje\/kwac052","article-title":"Perfluoroalkyl substances and incident natural menopause in midlife women:The mediating role of sex hormones","volume":"191","author":"Ding","year":"2022","journal-title":"Am J Epidemiol"},{"key":"R7-20260414","doi-asserted-by":"crossref","first-page":"106819","DOI":"10.1016\/j.envint.2021.106819","article-title":"Perfluoroalkyl substances (PFAS) in drinking water and risk for polycystic ovarian syndrome, uterine leiomyoma, and endometriosis:A Swedish cohort study","volume":"157","author":"Hammarstrand","year":"2021","journal-title":"Environ Int"},{"key":"R8-20260414","doi-asserted-by":"crossref","first-page":"175593","DOI":"10.1016\/j.scitotenv.2024.175593","article-title":"Association between exposure to perfluoroalkyl substances (PFAS) and endometriosis in the ENDEA case-control study","volume":"951","author":"de","year":"2024","journal-title":"Sci Total Environ"},{"key":"R9-20260414","doi-asserted-by":"crossref","first-page":"162267","DOI":"10.1016\/j.scitotenv.2023.162267","article-title":"Exposure to perfluoroalkyl substances and women's fertility outcomes in a Singaporean population-based preconception cohort","volume":"873","author":"Cohen","year":"2023","journal-title":"Sci Total Environ"},{"key":"R10-20260414","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/EDE.0000000000000552","article-title":"Perfluoroalkyl chemicals, menstrual cycle length, and fecundity:Findings from a prospective pregnancy study","volume":"28","author":"Lum","year":"2017","journal-title":"Epidemiology"},{"key":"R11-20260414","doi-asserted-by":"crossref","first-page":"455","DOI":"10.3390\/toxics12070455","article-title":"Effects of per- and polyfluoroalkylated substances on female reproduction","volume":"12","author":"Gonz\u00e1lez-Alvarez","year":"2024","journal-title":"Toxics"},{"key":"R12-20260414","first-page":"1","article-title":"Microplastics exposure:Implications for human fertility, pregnancy and child health","volume":"14","author":"Zurub","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R13-20260414","doi-asserted-by":"crossref","first-page":"106589","DOI":"10.1016\/j.envint.2021.106589","article-title":"Persistent organic pollutants and the size of ovarian reserve in reproductive-aged women","volume":"155","author":"Bj\u00f6rvang","year":"2021","journal-title":"Environ 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Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmh.jmh_93_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:27Z","timestamp":1787067807000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmh.jmh_93_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jmh.jmh_93_25","relation":{},"ISSN":["0976-7800","0976-7819"],"issn-type":[{"value":"0976-7800","type":"print"},{"value":"0976-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-04-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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