Impacts of Air Pollution on Gynecologic Disease: Infertility, Menstrual Irregularity, Uterine Fibroids, and Endometriosis: a Systematic Review and Commentary


Purpose of Review

Air pollution is widely known to affect human cardiopulmonary health, but only recently has research begun to focus on understanding the association between ambient air pollution and reproductive health and gynecologic disease incidence. In this article, we conducted a systematic literature review to examine studies conducted to evaluate the association between air pollution and the heterogeneous gynecologic diseases of infertility, menstrual irregularity, uterine fibroids, and endometriosis. In this review, the authors discuss exposure assessment considerations, outcome definitions, statistical analyses, and relevant biological mechanisms, and also provide ideas for future directions of research.

Recent Findings

Emerging literature evaluated associations between gynecologic diseases of infertility, menstrual irregularity, uterine fibroids, and endometriosis with air pollution exposures, specifically fine particulate matter (particles ≤ 2.5 μm in aerodynamic diameter [PM2.5]), coarse particulate matter (particles 2.5–10 μm in aerodynamic diameter [PM2.5–10]), traffic-related pollutants (NO2, NOx), and proximity to major roadways. Suggestive associations have been observed with distance to road and traffic exposures with incident infertility, fertility rates, and menstrual cycle irregularity. However, to date, the number of studies examining similar exposures and outcomes has been quite limited.


While initial studies suggest a potential relationship between air pollution and both infertility and menstrual irregularity, more studies need to be performed to validate these findings in other datasets and populations.

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Fig. 1


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Correspondence to Shruthi Mahalingaiah.

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Shruthi Mahalingaiah, Kevin J. Lane, Chanmin Kim, J. Jojo Cheng, and Jaime E. Hart declare no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Environmental Epidemiology

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Mahalingaiah, S., Lane, K.J., Kim, C. et al. Impacts of Air Pollution on Gynecologic Disease: Infertility, Menstrual Irregularity, Uterine Fibroids, and Endometriosis: a Systematic Review and Commentary. Curr Epidemiol Rep 5, 197–204 (2018).

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  • Air pollution
  • Uterine fibroids
  • Infertility
  • Endometriosis
  • Menstrual irregularity
  • Fine particulate matter