Environmental Chemicals and Female Reproductive Health: Unraveling Mechanisms and Societal Impacts — A Narrative Review

Objectives: To examine the impacts of environmental chemicals on female reproductive health, identify key mechanisms of reproductive toxicity, and discuss potential strategies to mitigate these effects. Mechanism: Environmental chemicals such as per- and polyfluoroalkyl substances, heavy metals, pesticides, microplastics, quaternary ammonium compounds, and other pollutants, disrupt the hypothalamic-pituitary-gonadal axis (HPG), impair ovarian function, and contribute to reproductive dysfunction through mechanisms such as oxidative stress, hormonal disruption, and epigenetic modifications. Findings in Brief: These chemicals contribute to menstrual irregularities, infertility, and pregnancy complications. They also increase the risk of reproductive system disorders, including endometriosis, polycystic ovary syndrome (PCOS), and ovarian cancer. Additionally, transgenerational effects mediated by epigenetic modifications, germ cell damage, and placental transfer may adversely affect offspring health, increasing the risk of reproductive dysfunction, neurodevelopmental disorders, metabolic diseases, and cancer. Conclusions: Despite growing evidence, significant knowledge gaps remain in understanding the mechanisms of reproductive toxicity, identifying biomarkers for early detection, and assessing the long-term effects of low-dose, chronic exposure. Addressing these challenges requires stricter regulations, the development of safer chemical alternatives, public awareness campaigns, and continued research to safeguard reproductive health for current and future generations.