# Phthalate exposure and hot flashes in midlife women

> **NIH NIH R01** · UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN · 2020 · $368,797

## Abstract

Hot flashes pose a significant public health problem because they are the most common perimenopausal
symptom reported by women in the United States and the primary reason that women seek medical care
during the menopausal transition. Despite the importance of hot flashes in a woman's life, little is known
about the risk factors for this symptom. Our preliminary data from 195 women (aged 45-54 years) suggest
that phthalate exposures are associated with an increased risk of hot flashes. Specifically, higher
concentrations of phthalates commonly found in personal care products (PCPs) were associated with an
increased risk of ever having hot flashes, having hot flashes in the past 30 days, and frequent hot flashes.
Further, our preliminary data suggest that increased levels of phthalate metabolites are associated with
reduced antral follicle counts, a known risk factor for hot flashes in women. Thus, the overall goal of this
application is to extend our preliminary analysis by testing the hypothesis that urinary phthalate metabolite
concentrations are associated with hot flashes and explore their associations with potential mechanisms
of hot flashes that involve low estrogen levels and ovarian failure. To test this hypothesis, we propose to
complete the following specific aims: 1) prospectively determine whether urinary levels of phthalate
metabolites are associated with subsequent hot flashes, 2) determine whether urinary levels of phthalate
metabolites are associated with low estrogen and androgen levels, 3) determine whether urinary levels of
phthalate metabolites are associated with ovarian follicle loss, and 4) explore whether any observed
associations between urinary phthalate metabolites and hot flashes are mediated by ovarian follicle loss
and/or low levels of sex steroid hormones. To complete these aims, we will use urine and blood samples,
transvaginal ultrasound data, and hot flashes histories that have been obtained from 782 women (aged
45-54 years) who participated in the Midlife Women's Health Study. The urine samples will be subjected
to measurements of phthalate metabolites and the blood samples will be subjected to measurements of
sex steroid hormone levels as well as anti-Müllerian and inhibin B levels. Transvaginal ultrasound data
will be used to determine antral follicle counts and ovarian volume. Statistical analyses then will be
conducted to assess correlations between urinary phthalate levels, hormone levels, antral follicle numbers,
and ovarian volume. Further, statistical analyses will be conducted to examine whether low sex steroid
hormone levels, reduced antral follicle counts, or small ovarian reserve mediate the association between
phthalate metabolites and hot flashes. The results of this study will provide a better understanding of the
risk factors for hot flashes and the mechanisms by which environmental chemicals are associated with
adverse reproductive outcomes in women. This may lead to the development of preventive...

## Key facts

- **NIH application ID:** 9883796
- **Project number:** 5R01ES026956-04
- **Recipient organization:** UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
- **Principal Investigator:** Jodi A. Flaws
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $368,797
- **Award type:** 5
- **Project period:** 2017-05-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9883796

## Citation

> US National Institutes of Health, RePORTER application 9883796, Phthalate exposure and hot flashes in midlife women (5R01ES026956-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9883796. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*