Review of 17α-ethynylestradiol in water across 32 countries: Estrogenic effects

https://pubmed.ncbi.nlm.nih.gov/34023789/

by JPLeRouzic • 4 years ago

112 117 4 years ago

pubmed.ncbi.nlm.nih.gov

swayvil• 4 years ago

2 obvious questions (because I can't penetrate this stuff)

Is this feminizing our population?

Does this affect the way we think?

__s• 4 years ago

What does feminizing mean?

virgulino• 4 years ago

https://en.wikipedia.org/wiki/Feminization_(biology)

lazide3• 4 years ago

To expand on the Wikipedia article of a peer comment:

- feminine features such as gynocomastia (used to be very rare, now quite common)

- decrease in sperm counts across the male population, which has been well documented.

- statistically significant decreases in traditionally male ‘problems’ (violent crime being one obvious one), but also aggressiveness in general. Well documented, but there are many possible causes there.

- behaviors that change from stereotypical male behaviors (which female->male trans folks I’ve know say were clearly from testosterone) towards more female ones. Including aggressive seeking of sex, towards general ‘meh’.

As to what is causing it or why, who knows - but that’s what it means, and it does seem to be a thing.

aaaaaaaaata2• 4 years ago

Breasts on men at a higher rate per capita, is a portion.

nonameiguess• 4 years ago

I have no idea why this was posted without full-text available, but there is at least this: https://ars.els-cdn.com/content/image/1-s2.0-S03014797210086...

I guess if you live in South America or China, then maybe the population is being feminized. Otherwise, no, at least not by this.

BruceEel• 4 years ago

Indeed, + thank you. PS: Benelux-based reader here, I can see my country is not in the top-10 but that's about it, what they call "high-res" isn't!

no-s• 4 years ago

“Antractica”

The porbelm si?

norwalkbear• 4 years ago

Yes it is

marricks6• 4 years ago

I'm concerned this is making numbers here because of fear mongers so I want to run the numbers a bit to

The top 10 countries ranked in the order of high to low average EE2 concentration in surface water, were Vietnam, Cambodia, China, Laos, Brazil, Argentina, Kuwait, Thailand, Indonesia and Portugal, with the respective mean concentrations of 27.7, 22.1, 21.5, 21.1, 13.6, 9.6, 9.5, 8.8, 7.6 and 6.6 ng/L

Going by Wikipedia, lets see what a does is... "Doses of more than 50 µg EE are considered high-dose, doses of 30 and 35 µg EE are considered low-dose, and doses of 10 to 25 µg EE are considered very low dose"[1] More specifically for transfem use of 2mg orally is considered a low dose[2]

Let's consider that the average person drinks 4 liters of water a day. In Vietnam that's 0.11µg a day, or 1/100th of a normal dose for an estradiol treatment for birth control and 1/20th rate of a "low dose" for MTF transfem usage in the most polluted country.

Do I think this pollutant is fine and not a concern? No. It has other side effects and it's probably not great to have all the compounds we give to livestock running off into our drinking water.

I bring this up because of the right wing fear of the "feminization of men." Vietnam you could get 1/20th a low dose of EE2 a day and whatever you're getting elsewhere less. Where the right wing ideology on this is strongest (US perhaps?) people would be getting a lower dose than even listed in the abstract, so 1/80th or less a day.

[1] https://en.wikipedia.org/wiki/Ethinylestradiol

[2] https://transfemscience.org/articles/e2-equivalent-doses/

----

EDIT: a different comment actually posted a chart showing the level of exposure in the US, which is LESS than 1ng. So less than 1/200th of a low dose. Calm down folks, or at least find something different to be afraid of.

georgia_peach2• 4 years ago

Ideology doesn't factor into this. There is something in the water that shouldn't be there, and someone put it there---largely without permission. And what constitutes a "low dose" frequently changes by several orders of magnitude depending on who does the study, and who paid for the study.

marricks6• 4 years ago

I agree! I explicitly state that I don't think random pollutants are good in that comment and there could be other reasons to care about it.

I'm merely calling out that the thing most people freak out about with this compound (feminization) is not worth freaking out about.

newsclues• 4 years ago

Ideology doesn’t factor into this?

Seems odd to say in an era where hormone therapy is being normalized and science is weaponized for ideological purposes regularly.

pure_simplicity• 4 years ago

Dropping testosterone levels and decreasing sperm quality are not a "right wing fear", but a scientific fact, and that should concern everyone: right and left wing, men and women.

Also, to look at this 1 compound in isolation and downplay the significance of it, without considering the cumulative and synergistic effects of all the other xeno estrogens we are exposed to on a daily basis is irresponsible.

panarky3• 4 years ago

not a "right wing fear", but a scientific fact

Of course it's both, with the kernel of scientific fact being hyped and exaggerated by the right.

It's important to call this out so people can evaluate whether the discussion is in good faith or if it's part of an information operation.

User23• 4 years ago

I bring this up because of the right wing fear of the "feminization of men."

The secular testosterone decline in the west is absolutely incontrovertibly real. The error is looking for a single cause to pin a civilizational scale endocrine disruption event to.

lazide3• 4 years ago

Which can also be related to the mass decrease in exercise and other activities which are known to increase testosterone in men, and rapid increases in stress and sedentary behaviors that are known to decrease it.

Not saying the chemicals aren’t contributing, but our lifestyle is terrible and it has been getting that way rapidly and over a relatively short period of time (a generation).

littlecranky67• 4 years ago

I agree there is no single isolated cause but multiple factors of declining testosterone levels. Body fat and obesity is also linked to reduced testosterone levels, and lifestyle in western countries (the US in particular) leads to more and more overweight and obese population. So if you are concerned about your testosterone levels, and immediate step you can take is to reduce your body fat.

TazeTSchnitzel• 4 years ago

I think it's also worth bearing in mind that œstradiol is not some exclusively “female” hormone: cis men have it in their blood too, just at a lower concentration. In fact, without it, males are infertile!

bergenty5• 4 years ago

Sure but when you’re talking about order of magnitude differences there is a clear delineation and the fear is not unwarranted.

teslabox• 4 years ago

Estrogen is a 'stress hormone' that needs to be balanced with anti-stress hormones for optimal health.

All the steroids in the body are made from cholesterol. The term is steroidogenesis: https://en.wikipedia.org/wiki/Steroid#Steroidogenesis

Estrogen is at the end of the steroidogenesis pathway. It's a stress hormone. In the menstrual cycle, estrogen tells the uterine lining to 'swell and divide'. Fertile women are protected from their higher estrogen levels by their high levels of Progesterone USP during the luteal phase of their menstrual cycle. When women reach menopause, their heart attack numbers rapidly reach men's heart attack numbers.

Adipose tissue has a lot of the aromatase enzyme [0], which converts testosterone to estrogen. People with more adipose tissue lose their testosterone by converting it to estrogen. The heart of both genders concentrates testosterone.

[0] https://en.wikipedia.org/wiki/Aromatase

[1] Obesity, estrogens and adipose tissue dysfunction – implications for pulmonary arterial hypertension - https://journals.sagepub.com/doi/full/10.1177/20458940209520...

I sold a progesterone supplement on Amazon years ago... My best customer was "Billie", who I suspect was MTF and was using progesterone USP to balance his estrogen treatments. I referred him to other manufacturers when he noticed my supplement was no longer available.

Pregnenolone is a useful supplement for balancing the steroid system: https://en.wikipedia.org/wiki/Steroid#/media/File:Steroidoge...

(edit: added [1])

bergenty5• 4 years ago

There nothing right wing about this concern. As a progressive man I don’t want to be feminized, it’s terrifying, both at the personal and species level.

davmar2• 4 years ago

The top 10 countries ... were Vietnam, Cambodia, China, Laos, Brazil, Argentina, Kuwait, Thailand, Indonesia and Portugal...

in many of those countries people drink bottled or purified (not surface) water.

jhugo• 4 years ago

The average person in most of those countries drinks tap water, either boiled or filtered to varying levels of efficiency.

In addition, fish are often caught in surface water, livestock may drink it, etc.

rayiner9• 4 years ago

I bring this up because of the right wing fear of the "feminization of men."
Where the right wing ideology on this is strongest (US perhaps?)

I can’t imagine the confusion that would lead someone to conclude that “feminization of men” is a “right wing fear” that is perhaps “strongest” in the US? The US has among the loosest gender norms of any place in the world, including a number of European countries.

In the other countries you mentioned, like China, Kuwait, etc., traditional gender norms aren’t even “right wing”—because that would imply they’re even up for debate: https://www.bbc.com/news/world-asia-china-55926248

stevehawk• 4 years ago

they probably assume it because Republicans say it out loud.

the_only_law• 4 years ago

In the other countries you mentioned, like China, Kuwait, etc., traditional gender norms aren’t even “right wing”—because that would imply they’re even up for debate:

Yet another reason why left/right dichotomy is useless.

pfisherman2• 4 years ago

I would say this is more about gender roles than gender norms, particularly women’s place in social status / power hierarchy.

It is a fact our increasingly connected world favors some traits that have been traditionally thought of as feminine, such as high emotional intelligence, openness, and agreeableness; and people are adapting. All this anxiety about feminization of men - and masculinization of women - is just useless gnashing of teeth from those who are having trouble coping with rapid change brought on by technological advancement.

SequoiaHope• 4 years ago

There is a common trend in the USA or right wing people (generally men) complaining about soy products and the supposed estrogen content that they think is causing widespread hormonal changes in men, despite soy phytoestrogens being the wrong kind of estrogen to do anything and being at extremely low levels.

EDIT: I’m just citing a factual cultural phenomenon in the USA. Look here is a source: https://knowyourmeme.com/memes/soy-boy

specialist• 4 years ago

Progress begets reaction. Reactionary is more often associated with right wing.

gnorme• 4 years ago

Humans aren't the only thing we should be considering.

Collapse of a fish population after exposure to a synthetic estrogen

"We conducted a 7-year, whole-lake experiment at the Experimental Lakes Area (ELA) in northwestern Ontario, Canada, and showed that chronic exposure of fathead minnow (Pimephales promelas) to low concentrations (5–6 ng·L−1) of the potent 17α-ethynylestradiol led to feminization of males through the production of vitellogenin mRNA and protein, impacts on gonadal development as evidenced by intersex in males and altered oogenesis in females, and, ultimately, a near extinction of this species from the lake."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874224/

stuckinhell3• 4 years ago

That's a bit misleading. One of the major issues is that we have a food chain, in which these chemicals can become concentrated and yes at higher concentrations it would feminize men, or earlier puberty in young girls.

At the same time, we have radical increases in transgendered humans, and earlier puberty in young girls worldwide. Correlation isn't causation, but its often a place to start running experiments looking at causation.

underlying1941• 4 years ago

More specifically for transfem use of 2mg orally is considered a low dose

That refers to "regular" estradiol. Ethinylestradiol is much more powerful. You can't compare doses 1:1.

marricks6• 4 years ago

Apparently everyone is downvoting everything they can because this is a sensitive topic. I'd just like to call out, where feminization is a major concern (US, maybe Europe), there is less than 1ng/L of this compound in water, see elsewhere on this thread for the graphic.

The lowest dose of EE2 for trans-women is 2mg a day orally. That means whatever the dosage is in the US it's less than 1/10th* of what trans folk find actually useful. That's based off drinking 4 liters of water a day, lord knows most people don't drink that though.

In summary: US and Europe folks don't need to care about this and if you see a news story hyping this compound up, it's probably just that: hype.

*EDIT: I had a couple mistakes here:

- EE2 is not estrogen and can be considered ~100x more effective

- 1ng / 1mg is 1000th not 100th.

goda90• 4 years ago

Is there any accumulation in food? Is it heat stable to survive cooking?

marricks6• 4 years ago

If you live in the US lead* is probably a far greater concern, and that sure does survive cooking.

oceanplexian• 4 years ago

This still sounds concerning to me, if the dose is 2mg for a healthy adult what is it for children and infants? What about babies in the womb?

We saw the same exact thing with PFAS/PFOA, the experts said it was harmless, present in impossibly small quantities, and it would "pass right through you" for literally years. But then it turned out the experts were completely wrong. They found 2000PPM of PFAS in my Mom's well in New Hampshire, out in in the country, miles away from a Teflon factory that leaked into the water supply. She found it after hundreds of dollars of testing when I told her she should be paranoid.

marricks6• 4 years ago

For this specific chemical, it actually has been studied since at least 1943[1] and used in a few different medical contexts. That mean it has a leg on some random pollutant never considered for medicinal use.

Does that mean it's great in drinking water? No... but I think we shouldn't just jump from one type of catastrophizing to the next. There's endless questions we can ask to scare ourselves, but maybe it's a better use of our time to point that concern on things which we already know or damaging our kids, like: lead in drinking water, malnutrition, lack of affordable pre school options, etc etc.

[1] https://en.wikipedia.org/wiki/Ethinylestradiol

wjnc• 4 years ago

2000 PPM is 0.2% or one-in-fivehundred, right? That’s massive pollution. My layman’s logic would suggest you need to dump 0.2% of total aquifer volume of 100% PFAS to reach that level? And then I expect pollution to spread in a semi-sphere unless there are rocky sediments. Edit: thinking more about water, perhaps you can dump less in wetter conditions and then in a drought get higher values because PFAS won’t evaporate. But still, it suggests tons and tons of dumping?

Sunspark3• 4 years ago

The forever chemicals like those are absolutely awful.

Fracking is another source of chemicals into water supplies.

zackmorris4• 4 years ago

Also it's not just endocrine disruption. Forever chemicals and microplastics can lodge in muscle and cause accumulated damage as the body tries to encapsulate it to keep from getting injured. And the circulatory system where it can clog arteries/veins/capillaries and cut off circulation. The images in this paper show plastic fibers embedded in fish muscle:

https://www.sciencedirect.com/science/article/pii/S004896971...

Maybe most particles are too large to cross the intestinal lining, but can they prove that's still the case with "leaky gut" which a large number of people in the US are susceptible to due to the missing fiber in our diet? What about worse inflammation like IBS, IBD, Crohn's disease and diverticulitis?

https://nypost.com/2021/12/23/irritable-bowel-syndrome-linke...

We eat a credit card's worth of microplastic every week, mostly coming from our water supply apparently. This is the kind of news whose implications are so serious that it's much easier to just ignore it!

elil172• 4 years ago

Trans women typically take E2 (bioidentical estrogen), not EE2. EE2 is 100 times more potent than E2 for certain endocrine interactions. Unlike E2, EE2 is not a naturally occurring hormone. E2 causes female puberty when administered to males (except for menstruation), but EE2 isn’t necessarily going to do the same thing because it is a different molecule. While worrying about “feminizing” is probably hype, worrying about possible effects such as infertility seems totally reasonable.

gcr4• 4 years ago

Back in the day ('70s and '80s i think), trans women used to take synthetic estrogens (such as premarin, IIRC was the drug of choice) before switching to bioidentical estrogen from estradiol tablets in the '90s and '00s, I think because bioidentical E is seen as more effective with a softer side effect profile than the synthetics, in particular bioidentical doesn't hurt the liver as much.

Drinking horse piss in the 70s sure was metal though. ("pre-mar-in" = "pregnant mare urine," a source of estrogen since 1930).

(folk knowledge and personal anecdata)

sudosysgen6• 4 years ago

It's still not that bad though, because the math is off. 4 ng is about 250,000x less than the smallest E2 dose a trans woman would take, and 2 million times less than the strongest doses some take.

marricks6• 4 years ago

Thank you for the correction!

rayiner9• 4 years ago

I'd just like to call out, where feminization is a major concern (US, maybe Europe)

What’s that supposed to mean? The article shows the rates in Southeast Asia are 10 times higher than the US. I can assure you that “feminization” would be a much more significant concern there than in the US or Europe.

xeromal• 4 years ago

I believe they mean the fear of feminization.

gcr4• 4 years ago

i think OP's two points are that

1. backlash against "feminization of men" is something that people seem to care about more in the USA than other countries (HN audiences skew toward this population anyway);

2. these days, right-wing extremists in my country (USA) see "feminization of men" as a politically beneficial wedge issue, and this politicization makes it impossible to study the actual societal effects impartially/neutrally.

gcr4• 4 years ago

Another important point is that trans women typically start on an antiandrogen as well as an estradiol supplement. Testosterone's effects are orders of mag stronger than estrogen, so trans women typically have to take drastic measures to significantly reduce testosterone first so the estrogen can work, such as taking large amounts of spironolactone or cyproterone acetate or orchiectomy; without these measures, estrogen isn't nearly as effective. You don't exactly see much spironolactone in the water supply! (Personal anecdata)

sudosysgen6• 4 years ago

Your math is a bit off. 4 liters would be 4 nanograms, which is 250,000 times less than a trans woman would take (in the milligrams, not micrograms)

lazzlazzlazz• 4 years ago

If just drinking water gives you 10% of the dose that a trans person would seek medically, that seems like an incredibly high amount. Your post seems to reinforce concerns, not dissolve them.

stuckinhell3• 4 years ago

I agree here. It bothers me to see people try to defend a contaminant in the water supply.

throwaway0x7E6• 4 years ago

So in the end the number is less than 1/20th.

even for fully-grown adults it is an extremely alarming figure.

god only knows the full extent of damage done to children by this and other phytoestrogens.

baldisbasics5• 4 years ago

I swear, everyone in my part of the US had massive hair shedding around 2018 or so (man and woman, young and old). We speculated at the time that maybe something in the water supply was causing everyone to lose hair in clumps, and by golly this appears to match with our pet theories.

sudosysgen6• 4 years ago

Estrogen doesn't cause hair loss in general.

baldisbasics5• 4 years ago

Hormonal disruption does, though.

kelseyfrog2• 4 years ago

Maybe grandparent is confusing estrogen with dihydrotestosterone.

zackmorris4• 4 years ago

That's interesting, which part of the US is it, and does anyone have hard evidence of that trend?

Only one datapoint, but: the outer half of my eyebrows fell out in 2018 just before my digestive issues flared up and I burned out in the spring of 2019. I wondered if maybe radiation from Fukushima affected my thyroid, since radiation levels in southern Idaho were 80 times normal before they quit reporting them.

I've since made a full recovery, but it took 3 years and endless research where it felt like I was losing my wits at times. I feel now that our health actually comes from our gut, so a multivitamin and a daily low-dose "stress" B vitamin, along with twice the water we think we need, and about 4 times the fiber (in the US at least) and greens mix or fresh leafy vegetables, is critical to maintain health in today's age where so much produce is lacking vitamins and minerals due to depleted soils.

I know several people who went through autoimmune issues around that time and now can no longer eat wheat without consequences like weight gain to severe GI distress. I feel like I developed lactose intolerance, so maybe a toxin got concentrated in milk. It's probably just middle age though.

baldisbasics5• 4 years ago

It was everyone I know in Indiana and South Carolina, so it appears to have been wide spread. Some were spared, but this was notably pre-COVID. I wouldn't be surprised if it isn't directly the chemical mentioned in this study, but a multifactor issue. My key point is that out hunch was "what could be leaking into the water or food supply to cause this?" I always leaned more toward the microplastic theory, but that brings us back to endocrine disruption yet again. As for hard evidence, I'm afraid my accounts are colloquial at the moment, but the increase of hairloss products aimed at young men (ie Keeps) should point a curious mind in the right direction.

jvanderbot• 4 years ago

Confirm. Had massive hair loss in 2018, up to half my head was bald, the back and sides included. I've been fighting it ever since, with regular injections of steroids required to stop the loss.

I was in upper midwest US, Eastern seaboard, and Los Angeles at various times that year.

But I don't see how this connects to the article.

schemescape• 4 years ago

Does the paper reference 2018 somewhere? I see a few comments related to 2018, but I can't seem to access the paper, and I'm not seeing any timelines.

hn_throwaway_99• 4 years ago

The study actually shows the exact opposite. It looks at levels by country, and the US levels were less than 1 ngE2/L, meaning "no risk".

https://ars.els-cdn.com/content/image/1-s2.0-S03014797210086...

DoingIsLearning3• 4 years ago

Another potential contamination of EE2 is aquaculture. Based on a recent investigation, high concentrations of EE2 ranging from <0.3–7.67 ng/L in estuarine water nearby aquaculture activities in Malaysia, were re- ported (Ismail et al., 2019)

Why is aquaculture waste water contributing to EE2 contamination?

What step in aquaculture would create this..

formerly_proven• 4 years ago

Female fish are generally bigger than male fish and caviar can only be harvested from females.

DoingIsLearning3• 4 years ago

The example source in the paper is in Malaysia which I think is a bit too warm for sturgeon.

moralestapia• 4 years ago

Another potential contamination
Why is aquaculture waste water contributing to EE2 contamination?

Why could aquaculture ...

They are not affirming it, they are suggesting a possible link, that is all.

mancerayder5• 4 years ago

Am I the only lunatic that drinks almost exclusively bottled water? I've done so since I was a child.

athorax• 4 years ago

Where do you think the water in those bottles comes from exactly?

mancerayder5• 4 years ago

What are you implying? San Pellegrino, Evian, etc - I'd expect less garbage in it than municipal water. Why would spring sources be contaminated in the same way?

driverdan• 4 years ago

If you're worried about water quality you're much better off drinking filtered tap water. Most bottled water is just municipal water with extra trash.

mancerayder5• 4 years ago

It's primarily for taste. I can't stand the taste of tap water, anywhere. While everyone seems used to it, the chlorine and chemical flavors, sometimes bordering on slightly sweet, are repulsive.

aaaaaaaaata2• 4 years ago

Reverse osmosis.

istorical• 4 years ago

Doing so seems incredibly wasteful and pollution-generating. A filter pitcher like a Brita + a reusable water aluminum/glass/steel/whatever water bottle seems like it'd be a better substitute.

JPLeRouzic• 4 years ago

Doesn't it add (chemical) salts in water to remove impurities such as calcium? [0] Can't those salts create hypertension [1] ?

[0] https://en.wikipedia.org/wiki/Ion-exchange_resin#Water_purif...

[1] https://en.wikipedia.org/wiki/Hypertension

Review of 17α-ethynylestradiol in water across 32 countries: Estrogenic effects

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