Table 2.

Overview of the relation between exposure to selected endocrine disrupting environmental exposures and male reproductive health.

Exposure	Exposure route	Experimental evidence	Human evidence	Exposure mitigation
Phenols	Dermal, oral, inhalation	Anti-androgenic / estrogenic activity. Impaired spermatogenesis and steroidogenesis	Human data for BPA and replacement products, consistent with animal data. Human data for other phenols is scarce	Avoid packaged and canned food. Use phenol-free personal care products.
Phthalates	Dermal, oral, inhalation	Anti-androgenic activity. Impaired spermatogenesis, steroidogenesis, decreased testis size. External male genitalia malformations (in utero exposure).	Lower semen quality and testosterone levels. Decreased anogenital distance. Increased risk of cryptorchidism and hypospadias	Choose fragrance-free products. Avoid vinyl products. Use phthalate-free containers.
Pesticides	Diet (fruits and vegetables). Residential or commercial use of pesticides (e.g. lawn care)	Increased oxidative stress. Altered sperm chromatin structure. Altered Leydig cell function, steroidogenesis. Alternation of sperm epigenome.	Decreased semen quality including oligospermia, azoospermia, asthenospermia. Increased LH, FSH. Decreased T, E2	Avoid direct handling of pesticides. Choose low pesticide contamination produce, including organic.
PFAS	Consumption of contaminated food and water. Water/stain/oil repellent fabrics and other household products.	Decreased expression of GnRH gene. Decreased T production. Disruption or blood-testis barrier. Altered Leydig and Sertoli cell gene expression. Altered sperm membrane permeability. Increased oxidative stress, sperm apoptosis.	Inconsistent associations with semen quality and sperm DNA damage. Increased LH, FSH, decreased T; somewhat consistent. Suggestive association with higher risk of testicular cancer.	Reduce or limit the amount of fast food, microwave food, and takeout you eat. Reduce or limit your use of non-stick cookware.
Air pollution	Inhalation	Decreased production of spermatozoa and increased sperm DNA damage. Changes in Leydig cells and reduction in the number of Sertoli cells. Decreased T and increased LH.	Lower semen quality (concentration, total count, total motility) Lower T	Use of masks and air filters in days of high exposure to ambient particulate matter.