Table 4.
Summary of studies assessing associations between PFAS exposure and puberty, menarche, and sex hormone levels.
| PFAS group | Timing of exposures | Outcomes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Girls | Boys | |||||||||||||
| Early pregnancy | Mild-late pregnancy | Child | Adolescent | Earlier pubertal onset | Earlier menarche | Sex hormone levels | Earlier pubertal onset | Sex hormone levels | ||||||
| Testosterone | Estradiol | Others | Testosterone | Estradiol | Others | |||||||||
| Prenatal exposure | PFOA | ↔ (102)* | ↔ (102) | |||||||||||
| ▼ (103); ↔ (104, 105) | ▲ (106) | ↔ (106)SHBG | ||||||||||||
| PFNA | ▲ (102) | ▼ (102)* | ||||||||||||
| ↔ (104, 105) | ↔ (106) | ↔ (106)SHBG | ||||||||||||
| PFDA | ▲ (102)* | ▼ (102)* | ||||||||||||
| ↔ (104, 105) | ||||||||||||||
| PFOS | ▲ (102)* | |||||||||||||
| ↔ (103–105) | ▲ (106) | ↔ (106)SHBG | ||||||||||||
| PFHpS | ▲ (102)* | ▲ (102) | ||||||||||||
| PFHxS | ▲ (102) | ▲ (102) | ||||||||||||
| ↔ (104, 105) | ▲ (106) | ↔ (106)SHBG | ||||||||||||
| PFOSA | ↔ (104, 105) | |||||||||||||
| Et-PFOSA-AcOH | ↔ (104, 105) | |||||||||||||
| Me-PFOSA-AcOH | ↔ (104, 105) | |||||||||||||
| Postnatal exposure | PFOA | ↔ (107) | ↔ (107) | ▼ (107) | ↔ (107) | |||||||||
| ▼ (108) | ↔ (107, 109–111) | ↔ (107, 109, 110) | ▼ (109)SHBG; ↔ (109)LH,FSH | ↔ (108) | ▲ (112); ↔ (109–111) |
▲ (110) ↔ (109) |
▲ (112)LH; ↔ (109)LH,FSH,SHBG (112);FSH | |||||||
| PFNA | ↔ (107) | ↔ (107) | ↔ (107) | ↔ (107) | ||||||||||
| ↔ (109–111) | ↔ (109, 110) | ↔ (109)LH,FSH,SHBG | ▼ (110) ↔ (109, 111) |
↔ (109, 110) | ↔ (109)LH,FSH,SHBG | |||||||||
| PFDA | ↔ (110) | ↔ (110) | ▼ (110) | ↔ (110) | ||||||||||
| PFUnDA | ↔ (109) | ↔ (109) | ▼ (109)FSH; ↔ (109)LH,SHBG | ↔ (109) | ↔ (109) | ↔ (109)LH,FSH,SHBG | ||||||||
| PFDoDA | ▼ (110) | ↔ (110) | ↔ (110) | ↔ (110) | ||||||||||
| PFTeDA | ↔ (110) | ↔ (110) | ↔ (110) | ↔ (110) | ||||||||||
| PFHxA | ↔ (110) | ↔ (110) | ▼ (110) | ↔ (110) | ||||||||||
| PFOS | ▼ (107) | ↔ (107) | ▼ (107) | ▼ (107) | ||||||||||
| ▼ (108) | ▼ (109),↔ (110, 111) | ↔ (109, 110) | ↔ (109)LH,FSH,SHBG | ▼ (108) | ▼ (110) ↔ (109, 111, 112) |
↔ (109, 110) | ▼ (109)FSH; ↔ (109)LH,SHBG (112);LH,FSH | |||||||
| PFHxS | ↔ (107) | ↔ (107) | ↔ (107) | ↔ (107) | ||||||||||
| ↔ (110, 111) | ↔ (110) | ▼ (110) ↔ (111) |
▲ (110) | |||||||||||
| PFBS | ↔ (110) | ↔ (110) | ↔ (110) | ↔ (110) | ||||||||||
PFOA, perfluorooctanoic acid; PFNA, perfluorononanoic acid; PFDA, perfluorodecanoic acid; PFOS, perfluorooctane sulfonic acid; PFHpS, perfluoroheptanane sulfonic acid; PFHxS, perfluorohexane sulfonic acid; PFOSA, perfluorooctane sulfonamide; Et-PFOSA-AcOH, N-ethyl-perfluorooctane sulfonamidoacetic acid; Me-PFOSA-AcOH, N-methyl-perfluorooctane sulfonamidoacetic acid; PFUnDA, perfluoroundecanoic acid; PFDoDA, perfluorododecanoic acid; PFTeDA, perfluorotetradecanoic acid; PFHxA, perfluorohexanoic acid; PFBS, perfluorobutane sulfonic acid; SHBG, sex hormone-binding globulin; LH, luteinizing hormone; FSH, follicle stimulating hormone.
▲, Positive associations; ▼, Inverse association; ↔, Null association; *Non-monotonic dose-response relationship
Early and mild-late pregnancy refer to 1st trimester, and 2nd or 3rd trimester, respectively.
Long-chain PFAS include PFOA, PFNA, PFDA, PFUnDA, PFDoDA, and PFTeDA in PFCA group, and PFOS, PFHpS, PFHxS, PFOSA, Et-PFOSA-AcOH, and Me-PFOSA-AcOH in PFSA group. Short-chain PFAS include PFHxA in PFCA group and PFBS in PFSA group.
Shading boxes indicate exposure timing.