Barrett · Hormones and behavior 2014 · Nested cross-sectional cohort study · n=360

Environmental exposure to di-2-ethylhexyl phthalate is associated with low interest in sexual activity in premenopausal women.

Cited 27 times in the scientific literature.

Level 3 - non-randomized controlled study

Observational analysis nested within a prospective pregnancy cohort study.

PubMed 25448532 · doi:10.1016/j.yhbeh.2014.10.003 · record verified 2026-08-27

What was done

Researchers analyzed data from 360 premenopausal women participating in the Study for Future Families pregnancy cohort. They evaluated whether urinary phthalate metabolite concentrations, specifically di-2-ethylhexyl phthalate (DEHP) metabolites, were associated with two self-reported dimensions of sexual dysfunction in the months prior to conception: lack of sexual interest and vaginal dryness.

What was found

Women in the highest quartile of urinary concentrations of mono-2-ethyl-5-hydroxyhexyl phthalate had an adjusted odds ratio (aOR) of 2.58 (95% CI 1.33, 5.00) of reporting that they almost always or often lacked interest in sexual activity. Findings were similar for mono-2-ethyl-5-oxohexyl phthalate (aOR 2.56, 95% CI 1.32, 4.95). Self-reported vaginal dryness was not associated with any phthalate metabolite concentration.

Why it matters

This study provides early evidence linking everyday environmental DEHP phthalate exposure to reduced sexual interest in reproductive-aged women.

Limits

The study evaluated only pregnant women who successfully conceived, limiting generalizability to broader female populations. Sexual dysfunction metrics were self-reported retrospectively for the period before conception, raising the possibility of recall bias. As an observational study, residual confounding remains possible and causality cannot be established.

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