Link Between Bisphenol Exposure and Risk of Polycystic Ovary Syndrome: A Comprehensive Systematic Review and Meta-Analysis

By
Zongying Gui
Huizhen Lin
Chuhan Wang
Yingsha Yao
June 11, 2026

Frontiers In Endocrinology

Overview

This systematic review and meta-analysis found significant associations between bisphenol exposure and increased risk of polycystic ovary syndrome (PCOS). Specifically, elevated serum and urinary levels of bisphenol A (BPA) and bisphenol S (BPS) were linked to PCOS, highlighting the need for further research and regulatory measures.

Background

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 11-13% of women of reproductive age, associated with various metabolic and reproductive complications. Environmental endocrine-disrupting chemicals, particularly bisphenols, are suspected contributors to PCOS pathogenesis. Understanding the relationship between bisphenol exposure and PCOS is crucial for developing preventive strategies and clinical management.

Data Highlights

Exposure	Standardized Mean Difference (SMD)	95% Confidence Interval (CI)
Serum BPA	1.32	0.83–1.82
Urinary BPA	2.69	1.41–3.97
Serum BPS	0.26	0.07–0.46

Key Findings

Significant positive association between serum BPA and PCOS risk (SMD = 1.32).
Urinary BPA levels showed a stronger association with PCOS (SMD = 2.69).
Serum BPS was also positively associated with PCOS risk (SMD = 0.26).
High heterogeneity was observed for BPA studies (I² = 95–99%), while BPS studies showed no heterogeneity (I² = 0%).
Sensitivity analyses confirmed the robustness of the findings, excluding lower-quality studies.
Subgroup analyses indicated slightly attenuated associations for BPA when using Rotterdam criteria.

Clinical Implications

Clinicians should consider the potential role of bisphenol exposure in the assessment and management of PCOS. Incorporating biomonitoring for bisphenols may enhance patient care and inform preventive strategies. Regulatory measures to reduce bisphenol exposure could be beneficial for public health.

Conclusion

The findings underscore a significant association between bisphenol exposure and PCOS risk, warranting further investigation and potential regulatory action to mitigate exposure. Addressing this environmental risk factor may provide new avenues for PCOS prevention and management.