PCOS Messages for June, 2002: Re: PCOS--too much estrogen or too much testosterone?

Re: PCOS--too much estrogen or too much testosterone?

From: Renee (anonymous@obgyn.net)
Fri, 14 Jun 2002 08:39:20 -0700

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Even if both increased at the same time (use of DDT and cases of PCOS), that does not mean that they are correlated. There could have been an awareness of PCOS increase leading to more recognition, testing, and diagnosing. There could have been a change in the diagnostic process, such as new criteria or testing methods, that would have included more people in the definition. That happened with AIDS a few years back, for example. They raised the CD4 T-cell level needed to be considered AIDS, so thousands of people who didn't have AIDS suddenly did. The rise in numbers that year was certainly correlated with something else in the world, though it wasn't caused by it. The number of PCOS cases could have been related to a different environmental issue, and the DDT use was just coincidental. How does the PCOS curve (cases/year) follow the DDT use curve? There would have to be some lag time, I'm sure. So, if they match up exactly, that would tip me toward correlation, if there was a lag, more towards causation (though more proof is needed). Does DDT affect only those with developing reproductive systems (ie: kids), or will it convert a healthy grown women into a PCOS-er? Does that data (theory?) match the prevalence pattern of the cases?

Correlation does not mean causation. There is a real correlation between the rainfall in Tokyo and the car crashes in New York City on a given day. There is no conceivable way to think of a causation, but there is definitely a correlation.

I'm not saying the link is impossible. I'm saying that it needs to be proven, if it exists. And, one correlation study (how well was it designed?) isn't enough. If there was a comparison between one country that used DDT and another one that didn't, and the diet and activitiy levels, etc., were similar, that would be interesting. Or, if a country used it in one portion but not in another, and wind patterns didn't carry it from the one with to the one without, and food didn't move from "with" to "without." Also, if blood hormone levels had been taken at the time before and after DDT use, that could lend a lot of credence to the theory. In theory, with DDT use ending, the rates should go back down again. Was there a spike over that 10-15 years that then dropped?

I don't know if DDT and PCOS are linked. I don't know if any research has been done on it, and the quality of the research. So, I'm not saying they're not linked, and I'm not saying they are. I'm saying we don't know. One possibly correlative paper doesn't show anything.

This is why epidemiology is a profession of its own. It is a complicated science, and some degree of training is needed to understand it thoroughly. But, I heartily encourage everyone to consider taking a single biostatistics or epidemiology class (epi is more interesting, as it's context driven, not just numbers) to help understand everything. If we need to take charge of our own health care, which we do, then we need to understand how to read studies and make appropriate conclusions, and what conclusions not to make.

Renee

>
> At Fri, 14 Jun 2002, cat wrote:
> >. Endo is particularly
> >sensitive to these estrogenic chemicals. And I remember reading a study
> >on medline from europe (Germany I think) which linked increased cases of
> >pcos with the introduction of DDT, which happens to be estrogenic.
> >
> >--
> >Cat xxx
> >

-- -------------- Renee Cordrey, MSPT, MPH, CWS

---
Dwell in Possibility.
--Emily Dickenson

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