We are all aware of the fact that the use of plastics causes harm to our environment, and dangerously so. But not many people think about what happens when plastics enter our bodies.

As far as gynaecological reproductive health is concerned, while the major emphasis continues to remain on genetics, hormonal imbalances, diet and exercise, with PCOS and endometriosis remaining significant concerns in India, there may now be another looming threat: microplastics and nanoplastics in reproductive organs.

Can microplastics and nanoplastics enter the ovaries and damage sexual and reproductive health? The answer, is yes.

Microplastics, along with nanoplastics, have actually been detected in ovarian tissues and in follicular fluid. Follicular fluid is a liquid that surrounds and nourishes developing eggs in the ovarian follicles. Last year, a study, for the first time, found microplastics in human ovary follicular fluid.. The study assessed 18 women (undergoing assisted reproductive treatment in southern Italy) for the presence of microplastics in follicular fluid. Microplastics were detected in 14 out of 18 samples. The most alarming discovery was a direct correlation between microplastic concentration and Follicle-Stimulating Hormone (FSH) levels. In clinical practice, high FSH is a marker of diminished ovarian reserve, suggesting that microplastics may be a hidden driver of premature ovarian ageing.

Understanding the impacts

To grasp the scale of this issue, one must first define the particles involved. Microplastics are tiny fragments of plastic less than five millimetres in size, while nanoplastics are less than one micrometre in size. They are invisible to the naked eye and can easily bypass the body’s natural biological barriers. They can be identified as multiple polymers, including polyethylene (PE), polypropylene (PP), polystyrene (PS) and polyethylene terephthalate (PET), commonly used in packaging and agricultural materials. It is now understood that these particles enter the bloodstream through food, water, and even the air we breathe.

The ovaries were once thought to be a protected zone, shielded by complex filtration systems. But we now know that microplastics from the bloodstream can directly seep into the reproductive organs too. Common polymers including polyethene found in plastic bags, and polystyrene used in packaging, are now being identified in the very fluid that determines the quality and competence of a woman’s oocytes.

How damage occurs

From a clinical standpoint, the concern is not just the presence of the plastic itself, but the Trojan Horse effect it creates. These particles often carry Endocrine Disrupting Chemicals (EDCs). When they lodge themselves in ovarian tissue, they trigger several harmful processes:

Oxidative stress and cellular ageing: The presence of a foreign object in the ovary triggers the production of Reactive Oxygen Species (highly reactive molecules derived from oxygen). This is a form of cellular rusting, as oxidative stress can damage the DNA of the oocytes and potentially cause poor maturation and a decline in overall egg quality at an early stage of its life.

Hormonal mimicry: Most plastics contain chemicals that mimic oestrogen. When these enter the follicular environment, they disrupt the natural signalling of progesterone and oestrogen. This can lead to irregular menstrual cycles and has been linked to conditions such as Polycystic Ovary Syndrome (PCOS).

Mitochondrial dysfunction: Nanoplastics are particularly invasive because they can penetrate cell membranes. Once inside, they can disrupt the mitochondria, the cells’ powerhouses. Since an egg cell requires an immense amount of energy to develop and eventually fertilise, any disruption to energy production can compromise fertility. Also, plastic is eternal; it’s very difficult for the human body to dissolve it and remove it from the body.

How you are exposed

It is important to recognise that this is a cumulative issue. Human beings are exposed to these particles through multiple daily touchpoints:

Ingestion: Microplastics shed from plastic water bottles, especially when heated. They are also found in ultra-processed foods and certain seafood. We should stop using plastic containers to store food and water, and shift to glass containers and copper bottles, beneficial for both the environment and the body. Using high-quality carbon or reverse osmosis filters can catch a significant percentage of micro-particles.

Inhalation: In urban environments, people breathe in synthetic fibres from clothing and carpets. The main component of most clothing today is polyester, especially blankets and sheets which come in direct contact with skin. Polyester can directly penetrate our body and cause immense harm.

Dermal contact: Some personal care products contain microbeads or plastic-based thickeners that can be absorbed through the skin. Care must be taken while purchasing products; it is essential to read product labels.

The way forward

While there is strong evidence that microplastics are present in the ovaries, researchers are still studying the long-term, population-wide effects on fertility. What this means is that while there is no reason to panic, there is a need to gear towards preventive action.

There is a growing movement now to view infertility now just as a purely medical issue, but also as an environmental one. While policy-level changes are needed to regulate the use of plastic in food, clothing and beauty industries, for the general public, the first step is awareness. Awareness and educating oneself about this issue can help with preventive action. By making small changes today, individuals are not just protecting their own health, but also the biological integrity of generations to come.

(Dr. Rohit Raghunath Ranade is a senior consultant and clinical lead of gynaecologic oncology at Narayana Health City, Bengaluru. rohitraghunath.ranade.dr@narayanahealth.org)