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It would be hard to get out in front of some members of Congress in trash-talking their own herd. Yet on Wednesday, four Democratic and four Republican Senators standing together in front of TV cameras had something unalloyed to say for themselves: "There may be hope for us yet,'' Sen. Mark Warner (D-Va.) told reporters at a news conference announcing the introduction of a truly bipartisan campus sexual assault bill.
The most important thing the law would do is force universities to recalculate the cost of hiding a problem so widespread that in surveys, one woman in five says she's been assaulted during college. Currently, schools that dutifully report such attacks to the Department of Education, as they're required to do under Title IX, wind up looking worse than schools whose officials skirt the rules and hope for the best.
Just how common are attempts to pretend assaults only happen on other campuses? Well, at the universities my 18-year-old daughter and I visited over the last two years, I routinely asked the appropriate officials how many sexual assault reports they'd had in the last year -- and was repeatedly told their number was zero, even though some of those schools I knew had high-profile cases. Helpfully, officials at two schools did volunteer info about notorious cases on other nearby campuses, though.
Right now, the only stick the Department of Education has to try to get schools to comply is the threat that the university could, theoretically, lose every cent of its federal funding.
That's "like me telling my kids I'm never going to speak to them again" if they don't shape up, said Sen. Claire McCaskill (D-Mo.), who held a recent series of roundtable discussions on campus sexual assault and surveyed 350 colleges on their current practices. Could any threat be emptier?
Under the proposed bill, the Department of Education could impose fines of up to 1 percent of a school's budget -- which in the case of, say, Harvard University, would add up to a tidy $42 million.
The bill, which McCaskill said she'd like to see on the Senate calendar in September, also would require training for staff and regular surveys of students, and it would provide funding for a confidential advisor for each student who reports an assault.
Other co-sponsors of the bill include Senators Marco Rubio (R-Fla.), Richard Blumenthal (D-Conn.), Dean Heller (R-Nev.), Kirsten Gillibrand (D-N.Y.) , Charles E. Grassley (R-Iowa), and Kelly Ayotte (R-N.H.)
Astonishingly, every one of them had something intelligent to say on the issue and none sounded as though he or she had been briefed by an aide on the way over.
"Sometimes the victim is treated worse than the person who has committed the crime,'' said Grassley, while Rubio declared that there can no longer be any "special preference because someone can dunk a basketball or throw a ball 80 yards down the field."
Ayotte noted that in 20 percent of the schools surveyed, "we have actually found evidence that athletic programs [themselves] have investigated sexual assaults."
Annie Clark, a 2011 graduate of the University of North Carolina and co-founder of an advocacy group called End Rape on Campus, said that after she reported being raped at UNC, she was told by a university staffer that "rape is like a football game; you should look back on it and think about what you could have done differently.' ''
Her own message to others who have been assaulted is a little different: "You're not alone, it's not your fault, and we believe you."
A young woman named Anna, who was the subject of a recent story in the New York Times and who asked to be identified only by her first name, said she had reported being attacked by multiple football players early in her freshman year at Hobart and William Smith Colleges in New York.
"I stand here today, and I'm not okay," she said at the news conference. Though a nurse examiner found evidence of blunt force trauma, the district attorney closed the case a day after it was referred to him, and the student was found not responsible at a campus disciplinary hearing.
Anna's mother, Susan, said in a tremulous voice how proud she was of her daughter and of others who have reported assaults despite enormous pressure to keep quiet. She asked senators to fight to get the bill onto the floor "also for those who didn't make it, for Jeanne Clery's parents and Lizzy Seeberg's parents and many, many more.'' Clery was raped and murdered in her dorm at Lehigh University in 1986, and Seeberg committed suicide in 2010, 10 days after reporting that she'd been sexually assaulted by a Notre Dame football player. Tuesday would have been her 23rd birthday.
Gillibrand, too, said she wanted to thank both those present and those "who aren't here today."
In concluding his remarks, on a day that also produced nearly unanimous passage in the House of a Veterans Affairs reform package, Rubio said, "I pray this doesn't get caught up in all the other things that go on in this city"-- politics, he meant.
But Gillibrand said she actually didn't think that would be a problem, and McCaskill said the only real obstacle will be "trying to elbow our way" onto the schedule in the fall.
After the cameras were turned off and most reporters had gone, McCaskill and Gillibrand hugged each of the five survivors. "You all kicked it,'' McCaskill told them. "You just kicked it."
Many chemicals that we are exposed to through food, water, plastics, personal care products, and lifestyle choices can mimic and alter hormones in the body. These chemicals are called hormone-disrupting compounds and have been linked to reproductive and other health problems. Most of the science is focused on the health effects of these chemicals in women and children. But they also affect men and are starting to cause concern that men's reproductive and hormonal health is at risk. Here is review of some of the recent studies linking chemicals in the environment to hormonal changes in men.
Pesticides Block or Mimic Male Hormones
A recent study published in the Journal Environmental Health Perspectives discovered that pesticides, some previously unknown to disrupt hormones, had antiandrogenic effects in men. Scientists at the University of London studied 37 pesticides for in vitro androgen receptor (AR) antagonism. Of these, 14 were previously reported to be AR antagonists, 4 were predicted AR antagonists, 6 were predicted to not be AR antagonists, and 13 had unknown activity. All 14 pesticides with previous evidence of AR antagonism were confirmed as antiandrogenic, and 9 previously untested pesticides were identified as antiandrogenic. They were: dimethomorph, fenhexamid, quinoxyfen, cyprodinil, l-cyhalothrin, pyrimethanil, fludioxonil, azinphos-methyl, and pirimiphos-methyl. In addition, 7 compounds were classified as androgenic.1
Comment: This study is significant because it focuses on pesticides currently being used and found on fruits and vegetables. Past studies focused on pesticides that are no longer registered for use in the US and developed countries. In this study, 30 out of 37 pesticides tested altered male hormones. Most of the newly discovered hormone disruptors are applied to fruits and vegetables. Many of these had never been tested for hormone disruption activity. The researchers screened the pesticides using in vitro assays, which use human cells to check whether the pesticides activate or inhibit hormone receptors in cells. It is not known how these pesticides will behave in the human body at concentrations from consuming fruits and vegetables. The researchers strongly recommended that all pesticides in use today be screened to check if they block testosterone, which is critical to men's reproductive health and aging. This idea faces major opposition in the US from the pesticide industry. In the US, the Environmental Protection Agency is responsible for testing chemicals found in food and drinking water to see if they interfere with hormones. None of the newly discovered pesticides with hormonal activity is included in the EPA's testing program, which means that they are not currently screened and there are no plans to do so.[/u]
Bisphenol A Affects Men's Thyroid and Reproductive Hormones
One hundred sixty-seven men were recruited from an infertility clinic at Massachusetts General Hospital. Men aged 18 to 55 without postvasectomy status participated in the study. Bisphenol A (BPA) was measured in a single urine sample of the 167 men, and blood hormone levels were measured the same day. Seventy-five of the men submitted a second urine sample and 4 men a third sample for measurement of BPA. These were collected one week to two months after the original sample. Hormones tested for were testosterone (T), estradiol (E2), sex hormone binding globulin (SHBG), inhibin B, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, free T4, total T3, and TSH. A free androgen index (FAI) was calculated as the ratio of total testosterone to SHBG. Results of this study showed that in spot urine samples collected on the same day as blood samples, urinary BPA concentrations were inversely associated with serum levels of FSH, inhibin B, FSH:inhibin B ration, and E2:T ratio. When one or two urine samples were collected in the weeks or months following collection of the blood sample, then the inverse association involving BPA and FSH and inhibin B weakened. Inverse associations were also found between BPA and SHBG, FAI, estradiol and TSH. The results of this study indicate that BPA exposure may be associated with altered hormone levels in men.2
Comment: BPA has long been known to be a hormone-disrupting chemical and linked to many health conditions in women, including infertility. The main way that we are exposed to BPA is through food and water. BPA can leach into food from the protective internal epoxy resin coatings of canned foods and from products such as polycarbonate plastic tableware, food storage containers, water bottles, and baby bottles.3 This recent study looks at BPA and men's hormones. BPA was collected in the urine from men presenting to an infertility clinic in Massachusetts. Urine is a good measurement for BPA, since it is rapidly metabolized and excreted from the body after exposure. Nine men were excluded from the study because they were already taking medications that alter hormone levels, such as finasteride or Clomid and GnRH, testosterone, or prednisone. The study's finding that BPA is inversely associated with serum E2:T ratio is significant, since estradiol is produced through aromatization of testosterone. A reduction in the E2:T ratio is considered a marker for decreased aromatase activity. This had been shown in the past in animal studies but not humans. BPA is known to have antiandrogenic activity in a number of studies and is confirmed here in regard to its decrease in FAI, E2, and TSH. Of course, there are several limitations to this study, which the authors point out; but given the widespread exposure to BPA and its known adverse effects on hormones and reproductive health, steps should be taken to minimize or eliminate the general population's exposure.
Phthalates from Plastics Have Negative Effects on Men's Hormones and Fertility
A recent study soon to be released in the Journal of Andrology has linked several phthalate monoesters to changes in men's hormones. This study includes men from two large ongoing studies looking at the environmental links to health. One of these, the Study for Future Families (SFF) is a multicenter study of pregnant women and their male partners, conducted at prenatal clinics affiliated with university hospitals in five US cities between 1999 and 2005. The second study included men who were male partners in infertile couples seeking evaluation at the Vincent Memorial Obstetrics and Gynecology Service, Massachusetts General Hospital, between January 2000 and May 2004.
In both studies the men completed a questionnaire and gave urine, blood, and semen specimens. Information was collected on demographics, medical history, and lifestyle factors. Four hundred and twenty-five men in each study population provided urine and blood samples. Urinary phthalate metabolites were measured in men, along with serum hormone levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), inhibin B, estradiol (E2), sex hormone-binding globulin (SHGB), and a free androgen index (FAI). Urinary concentrations of three metabolites of DEHP (mono-2-ethylhexyl phthalate [MEHP], mono-2-ethyl-5-hydroxyhexyl phthalate [MEHHP], and mono-2-ethyl-5-oxohexyl phthalate [MEOHP]) were inversely associated with the free androgen index (FAI) and calculated free testosterone (FT). Urinary concentrations of MEHHP and MEOHP were positively associated with SHBG, and MEHP was inversely associated with E2. No other phthalate metabolites were associated with serum hormones, consistent with results in each population. The study concludes that exposure to DEHP at environmental concentrations is associated with declines in free testosterone, both FAI and FT, and serum estradiol (E2). The other phthalate monoester metabolites examined (MEP, MBP, and MBzP) were not associated with any reproductive hormone changes.4
Comment: This is the first study to examine the associations between urinary concentrations of phthalate metabolites and reproductive hormone levels in a large study including both fertile men and male partners in infertile couples. This study suggests that DEHP has some antiandrogenic effects that alter male hormones and could affect fertility. Previous studies, including animal studies, have shown this same effect and proposed that DEHP is associated with reduced aromatase activity.4 Although this study looks at a large cohort of men, one limitation is that the study population from infertility clinics is not representative of the general population. However, according to data from the most recent National Health and Nutrition Examination Survey (NHANES), metabolites of DEHP are in 99% of the general population.5 DEHP is used in the production of polyvinyl chloride (PVC), and many men are exposed to it without being aware. DEHP migrates into food from plastics during processing and storage. It is in other products, including flooring, wall coverings, furniture, footwear, baggage, and packaging. Medical devices made of flexible PVC, such as IV bags and tubing, can leach the phthalate DEHP into patients.3 It is possible for physicians to order IV tubing and bags free of phthalates, while men should try to make healthful lifestyle choices by minimizing the use of plastics and plastic products.
These three studies highlight the concern about chemicals in the environment and men's health. Men are exposed to bisphenol A and phthalates on a daily basis from the use of plastic beverage bottles, plastic storage containers, plastic wrap on food, and canned foods. Men are exposed to pesticides through consumption of conventional fruits and vegetables that contain pesticide residue. While these chemicals have long been known to cause hormone disruption in animals, research has also shown that they affect humans. In the past, scientists have focused on the health effects of these chemicals on women and children, including infants. These three recent articles highlight the emerging concern for men. While scientist continue to bicker and claim that more research needs to be done, and industry responsible for putting these chemicals into products insist that they are safe, the public is starting to demand that they be removed from the environment. Some states are taking regulatory action that the federal government has resisted doing. For example, seven states have banned BPA from consumer products sold within their borders. Learn more about these and other hormone disrupting chemicals in my book, 8 Weeks to Women's Wellness.
1. Orton F et al. Widely used pesticides with previously unknown endocrine activity revealed as in vitro antiandrogens. Environ Health Perspect. 2011;119:794-800.
2. Meeker JD, Calafat AM, Hauser R. Urinary bisphenol-A concentrations in relation to serum thyroid and reproductive hormone levels in men from an infertility clinic. Environ Sci Technol. 2010;44(4):1458-1465.
3. Marchese M. 8 Weeks to Women's Wellness: The Detoxification Plan for Breast Cancer, Endometriosis, Infertility, and Other Women's Health conditions. Petaluma, CA: Smart Publ.; 2011.
4. Mendiola J et al. Urinary concentrations of di(2-ethylhexyl) phthalate metabolites and serum reproductive hormones: Pooled analysis of fertile and infertile men. J Androl. Epub May 19, 2011.
5. Aylward LL, Hays S, Kirman C. Urinary DEHP Metabolites and Food Fasting Time in NHANES. Consumer Products Safety Commission. September 8, 2010. Accessed online July 25, 2011. http://www.cpsc.gov/about/cpsia/chap/urinaryDEHP.pdf.
Marianne Marchese, ND