Recently the Italian press has been debating bisfenol as a cause of endometriosis. This needs some comments
1. The relationship between endometriosis and endocrine disrupters as dioxin started in 1994 with the article of Koninckx-Kennedy-Barlow soon followed by the primate article of Rier. Since then numerous articles have been published but the relationship remains unclear. The logic hypothesis that breastfeeding could cause endometriosis since dioxin is excreted in breast milk, fortunately has been proven not to be true - the opposite is true. This is a nice example how careful we have to be when interpreting scientific data , and not to jump at conclusions. Anyway there is no reason today to become really worried.
2. Also the story of bisfenol - another endocrine disruptor with estrogen like activity - goes back some time. It starts with a nice article of Tsutsumi. followed by an article of Newbold et al, 2005 . As demonstrated 30 years ago for stilbestrol , high doses of estrogens during neonatal live can cause congenital anomalies of internal genital organs . The first article linking bisfenol to endometriosis dates from 2009 and demonstrates that the concentrations of bisfenol in adult women with endometriosis is increased. They concluded that it is unclear whether the small doses found could cause any effect.
3. Recently Signorile, 2009 described ‘endometriosis-like lesions’ in mice in utero.  Since we disagreed that these lesions could be considered endometriosis we (Ronald E. Batt,  New York, USA ,Lone Hummelshoj,  London, England,Charles Chapron, Paris, France ,Dan C. Martin,  Memphis, USA, Glenna C. Bett,  New York, USA, John Yeh,  New York, USA, Philippe R. Koninckx, Leuven, Belgium )we wrote a respons to express our doubts. . Unfortunately the journal does not accept letters to the editor and the comment is “burried alive”. Therefore another article was written “the elephant in the room” which is ‘in press’.
4. Therefore the article in the Italian newspaper “Visto” has to be interpreted cautiously. What is worse however are the conclusions when surgical treatment is discussed, and where microscopic endometriosis is discussed as a causing recurrent interventions for endometriosis. Microscopical endometriosis is a concept of 25 years ago which never has been proven. Recurrences of endometriosis as discussed on this web site is generally caused by incomplete surgery. Linking bisfenol to endometriosis to microscopical endometriosis to conclude that repeated surgery might be necessary is scientifically more than speculative inducing unnecessary fear in women.

Prof P.R. Koninckx e Drssa A. Ussia