Bisphenol S and female reproductive toxicity: a scoping review of human studies

Bisphenol S (BPS) is a chemical analogue of Bisphenol A (BPA) used in the production of hard plastics, textiles, and thermal papers. As the use of BPA has declined, BPS human exposure has increased and is now widespread. BPS has endocrine-disrupting properties and growing evidence indicates BPS negatively impacts female reproductive health.

We conducted a scoping review of primary research articles related to BPS exposure and female reproductive toxicity in humans.

We searched five biomedical databases through January 2025 for studies that assessed the effects of BPS exposure on outcomes related to female reproduction in humans. Included studies used a cohort, case-control, or cross-sectional study design, measured BPS in individuals, presented original data analyses, and adjusted for confounding variables. We tabulated study characteristics and key findings of the included studies.

The literature search and screening yielded thirty-four studies for inclusion. Across studies, the LOD for BPS varied widely, from 0.002 to 0.20 ng/mL, and so did the proportion of samples with detectable BPS, from 14.8% to 100%. BPS was associated with greater risk of polycystic ovarian syndrome in two studies and gestational diabetes mellitus or related biomarkers in three studies. BPS was also associated with changes in thyroid hormones, reproductive hormones, and pubertal timing, though the directions of effects for these outcomes were mixed. BPS was not associated with endometriosis, gestational hypertension, or infertility.

There is evidence from human studies that BPS exposure can cause some adverse female reproduction outcomes, though data were limited in number of studies per outcome, variable limits of BPS detection, and differences in exposure to BPS across samples. Despite limitations, epidemiologic data, considered along with in vitro and animal data, is important in identifying BPS as a hazard to female reproduction.

Human exposure to BPS is increasing. The findings of this review of 34 epidemiologic studies suggests a link between BPS exposure and some adverse female reproductive health outcomes. This review also highlights data gaps in variable limits of BPS detection, differences in exposure, and the limited number of studies for specific outcomes. In addition to epidemiological evidence, in vitro and animal data show sufficient evidence to support BPS as a female reproductive.