An old culprit but a new story: bisphenol A and “NextGen” bisphenols

The concept that developmental events shape adult health and disease was sparked by the recognition of a link between maternal undernutrition and coronary disease in adults. From that beginning, a new field—the developmental origins of health and disease—emerged, and attention has focused on the effects of a wide array of developmental perturbations. Exposure to endocrine-disrupting chemicals has been of particular interest, and a ubiquitous environmental contaminant bisphenol A (BPA) has become the endocrine-disrupting chemical poster child. Bisphenol A has been the subject of intense investigation for nearly two decades, and exposure effects have been described in hundreds of experimental, epidemiological, and clinical studies. From the standpoint of reproductive health, the findings are particularly important, as they suggest that the ovary, testis, and reproductive tract in both sexes are targets of BPA action. The findings and the media and regulatory attention garnered by them have generated increasing public concern and resulted in legislative bans on BPA in some countries. The subsequent introduction of BPA-free products, although a masterful marketing strategy, is in reality only the beginning of a new and complex chapter of the BPA story. In this review we attempt to summarize what we have learned about the reproductive effects of BPA, present the reasons why studying the effects of this chemical in humans is no longer sufficient, and outline the challenges that the growing array of next generation bisphenols represents to clinicians, researchers, federal agencies, and the general public.