MedicalHypotheses: Autism spectrum disorder (ASD) is a group of developmental
disabilities that include full syndrome autism, Asperger’s syndrome, and
other pervasive developmental disorders. The identified prevalence of
ASD has increased in a short time period across multiple studies causing
some to conclude that it has reached epidemic proportions in the U.S. Many
possible explanations for the rise in numbers of individuals diagnosed
with ASD have been offered and yet, causes and contributing factors for
ASD are inadequately understood. Current evidence suggests that both
genetics and environment play a part in causing ASD.
One possible
risk factor for the increase in prevalence has been profoundly
overlooked in the existing biomedical and epidemiologic literature. As
the prevalence of ASD has risen in the last sixty years, so has the
prevalence of the usage of the oral contraceptives and other modern
hormonal delivery methods. In 1960 about one million American women were
using oral contraceptives, today close to 11 million women in the U.S.
use oral contraceptives. Eighty-two percent of sexually active women in
the U.S. have used oral contraceptives at some point during their
reproductive years. Thus, the growth in use of
progesterone/estrogen-based contraceptives in the United State has
reached near-ubiquitous levels among women in the child-bearing age
range.
The suppression of ovulation produced by
estrogen–progesterone is an indisputable abnormality. It is logical to
consider the outcome of the ovum that would have been normally released
from the ovary during ovulation. To date there is no comprehensive
research into the potential neurodevelopmental effects of oral
contraceptive use on progeny. The issue has been only sparsely
considered in the biomedical literature. This article hypothesizes that
the compounds, estrogen and progesterone, used in oral contraceptives
modify the condition of the oocyte and give rise to a potent risk factor
that helps explain the recent increase in the prevalence of ASD’s.
This
hypothesis does not propose to delineate the cause of autism. Rather,
it attempts to explain the recent dramatic increase in prevalence and
point the way for further study that will lead to causal examination.