Female reproductive aging often affects women's emotional, physical, and physiological well-being. Ovarian aging is characterized by fluctuations in reproductive hormones and determines the age at which menopause occurs. Understanding potentially modifiable factors that influence this process is essential for addressing health disparities, improving quality of life, and informing relevant public health strategies. This review synthesizes in vivo, in vitro, and epidemiological findings about the effects of endocrine-disrupting chemicals (EDCs), specifically heavy metals and perfluoroalkyl and polyfluoroalkyl substances (PFAS) on female reproductive aging. Most in vivo and in vitro studies have demonstrated that heavy metals alter ovarian morphology, folliculogenesis, and steroidogenesis. Evidence regarding the effects of PFAS is limited and inconsistent. Epidemiological studies have consistently shown that heavy metals are associated with a higher risk of diminished ovarian reserve (indicated by decreased anti-Müllerian hormone) and earlier menopause, with limited findings regarding reproductive hormone changes. PFAS exposure has been associated with decreased estradiol and earlier menopause but not significantly with ovarian reserve. Gaps in the literature require more comprehensive epidemiological research on the effects of EDCs on female reproductive aging, including ovarian reserve, age at menopause, and vasomotor symptoms, to inform future interventions to reduce hazardous exposures and improve women's health.
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