Voluntary Exposures: Natural Herbals, Supplements, and Substances of Abuse – What Evidence Distinguishes Therapeutic from Adverse Responses?

Herbals and supplements are frequently sold over the counter without the requirement of a prescription. While the beneficial effects are widely promoted in the lay press, the impact of these compounds on health may be positive, negative, or neutral. This chapter focuses on the effects of exogenous chemicals on the reproductive system across the life span. In addition, it explores where data permit, the relationship between exposure to these chemicals and adverse effects on the reproductive tract. Experiments on animals and studies from tissue culture are included where epidemiological studies provide evidence of a significant association to address issues of biological plausibility, dose‐response, modes and mechanisms of action, and relevance to human health. Of the many environmental toxicants and lifestyle factors known to affect fertility and ovarian function, cigarette smoking is potentially the most clinically relevant and preventable toxic exposure in women, is a global health issue, and it targets for infertility prevention.