In 2017, a study was published concluding that sperm counts had declined at a rate of 1 per cent per year over the past 50 years. That was alarming to hear. Last year, that study was updated. Shockingly, the authors discovered that since the start of the 21st century, sperm counts worldwide had been declining by 2.64 per cent each year.

One of the authors of these studies, leading environmental and reproductive epidemiologist Shanna Swan, explained that while lifestyle factors such as diet, smoking, alcohol, physical fitness, stress levels and personal decisions cannot be dismissed, environmental exposures to endocrine-disrupting chemicals like those found in pesticides, herbicides and plastics are also significant contributors to the changes we are seeing.

EDCs interfere with our body’s endocrine system, which produces and controls our hormones. They can impact our metabolism — contributing to obesity — thyroid function and, among many others, our sex hormones, which are responsible for fertility. Sex hormones such as testosterone, progesterone and oestrogen are needed for our bodies to produce healthy sperm and eggs. When our body is contaminated with EDCs, we may have difficulty conceiving either from the male side, through lower sperm counts, or the female side, with irregular menstruation (periods), anovulation (no ovulation with each menstrual cycle) or early menopause.

In women, EDCs have also been linked to miscarriages and fibroids. Fibroids are non-cancerous tumours that grow in or around the uterus and can cause multiple issues. As well as reproductive problems, they can cause pelvic and back pain, heavy menstrual bleeding and pain during sex.

A low sperm count is not only a reproductive concern, but even more frightening is that it is an indicator for other health problems in men. Studies, while still limited, have found a potential link between EDCs and erectile dysfunction. Low testosterone and low sperm counts are a predictor for increased mortality in men.

Exposure to EDCs in utero can have long-term impacts on the developing child. The male foetus, for example, requires exposure to adequate testosterone for the development of his sexual organs. If this is impaired, the knock-on effects can translate to infertility as an adult.

How can we turn this situation around?

For a start, we can make healthier lifestyle choices, and this is something that I and my colleagues in the medical and nutrition profession can provide help and support for. But this alone is not enough.

Two of the most common chemicals used in the manufacture of plastic are EDCs — bisphenol A, more commonly known as BPA, and phthalates.

A lot of plastic products are now printed with the prominent announcement “BPA-free”. Unfortunately, that does not mean that they are safe because other, less well-known EDCs are still permitted for manufacturers to use instead — such as bisphenol F or bisphenol S. These may be in turn proved to be just as harmful.

In the face of all this, it is easy to feel powerless, but the opposite is true. We are very powerful. Our choices and our money are our power.

One crucial way we can avoid the impact of EDCs on our health is to eliminate single-use plastic from our lives. If you haven’t already, the best place to start is by no longer buying plastic water bottles, and then working your way from there to refusing “paper” coffee cups, which are lined with plastic, and all forms of plastic food containers and cutlery.

Avoid plastic that is in contact with food whenever possible. Invest in reusable coffee cups and Pyrex dishes. Use a stainless-steel or glass water bottle instead of a plastic one. Never heat food in plastic containers because when plastic heats, the chemicals can leach into our food. This is the same for hot drinks.

Choose and support restaurants and vendors who are investing in your health and use non-plastic alternatives for food packaging. Encourage your favourite restaurants to adopt a reusable container scheme, or, at the very least, insist that they use foil, cardboard and paper for your meals if that is not their general practice, and take your own container to use as a doggy bag when you eat out. Although it is a challenge, try to avoid buying processed or imported food in plastic wrapping or containers. Eat fresh, locally produced food instead.

If you or someone you know has struggled with infertility, you are aware of the toll that this can have on an individual and their family. If we don’t make these changes, which may seem insignificant individually, the future does look rather bleak. Please do everything you can personally to avoid adding to the problem. Start by saying “no” to single-use plastic.

• Annabel Fountain, MD is a Bermudian endocrinologist and medical director of Fountain Health. Beyond Plastic Bermuda is a joint campaign by the Bermuda Environmental Sustainability Taskforce, Keep Bermuda Beautiful and environmental advocates to educate and help our island move away from plastic. For more information, contact info@beyondplastic.bm