Clotrimazole, Pregnancy and Endocrine Disruption: A Narrative Review

Abstract

Background: Clotrimazole is an antifungal drug commonly used in human medicine. It is considered to be safe in pregnancy. Besides this medical assumption ecotoxicology has developed over the last years an awareness of pharmaceuticals which have been detected in surface waters and are of concern for the biosphere. Some of those drugs are endocrine disruptors. So is clotrimazole.
Methods: Selective internet research on this subject incorporating medical and ecotoxicological positions.
Conclusions: Ecotoxicology and human medicine postulate divergent positions about the harmful effects of clotrimazole. Medicine bases its assumption on thousands of healthy newborn babies whose mothers were treated with clotrimazole during pregnancy. This argument is easy to refute as clotrimazole is an endocrine disruptor and possible consequences of exposure during sensitive periods of pregnancy will only show up much later in life. As a result medicine is challenged to incorporate ecotoxicological concerns into its advice for pregnant women.