Endometriosis patients have unique hormonal patterns that can be identified through blood tests, research suggests, which could revolutionize endometriosis diagnosis.
Scientists have discovered that people with endometriosis have previously overlooked differences in androgens (so-called male hormones that are also present in women) compared to people without endometriosis.
The discovery could provide an easier, non-invasive route for diagnosis of the disease, which currently takes an average of nine years in the UK and is diagnosed by surgery, experts say. However, they caution that further research is needed to validate the findings in larger and more diverse populations.
Endometriosis occurs when cells similar to those in the lining of the uterus are found elsewhere in the body. These cells grow and change in response to hormones, leading to inflammation, pain, and the development of scar tissue.
This condition is caused by the female hormones estrogen and progesterone, which are associated with the menstrual cycle. Research on the role of androgens such as testosterone is limited.
Scientists at the University of Edinburgh examined hormone levels in the blood of 159 women with confirmed endometriosis and 57 women without endometriosis. Their analysis focused on androgens, a group of hormones produced by the adrenal glands, including 11 oxygenated androgens.
Researchers found that endometriosis patients have a distinct hormonal fingerprint, including high levels of 11-oxygenated androgens, 11-ketotestosterone.
This unique hormonal signature was used to distinguish between those with and without endometriosis, and accurately identified more than 95 percent of endometriosis patients.
Working with Edinburgh Innovations, the university’s commercialization service, the team is now seeking industry partners to help develop a diagnostic blood test for endometriosis based on its results.
The study provides important new insights into the important role of androgens in the development of endometriosis and may also provide a potential route to future therapeutic targets, experts say.
This research was funded by Wellcome and the Medical Research Council. European Journal of Endocrinology: https://doi.org/10.1093/ejendo/lvag109 (URL will be valid after the embargo is lifted). The research team also included scientists from the University of Liverpool, the University of Glasgow and the University of Birmingham.
Dr Douglas Gibson, from the University of Edinburgh’s Center for Reproductive Health and lead researcher on the study, said: “These findings mark an important advance in our understanding of endometriosis, traditionally seen as an estrogen-induced disease. “Our study challenges this view by showing that androgen levels vary in endometriosis. We are optimistic that this new insight will lead to early diagnosis and the development of innovative new treatments for people affected by endometriosis.”
Dr Susan Bodie, director of innovation development and licensing at Edinburgh Innovations, said: “This is an exciting discovery that addresses a significant unmet need in the field of women’s health. Edinburgh Innovations encourages partners who can help develop this unique technology to reach women who are currently waiting years for an endometriosis diagnosis.”
Endometriosis affects one in 10 women and those assigned female at birth, but it has historically been under-researched and under-funded. Endometriosis patients have long faced unacceptably long waiting times for diagnosis, with it currently taking an average of more than nine years to obtain a diagnosis in the UK. Without a diagnosis, treatment may not be available and the disease may progress.
Reliable non-surgical diagnostic tests are much needed and long-awaited and could help reduce the diagnostic period to just a few months. Although these initial results are promising, larger trials are essential to validate these findings. This is exactly why investing in endometriosis research is so important, and why we are watching developments in this research with interest. ”
Emma Cox, CEO Endometriosis UK
Jill Jones, Associate Director for Global Health, Population and Systems Medicine at the Medical Research Council, said: “This important research addresses an area of unmet clinical need and has the potential to inform the diagnosis and treatment of endometriosis, which affects millions of women around the world.”
“This highlights the important role that discovery science plays in improving lives and, in this case, provides an exciting new avenue to accelerate diagnosis.”
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Reference magazines:
Simitzdelis, I. Others. (2026) Steroid hormone profiling reveals altered adrenal androgen production in endometriosis. European Journal of Endocrinology. DOI: 10.1093/ejendo/lvag109
