Hormone differences could pave way for endometriosis blood test
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People with endometriosis have a distinct pattern of hormones that could be identified by a blood test, with the potential to revolutionize diagnosis of the condition, research suggests. Scientists have found that those with endometriosis have differences in a previously overlooked group of androgens—so-called male hormones, which are also present in females—compared with those without the condition.
The findings, appearing in the European Journal of Endocrinology, could provide a simple, noninvasive route for diagnosis of the condition, which currently takes an average of nine years in the U.K. and is confirmed through surgery, experts say. However, they caution that further studies are needed to validate the findings in a larger and more diverse population.
Endometriosis occurs when cells similar to the ones in the lining of the womb are found elsewhere in the body. These cells can grow and change in response to hormones, leading to inflammation, pain and the development of scar tissue. The condition is driven by female hormones, estrogen and progesterone, linked to the menstrual cycle. Research into the role of androgens, such as testosterone, has been limited.
University of Edinburgh scientists looked at hormone levels in the blood of 159 women with confirmed endometriosis and 57 women without the condition. Their analysis focused on androgens, including 11-oxygenated androgens—a group of hormones produced by the adrenal glands.
Researchers found that those with endometriosis had a distinct hormone fingerprint, including high levels of the 11-oxygenated androgen 11-ketotestosterone. This unique hormone signature was used to differentiate between those with and without endometriosis, correctly identifying more than 95% of endometriosis patients.
The team is now looking for industry partners to help develop a diagnostic blood test for endometriosis based on the findings.
The study provides crucial new insights into the important role of androgens in the development of endometriosis and could also offer a potential route for future therapeutic targets, experts say.
The research team also included scientists from the universities of Liverpool, Glasgow and Birmingham.
The study's principal investigator, Dr. Douglas Gibson, from the University of Edinburgh's Centre for Reproductive Health, said, "These findings mark a significant breakthrough in our understanding of endometriosis. Traditionally seen as an estrogen-driven disorder, our research challenges this view by showing different androgen levels in the condition. We are optimistic that this new insight will lead to earlier diagnosis and the development of innovative new treatments for those affected by endometriosis."
Susan Bodie, director of innovation development and licensing at Edinburgh Innovations, added, "This is an exciting discovery that addresses an important unmet need in the field of women's health. Edinburgh Innovations would encourage partners who can help develop this proprietary technology, so it can reach women who currently wait years for an endometriosis diagnosis, to get in touch."
Emma Cox, CEO of Endometriosis UK, noted, "Endometriosis affects 1 in 10 women and those assigned female at birth, yet has historically been underresearched and underfunded. For too long, those with endometriosis have faced unacceptably long waits for a diagnosis, and it currently takes an average of more than nine years to get a diagnosis in the U.K. Without a diagnosis, treatment cannot be accessed and the disease may progress.
"A reliable, nonsurgical diagnostic test is much needed, long awaited, and could help drive down diagnosis times to just a few months. These early results are promising. However, larger trials will be essential to validate these findings. This is exactly why investment in endometriosis research matters—and why we will be following the progress of this research with interest."
Jill Jones, associate director of global health, population and systems medicine at the Medical Research Council, concluded, "This important study tackles an area of unmet clinical need and has the potential to inform diagnosis and treatment of endometriosis, which affects millions of women worldwide. It highlights the important role discovery science plays in improving lives, in this case offering an exciting new pathway to accelerating diagnosis."
Publication details
Steroid hormone profiling reveals altered adrenal androgen production in endometriosis, European Journal of Endocrinology (2026). DOI: 10.1093/ejendo/lvag109
Journal information: European Journal of Endocrinology
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Obstetrics & gynecologyWomen's healthEndocrinology Provided by University of Edinburgh Who's behind this story?
Stephanie Baum
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