Steroid hormone profiling reveals altered adrenal androgen production in endometriosis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective
Endometriosis is a chronic, hormone-dependent condition affecting an estimated 190 million women worldwide. Our understanding of hormonal contributions to endometriosis pathophysiology is incomplete, hindering the identification of diagnostic biomarkers and novel therapeutic targets. Although the role of estrogens is well established, research on androgens in endometriosis is limited and the contribution of adrenal-derived 11-oxygenated androgens remains largely unknown.
Methods
We performed steroid androgen profiling to measure androgen concentrations in serum from healthy controls and women with laparoscopically confirmed endometriosis. We found that women with endometriosis had a distinct hormone signature characterized by systemic differences in adrenal androgen concentrations and 11-ketotestosterone excess.
Using metabolomic data, we generated statistical models that showed robust discrimination between healthy controls and women with endometriosis (AUC = 0.99; positive predictive power = 96.84%, negative predictive power = 92.86%) consistent with an endometriosis-specific signature. Data were partitioned into train and validation groups to assess diagnostic potential and a refined model identified >95% of endometriosis patients in a blinded sample set.
Conclusions
Collectively, these data reframe endometriosis as an androgen-dependent disorder and highlight 11-oxygenated androgens as potential diagnostic biomarkers and future therapeutic targets.
Endometriosis is a chronic, hormone-dependent condition affecting an estimated 190 million women worldwide. Our understanding of hormonal contributions to endometriosis pathophysiology is incomplete, hindering the identification of diagnostic biomarkers and novel therapeutic targets. Although the role of estrogens is well established, research on androgens in endometriosis is limited and the contribution of adrenal-derived 11-oxygenated androgens remains largely unknown.
Methods
We performed steroid androgen profiling to measure androgen concentrations in serum from healthy controls and women with laparoscopically confirmed endometriosis. We found that women with endometriosis had a distinct hormone signature characterized by systemic differences in adrenal androgen concentrations and 11-ketotestosterone excess.
Using metabolomic data, we generated statistical models that showed robust discrimination between healthy controls and women with endometriosis (AUC = 0.99; positive predictive power = 96.84%, negative predictive power = 92.86%) consistent with an endometriosis-specific signature. Data were partitioned into train and validation groups to assess diagnostic potential and a refined model identified >95% of endometriosis patients in a blinded sample set.
Conclusions
Collectively, these data reframe endometriosis as an androgen-dependent disorder and highlight 11-oxygenated androgens as potential diagnostic biomarkers and future therapeutic targets.
Date Issued
2026-07-01
Date Acceptance
2026-06-01
Citation
European Journal of Endocrinology, 2026, 195 (1), pp.22-34
ISSN
0804-4643
Publisher
Oxford University Press (OUP)
Start Page
22
End Page
34
Journal / Book Title
European Journal of Endocrinology
Volume
195
Issue
1
Copyright Statement
© The Author(s) 2026. Published by Oxford University Press on behalf of European Society of Endocrinology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-com mercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/42410715
PII: 8725815
Subjects
11-oxygenated androgens
adrenal
androgen
endometriosis
Humans
Female
Endometriosis
Androgens
Adult
Biomarkers
Adrenal Glands
Testosterone
Case-Control Studies
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2026-07-07