Endometriosis and Testosterone: What’s the Link?


There may be a game changer on the horizon for women with endometriosis. Affecting 10 percent of women of reproductive age, endometriosis is a painful condition in which endometrial-like tissue grows outside the uterus on other organs, such as the ovaries, fallopian tubes, bowel, and the outside walls of the uterus. Endometriosis is infamously hard to detect: On average, it takes women between 7 and 10 ten years to get an accurate diagnosis.

A new study published in March 2021 in Evolution, Medicine, and Public Health may lessen that lag time and point a way to a new treatment using testosterone. Two of the first study’s authors produced a related review of medical literature published in the May 2021 issue of Evolutionary Applications called “Endometriosis and Polycystic Ovarian Syndrome (PCOS) Are Diametric Disorders.” The first study posits that endometriosis is related to fetuses developing in mothers with too little testosterone; the second notes that PCOS is related to receiving too much testosterone in utero.

RELATED: 14 Celebrities Speak Out About Endometriosis

A Hormone Imbalance May Start in the Womb

In studying the male sex hormone in women, the team reviewed a large body of existing literature across many disciplines, and found that compared with women without the disease, women with endometriosis were more likely to have developed as fetuses in mothers with low testosterone levels. “Low exposure to testosterone for developing females appears to lead to continual low ovarian testosterone relative to estradiol levels,” says Natalie Dinsdale, a PhD candidate in evolutionary biology at Simon Fraser University in Burnaby, Canada. Translation: A deficiency in or lack of testosterone in utero may set the hormonal stage for the later development of endometriosis.

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