Current Evidence on Testosterone, Androgens, and Endometriosis
When people talk about hormones and endometriosis, estrogen often gets most of the attention. However, researchers have shown interest in another group of hormones called androgens and how they may affect endometriosis symptoms and disease progression.
Androgens are commonly thought of as "male sex hormones," but everyone produces them. Testosterone is one of the most well-known androgens. These hormones are involved in many aspects of health, including reproductive and sexual function, mood, memory, muscle function, and bone health.
Androgens and Period Pain
Research on androgens and endometriosis is still limited, but some studies suggest they may influence pain levels.
A 2021 study of women who experience dysmenorrhea (painful periods) found that people with lower levels of androgens in their bodies tended to report more pelvic pain and more days of period pain. While these findings suggest a link between androgen levels and pain, scientists do not yet fully understand why this happens.
Hormones Within Endometriosis Lesions
Researchers have studied how hormones behave within endometriosis lesions. Endometriosis lesions can make their own estrogen using enzymes such as aromatase, which converts androgens into estrogen.
When these enzymes are more active, lesions may produce higher amounts of estrogen, which could worsen endometriosis progression.
Could Testosterone Be Protective Against Endometriosis?
Scientists have found that endometriosis lesions contain androgen receptors which allow cells to respond to hormones like testosterone.
Some research suggests that testosterone may help reduce inflammation. Because inflammation plays an important role in endometriosis, researchers are interested in whether maintaining healthy androgen levels could help reduce symptoms or slow disease progression.
At this point, there is not enough evidence to know whether testosterone could be used in treatment for endometriosis.
Implications for Treatment
These findings have led scientists to consider new treatment possibilities.
One existing treatment is aromatase inhibitors, which reduce estrogen production by blocking the transformation of testosterone into estrogen. These medications can help manage symptoms, but they may cause side effects such as hot flashes and bone loss.
Researchers wonder if combining aromatase inhibitors with testosterone may minimize side effects while improving endometriosis symptoms, but this remains an area for future study.
Looking Ahead
Research on testosterone and other androgens in endometriosis is still in its early stages. However, these studies highlight that endometriosis is influenced by more than just estrogen.
Understanding how different hormones work together may help explain why symptoms vary so much between individuals and why treatments that work well for some people might not work well for others.
As the endometriosis community continues to advocate for better research and care, studying emerging topics like testosterone and androgens may help researchers develop more effective and personalized treatment options in the future.
References
Evans, S. F., Kwok, Y., Solterbeck, A., Pyragius, C., Hull, M. L., Hutchinson, M. R., & Rolan, P. (2021). The relationship between androgens and days per month of period pain, pelvic pain, headache, and TLR4 responsiveness of peripheral blood mononuclear cells in young women with dysmenorrhoea. Journal of Pain Research, 14, 585–599. https://doi.org/10.2147/JPR.S279253
Evans, S. F., Hull, M. L., Hutchinson, M. R., & Rolan, P. E. (2021). Androgens, endometriosis and pain. Frontiers in Reproductive Health, 3, Article 792920. https://doi.org/10.3389/frph.2021.792920