Reproductive steroids are powerful hormones that play a critical role in human growth, development, and reproductive health. These naturally occurring chemicals, produced primarily by the ovaries in women and the testes in men, regulate essential processes such as puberty, fertility, and overall well-being. Their impact extends beyond reproduction, influencing various bodily functions, including bone health, muscle growth, and immune response. Recent research suggests that reproductive steroids may hold the key to understanding and treating complex conditions like endometriosis.
Dr. Philippa Saunders, a leading expert in reproductive steroids, defines them as a group of essential hormones that regulate bodily changes. The most recognized among these are estrogen, progesterone, and testosterone. Estrogen, predominantly found in women, facilitates breast development, initiates menstrual cycles, and prepares the body for pregnancy. Progesterone, another crucial female hormone, thickens the uterine lining to support pregnancy. In contrast, testosterone, primarily a male hormone, fosters muscle growth, deepens the voice, and aids in the development of male physical characteristics. Though present in both sexes, these hormones function differently based on individual needs.
“Reproductive steroids, particularly estrogen and progesterone, play a central role in regulating the menstrual cycle and preparing the uterus for pregnancy,” explains Dr. Saunders. However, in women with endometriosis, the endometrial tissue often exhibits “progesterone resistance,” meaning it does not respond effectively to progesterone. This imbalance disrupts the menstrual cycle, reduces the endometrial lining’s receptiveness to implantation, and contributes to infertility. In Kenya, particularly in rural areas, limited awareness and restricted access to specialized care further exacerbate these challenges.
Endometriosis is a complex and often misunderstood condition affecting millions of women worldwide, including an increasing number in Kenya. It is characterized by the presence of endometrial-like tissue outside the uterus, leading to chronic pain, heavy menstrual bleeding, and infertility.
Dr. Ezekiel Mecha, an endocrinologist, explains, “Endometriosis is not a single disease; it consists of three subtypes with distinct risk factors. Ovarian endometriosis causes lesions on the ovaries and is often inherited. Deep endometriosis infiltrates deeper into the pelvis, forming hard nodules, while peritoneal endometriosis features smaller lesions scattered along the pelvic lining.”
A striking finding from Dr. Saunders’ research is that endometriosis lesions can produce their own steroids. These lesions form a microenvironment with immune cells, nerves, and blood vessels, enabling them to survive independently of ovarian hormone production. This self-sufficiency can make traditional hormonal therapies less effective, leaving many women reliant on costly surgical interventions, which remain largely inaccessible in Kenya.
Traditionally, endometriosis has been regarded as a gynecological disorder, but new research reveals that it is a systemic disease affecting multiple organs. Endometriosis-related inflammation may contribute to cardiovascular problems, autoimmune disorders, and even neurological issues.
Women with endometriosis face an elevated risk of conditions such as high blood pressure, stroke, and heart disease. Studies also link the disorder to autoimmune conditions like rheumatoid arthritis, asthma, and lupus. Chronic pain conditions such as migraines and fibromyalgia are also more common among those with endometriosis.
According to the World Endometriosis Society (WES), painful endometriosis can affect the entire body, not just the pelvic region. “Many physicians don’t recognize the symptoms, and it takes an average of eight years for sufferers to be diagnosed,” says Dr. Mecha.
One significant case published in The Standard’s Health and Science Magazine highlighted how endometriosis-related tissue growth in the lungs led to a young Kenyan woman experiencing unexplained chest pain and breathlessness. Her case underscores the need for broader awareness of endometriosis as a whole-body condition.
Emerging studies suggest that understanding reproductive steroid interactions could unlock new treatment avenues for endometriosis. Transforming growth factor beta (TGF-beta), a protein influencing reproductive steroids, has been identified as a key player in the spread of endometriosis. Researchers are now exploring whether targeting TGF-beta could offer new non-hormonal treatment options.
Current hormonal therapies for endometriosis, including birth control pills, progestins, gonadotropin-releasing hormone (GnRH) agonists, and aromatase inhibitors, aim to reduce pain and slow tissue growth. However, these treatments do not cure the disease and often come with side effects such as mood changes, weight gain, and decreased bone density.
Newer non-hormonal therapies, including drugs targeting inflammatory molecules like prostaglandins and interleukin-8 (IL-8), offer hope for better symptom management. Additionally, repurposed drugs such as dichloroacetate (DCA) are being investigated for their ability to reduce pelvic inflammation. While these developments are promising, their availability remains a challenge in Kenya, where healthcare infrastructure is still developing.
In Kenya, endometriosis remains underdiagnosed and often misunderstood. Many women suffer in silence, misdiagnosed for years, and receive only painkillers or hormonal contraceptives without addressing the underlying condition. Cultural stigma surrounding menstrual health further discourages discussions, delaying diagnosis and treatment.
A multifaceted approach is necessary to improve endometriosis care in Kenya. Public education campaigns can raise awareness, while affordable diagnostic tools and specialized healthcare training can enhance early detection and treatment. Integrating global research findings with local initiatives will be essential in providing better care for Kenyan women.
As scientific understanding of reproductive steroids advances, it could revolutionize endometriosis treatment. By addressing both hormonal imbalances and inflammatory factors, future therapies may offer more effective and accessible solutions. Until then, advocacy, education, and improved healthcare systems will remain critical in ensuring that women with endometriosis receive the care they need.
