Sex hormone binding globulin and its role in the development of endometriosis

DOI

https://dx.doi.org/10.18565/aig.2024.323

Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I.
1) Belgorod State National Research University, Belgorod, Russia; 2) St. Joasaph Belgorod Regional Clinical Hospital, Belgorod, Russia

Endometriosis is one of the most common gynecological diseases of the female reproductive system, and sex hormones play an important role in its pathogenesis. Sex hormone binding globulin (SHBG), a plasma glycoprotein, specifically binds androgens and estrogens and regulates the levels of biologically active (free) steroid hormones in plasma. The SHBG level in the body is influenced by age, gender, and body mass index. Genetic factors are important in determining the SHBG levels. The SHBG expression is negatively affected by monosaccharides, insulin and androgens, while thyroid and estrogenic hormones as well as phytoestrogens, on the contrary, increase its production. The high levels of estrogen and low levels of testosterone are associated with an increased risk of endometriosis. Since SHBG is important in the regulation of testosterone and estrogen levels, there is obviously an association between the SHBG levels and the likelihood of endometriosis.
Conclusion: The literature review suggests that SHBG plays a significant role in regulating the level of biologically active sex hormones in the body, and this role is frequently underestimated by medical professionals. The SHBG levels and its genetic determinants may be promising biological markers that can predict the risk of endometriosis. Further research in this area is required to provide evidence for the use of SHBG in clinical practice.

Authors’ contributions: Ponomareva T.A. – literature search and analysis, evidence summary, writing the text of the manuscript; Ponomarenko I.V. – editing the text of the manuscript; Altukhova O.B. – developing the concept and design of the article; Churnosov M.I. – reviewing, final editing.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
For citation: Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I.
Sex hormone binding globulin and its role in the development of endometriosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (4): 5-11 (in Russian)
https://dx.doi.org/10.18565/aig.2024.323

sex hormone binding globulin

endometriosis

estrogens

testosterone

Full text (in Russian)

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Received 07.12.2025

Accepted 21.03.2025

Tatiana A. Ponomareva, PhD student, Department of Medical and Biological Disciplines, Belgorod State National Research University, 85 Pobedy str., 308007, Belgorod, Russia; Obstetrician-Gynecologist, St. Joasaph Belgorod Regional Clinical Hospital, 8/9 Nekrasov str., 308015, Belgorod, Russia, rybaarbusova@icloud.com,
https://orcid.org/0009-0007-8533-9319
Oxana B. Altukhova, Dr. Med. Sci., Associate Professor, Head of the Department of Obstetrics and Gynecology, Belgorod State National Research University, 85 Pobedy str., 308007, Belgorod, Russia; Head of Gynecological Department, St. Joasaph Belgorod Regional Clinical Hospital, 8/9 Nekrasov str., 308015, Belgorod, Russia,
altuhova_o@bsuedu.ru, https://orcid.org/0000-0003-4674-8797
Irina V. Ponomarenko, Dr. Med. Sci., Associate Professor at the Department of Medical and Biological Disciplines, Belgorod State National Research University, 85 Pobedy str., 308007, Belgorod, Russia, ponomarenko_i@bsuedu.ru, https://orcid.org/0000-0002-5652-0166
Mikhail I. Churnosov, Dr. Med. Sci., Professor, Head of the Department of Medical and Biological Disciplines, Belgorod State National Research University, 85 Pobedy str.,
308007, Belgorod, Russia, churnosov@bsuedu.ru, https://orcid.org/ 0000-0003-1254-6134
Corresponding author: Tatyana A. Ponomareva, rybaarbusova@icloud.com

Sex hormone binding globulin and its role in the development of endometriosis

Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I.

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