Device Detects Endometriosis Biomarker in 10 Minutes Using Menstrual Blood

Endometriosis is a chronic, estrogen-dependent condition in which endometrial-like tissue grows outside the uterus, most commonly within the pelvic cavity. It affects an estimated 1 in 10 women, although up to 60% of cases may go undiagnosed. Despite its progressive nature and the direct involvement of easily accessible tissue, the average time to reach a correct diagnosis remains nearly nine years. Currently, no single point-of-care diagnostic test exists for the disease.

Researchers at Penn State may be leading the way for earlier, less invasive diagnosis. In a recent study published in ACS Central Science, they explored the diagnostic potential of menstrual effluent – biological material routinely shed and often disregarded as medical waste. This overlooked resource may harbor key biomarkers that could help detect endometriosis more efficiently and reduce the significant diagnostic delay.

A new diagnostic tool inspired by menstrual effluent

Current diagnostic methods for endometriosis rely on a combination of intravenous blood tests, laboratory analyses, imaging studies and comprehensive patient history – often resulting in delayed diagnoses. One study reported diagnostic delays of up 7 years, highlighting the urgent need for more accessible and efficient tools.

Researchers have now developed a proof-of-concept device that detects HMGB1 – a protein associated with the onset and progression of endometriosis – in menstrual blood with 500% greater sensitivity than existing lab-based methods.

The device functions similarly to a pregnancy test and is based on a novel technique that synthesizes nanosheets from borophene, an atomically thin, two-dimensional (2D) material.

“Despite the significant potential of menstrual effluent as a diagnostic tool for women’s health, it faces substantial challenges due to social stigma and lack of affordable testing options,” said Dr. Dipanjan Pan, professor of nuclear engineering and materials science and engineering at Penn State.

“By leveraging the unique properties of borophene, our approach offers an opportunity to break down menstrual stigma while advancing women’s health,” he added.

Borophene, a boron-based 2D material, shares structural similarities with the better-known graphene but offers key advantages.

“Our research shows borophene is highly biocompatible and biodegradable, making it ideal for biomedical applications,” Pan said.

However, producing high-quality borophene remains challenging. Traditional fabrication methods involve multiple steps and the use of harsh solvents, such as isopropyl alcohol, which can degrade both the material’s yield and its suitability for medical use.

Harnessing borophene for sensitive biomarker detection

In this study, the researchers replaced the traditional alcohol-based solvent with water. By dispersing powdered boron into water, they were able to break down the compound and reform it into what Pan described as “pristine” nanosheets. Antibodies designed to detect HMGB1 were then attached to the nanosheets.

“Think of planting a garden,” Pan said. “The ground – the nanosheets – must be even and clear of weeds before you can fertilize the soil – adding the antibodies. Then, you have the best environment to support the desired vegetables – the HMGB1 proteins. That was our goal here, to create a uniform foundation on which the antibodies could recognize and capture the HMGB1 proteins.”  

To confirm that the antibodies were correctly bound to HMGB1, the team used multiple imaging and chemical analysis techniques. Once validated, they integrated the nanosheets into a test device. The device displays one line for a negative result and two lines if HMGB1 is detected. As menstrual blood flows over the strip, any HMGB1 proteins present bind to the antibodies, causing the test line to darken.

To evaluate the device’s sensitivity, the researchers introduced various concentrations of HMGB1 into menstrual blood samples. The test successfully detected low levels of the protein with five times greater sensitivity than existing lab-based methods, which often require complex preparation and analysis.

“Clinical evidence shows HMGB1 levels in menstrual blood are significantly higher in individuals with endometriosis than in healthy controls,” said Pan. “However, early-stage or asymptomatic cases may show only modest increases.”

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“That’s why high sensitivity to low concentrations is essential – early detection enables timely intervention. Unlike conventional lab tests, our device offers both sensitivity and practicality, making it well-suited for use in settings without centralized medical facilities or laboratory infrastructure,” Pan continued.

Toward at-home testing and broader clinical applications

Pan noted that the test could even be integrated into menstrual pads, offering a discreet and convenient way to monitor HMGB1 levels at home.

“The ability to detect critically important biomarkers via a decentralized platform, like our approach, empowers patients with facilitating widespread use in more rural areas or settings without expansive medical resources,” he said. “This study highlights the broader research opportunities essential for realizing next-generation biotechnologies, with 2D materials at their core. I’m excited about the promise this class of nanomaterials holds for advancing health care applications.”

The research team plans to scale up the device for clinical studies, enhance its sensitivity and expand its capabilities to detect additional disease biomarkers, including those for human papillomavirus and cervical cancer.

Reference: Natarajan S, Dighe K, Aditya T, et al. Photoinduced immobilization on two-dimensional nano borophene spatially orients capture antibody for highly sensitive biological interactions. ACS Cent Sci. 2025. doi: 10.1021/acscentsci.5c00474

This article is a rework of a press release issued by The Pennsylvania State University. Material has been edited for length and content.