The National Institute for Health and Care Excellence (Nice) has approved two new tests for endometriosis—Endotest and EndoSure—for use on the NHS, in a move expected to dramatically reduce the time it takes for women to receive a diagnosis. Currently, the average diagnosis time for endometriosis in the UK exceeds nine years, rising to 11 years for women from ethnically diverse communities, according to Nice.
How the New Tests Work
Endotest analyses a saliva sample for microRNAs, tiny biological markers that indicate the presence of endometriosis. The sample is sent to a lab, with results returned to the GP or healthcare professional. EndoSure detects endometriosis by measuring electrical signals in the gut using sensor pads on the abdomen. Women fast for six to eight hours before the test and then drink water for 45 minutes during the procedure; results are available immediately upon completion.
Both tests are intended for women where endometriosis is still suspected despite a normal clinical examination and negative or inconclusive imaging results, or where imaging has not been used. They are not standalone diagnostic tools but are designed to expedite the pathway to diagnosis and treatment.
Impact on Patients
Endometriosis affects around one in 10 women of reproductive age in the UK. A survey of more than 10,000 women by the All-Party Parliamentary Group on endometriosis found that over half visited their GP more than 10 times before receiving a diagnosis, and more than half had attended A&E due to symptoms. Delays often stem from varying expertise in transvaginal ultrasounds and long waiting times for hospital gynaecology services.
Ami Robertson, a 23-year-old Pilates instructor from Glasgow, experienced symptoms from age 16 but was repeatedly told she had irritable bowel syndrome. She said: “I spent years being told my pain was something else entirely. I started to doubt myself, wondering if it was all in my head. When I finally had the test, it took less than an hour and gave me something I’d never had before: concrete evidence I could take to my doctor. For the first time, I was believed, and I could finally get the help I needed.”
Simran Chavda, 15, from Huddersfield, began experiencing severe pelvic pain at 13. After repeated GP visits and A&E attendances, the test confirmed endometriosis. She said: “Getting my diagnosis honestly felt like the best thing in the world. Everyone kept saying it might be irritable bowel syndrome. I was sent to hospital multiple times and sent back home. The test itself was easy, it wasn’t painful at all. Just drinking water and being monitored. Really simple.”
Clinical and Expert Endorsement
Dr Anastasia Chalkidou, healthtech programme director at Nice, said: “A diagnosis of endometriosis can for some women take the best part of a decade, with the UK average standing at nine years and four months, and rising to 11 years for those from ethnically diverse communities. That delay means living with chronic pelvic pain that affects daily life, relationships and work. These technologies have the potential to change that by giving primary care professionals better non-invasive tools to identify endometriosis earlier, allowing earlier and better treatment.”
Dr Gail Busby, consultant gynaecologist at Manchester University NHS Foundation Trust, added: “As a gynaecologist working with both adults and adolescents, I’ve seen first-hand how endometriosis can devastate young people’s lives, causing them to miss school, struggle through GCSEs and miss out on the experiences that matter most during those formative years. Too many of my patients have spent years being told their pain is normal when it isn’t. These tests are a game-changer because they give us answers much earlier, without the need for invasive surgery, and that means we can start the right treatment sooner.”
Implementation and Future Steps
The draft recommendation approves Endotest and EndoSure for three years in the NHS, during which additional evidence on their effectiveness will be collected before final approval. A third test, DotEndo, requires further research. Emma Cox, chief executive of Endometriosis UK, welcomed the tests but stressed: “Availability of these new tests needs to go hand in hand with education of GPs and practice nurses to ensure prompt access to those that need them, and an end to pain and symptoms not being recognised.”
