In a major step forward for women's health, the National Institute for Health and Care Excellence (NICE) has issued draft guidance recommending two non-invasive diagnostic tests for endometriosis, which could dramatically reduce the average diagnosis time of nearly a decade. The tests, a saliva-based test called Endotest and a gut electrical signal test named EndoSure, will be funded by the NHS while further data on their effectiveness is collected.
New Tests Offer Hope to Thousands
Endometriosis affects around one in 10 women of reproductive age in the UK, yet the average time to diagnosis is nine years and four months, rising to 11 years for women from ethnically diverse communities, according to NICE. The condition leads to chronic pelvic pain, fatigue, and fertility issues, with over 582,744 women on the gynaecology waiting list in England last year.
Dr Anastasia Chalkidou, director of NICE's healthtech programme, said: 'A diagnosis of endometriosis can for some women take the best part of a decade... 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.'
How the Tests Work
Endotest analyses a saliva sample for tiny biological markers called microRNAs in a laboratory, which can indicate whether endometriosis is likely present. Results are sent back to the treating clinician to inform next steps. EndoSure detects endometriosis by measuring electrical signals in the gut using sensor pads on the abdomen. Patients must fast for six to eight hours before and drink water during the 45-minute test, with results available immediately upon completion.
Both tests are intended to support diagnosis, referral and management, and are not standalone diagnostic tools. A third technology, DotEndo, was also announced but requires more research before NICE can recommend NHS funding.
Patient Experiences Highlight Impact
Ami Robertson, 23, a Pilates instructor from Glasgow, experienced symptoms at age 16 but was repeatedly told she had irritable bowel syndrome. After finally being diagnosed using the non-invasive test, she said: 'I spent years being told my pain was something else entirely. I started to doubt myself... When I finally had the test, it took less than an hour and gave me something I'd never had before: concrete evidence... 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. Her mother, GP Sharan Uppal, said repeated GP visits and A&E attendances failed to identify the cause. The non-invasive test came back strongly positive, enabling a referral and diagnosis of widespread endometriosis. Simran said: 'Getting my diagnosis honestly felt like the best thing in the world. The test itself was easy, it wasn't painful at all... I know I'm not going to be in pain all the time, and that means everything.'
Expert Endorsement
Dr Gail Busby, consultant gynaecologist at Manchester University NHS Foundation Trust, called the tests '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. An earlier diagnosis doesn't just change one person's life, it frees up appointments and surgical slots for everyone waiting for care.'
Currently, endometriosis is diagnosed via laparoscopy under general anaesthesia. A survey of over 10,000 women with the condition by the All-Party Parliamentary Group found over half visited their GP more than 10 times before receiving a diagnosis.
