Endometriosis affects around one in 10 women of reproductive age in the UK, yet the average time to diagnosis is nearly a decade. That is set to change with the introduction of two new non-invasive diagnostic tests recommended by NICE, the independent body that advises the NHS on treatment. The tests aim to give women faster access to treatment, offering hope to the reported 582,744 women on the gynaecology waiting list in England last year.
Two new tests approved
The first test, called 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 in diagnosis and care. The second test, 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. Results are available as soon as the test is complete.
Both tests will be used and funded by the NHS while researchers collect more data on their effectiveness. They are intended to support diagnosis, referral and management, and are not standalone diagnostic tests. NICE also announced a third technology, DotEndo, but says it requires more research before recommending NHS funding.
Impact on diagnosis time
Dr Anastasia Chalkidou, NICE healthtech programme director, 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.'
Currently, endometriosis is diagnosed using laparoscopy, which requires general anaesthesia and a small camera inserted through a cut in the abdomen. In a survey of over 10,000 women with the condition, over half reported visiting their GP more than 10 times before receiving a diagnosis, according to the All-Party Parliamentary Group.
Patient stories
Ami Robertson, 23, experienced symptoms of endometriosis at age 16 but was repeatedly told she had irritable bowel syndrome. She was finally diagnosed using the non-invasive tests, enabling her to access treatment. The Pilates instructor from Glasgow 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, began experiencing severe pelvic pain at 13, but repeated GP visits and A&E attendances failed to identify the cause. Her mother Sharan Uppal, a GP, said having the non-invasive test finally gave them the evidence to push for a referral and a 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 – just drinking water and being monitored. Really simple.'
Expert opinion
Dr Gail Busby, consultant gynaecologist at Manchester University NHS Foundation Trust, said: '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. An earlier diagnosis doesn't just change one person's life, it frees up appointments and surgical slots for everyone waiting for care.'
Endometriosis is a painful chronic condition where cells and tissue like those in the womb grow in other parts of the body, typically in pelvic organs such as ovaries, fallopian tubes and the outer surface of the bowel or bladder. This results in hormonal changes, inflammation, scar tissue and severe pain. Symptoms include heavy menstrual bleeding, fatigue, pain when urinating, pelvic pain, difficulty getting pregnant and painful bowel movements.
