The National Institute for Health and Care Excellence (Nice) has approved two new tests for endometriosis, EndoSure and Endotest, for use in NHS GP surgeries. These non-invasive tests aim to significantly reduce the average nine-year wait for a diagnosis of the condition, which affects approximately one in 10 women of reproductive age in the UK.
How the tests work
Endotest analyses a saliva sample in a laboratory for microRNAs, biological markers indicating endometriosis. EndoSure measures electrical signals in the gut using sensor pads on the abdomen; patients must fast for six to eight hours and drink water for 45 minutes during the test. Both tests are intended for women with suspected endometriosis who have normal clinical exams and negative or inconclusive imaging results, or where imaging has not been used.
Endotest results are returned to the GP to guide next steps, while EndoSure results are available immediately after the test. The draft recommendation approves both tests for three years on the NHS, during which additional evidence will be collected before final approval.
Impact on patients
In a survey of over 10,000 women by the All-Party Parliamentary Group on endometriosis, more than half reported visiting their GP more than 10 times before diagnosis, and over half had attended A&E for symptoms. Delays are often due to varying expertise in transvaginal ultrasounds and long waiting times for hospital gynaecology services. Current diagnostic methods include ultrasound, MRI, or laparoscopy.
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.”
Patient experiences
Ami Robertson, 23, 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. When I finally had the test, it took less than an hour and gave me concrete evidence. For the first time, I was believed.” Simran Chavda, 15, from Huddersfield, began severe pelvic pain at 13. After repeated GP visits and A&E attendances, a test confirmed endometriosis. She said: “Getting my diagnosis honestly felt like the best thing in the world. The test itself was easy, it wasn’t painful at all.” Her mother, Sharan Uppal, 46, added: “We were hitting roadblocks everywhere. When the test came back strongly positive, it gave me the empowerment to push for a referral.”
Expert and charity reactions
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. An earlier diagnosis doesn’t just change one person’s life, it frees up appointments and surgical slots for everyone waiting for care.” Emma Cox, chief executive of Endometriosis UK, welcomed the tests but stressed that “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.” A third technology, DotEndo, requires more research before approval.
