Rapid endometriosis tests to be made available on NHS in England and Wales

The National Institute for Health and Care Excellence (NICE) has approved two rapid tests for endometriosis, EndoSure and Endotest, to be used in the NHS in England and Wales. Endometriosis affects one in ten women of reproductive age, causing tissue similar to the womb lining to grow elsewhere, such as the ovaries and fallopian tubes. Symptoms include painful periods, painful bowel movements, pain when urinating, and pain during or after sex.

Currently, diagnosis relies on ultrasound scans, MRI, or laparoscopy – an invasive procedure. Women in England and Wales often wait up to a decade for a diagnosis. This delay leads to increased suffering, prolonged ill health, and more challenging treatment.

The Endotest uses a saliva sample to detect microRNA markers indicating endometriosis. The EndoSure test measures electrical signals in the gut using sensor pads on the abdomen. Women fast for six to eight hours before the test, then drink water until full during the 45-minute procedure. Results are available immediately.

NICE's draft recommendation approves the tests for three years, during which further evidence will be collected on their effectiveness. A final decision on permanent NHS use will follow. A third test, DotEndo, requires more research.

The tests are not standalone but are intended for women where endometriosis is still suspected after a normal clinical exam and inconclusive imaging. Experts say earlier diagnosis reduces the need for invasive surgery and frees up appointments and surgical slots for others.

Dr Anastasia Chalkidou, NICE's healthtech programme director, noted that delays cause chronic pain affecting daily life, relationships, and work. Dr Gail Busby, a consultant gynaecologist at Manchester University NHS Foundation Trust, called the tests a "gamechanger" as they provide answers much earlier without invasive surgery. Emma Cox of Endometriosis UK welcomed the tests but stressed the need for GP and nurse education to ensure prompt access and symptom recognition.