New tests can cut the long wait for an endometriosis diagnosis

Endometriosis affects around one in ten women of reproductive age in the UK, yet a diagnosis still takes far too long to reach. The current average sits at more than nine years, and for women from ethnically diverse communities the wait stretches longer still. New draft guidance from the National Institute for Health and Care Excellence, known as NICE, could help change that picture. It recommends two non-invasive tests for use in the NHS while further evidence on their accuracy is gathered.

Why a Diagnosis Takes So Long

Endometriosis is often mistaken for other conditions, as its symptoms overlap with problems like irritable bowel syndrome. Many women are told their pain is normal, or are sent away without a clear answer. In a survey of more than 10,000 women run by the All-Party Parliamentary Group on endometriosis, more than half had visited their GP over ten times before being diagnosed, and more than half had attended an emergency department with their symptoms.

The reasons for the delay are layered. Women often present late, as symptoms build gradually and can be dismissed. Diagnostic ultrasound depends heavily on the skill of the operator, referral pathways can be slow, and gynaecology waiting lists remain long. Each step adds months, sometimes years, and the disease can progress in the meantime.

What NICE Has Recommended

The draft guidance, published in July 2026, backs two tests called Endotest and EndoSure. Both can be used in primary care during a three-year period while data is collected on how well they perform and whether they offer good value. A third test, DotEndo, needs more research before NICE will consider funding its early use.

The status of this guidance deserves particular emphasis. This is a draft recommendation, and it is not yet final. NICE has opened a consultation, and its committee will review the proposals again before any final decision is reached. The tests are meant to support clinical judgement rather than replace it, and a healthcare professional uses them as part of a wider assessment.

How the Two Tests Work

Endotest looks at a saliva sample for microRNAs, which are small biological markers that can signal whether endometriosis is likely to be present. The sample goes to a laboratory, and the result returns to the clinician to guide the next steps. Results typically take a couple of weeks.

EndoSure works in a completely different way. It measures electrical activity in the gut through sensor pads placed on the abdomen. Patients fast for six to eight hours beforehand and drink water during the test, which lasts around 30-40 minutes, and the result is ready straight away.

Both tests are intended for a specific situation. They are aimed at women where endometriosis is still suspected despite a normal examination and imaging that is negative, inconclusive, or unavailable. Each test adds another piece of information to the standard clinical pathway, helping a clinician decide the next step.

What This Could Mean for Patients

For women stuck in years of uncertainty, a faster and less invasive route to answers would be welcome. The current way to confirm endometriosis definitively is a laparoscopy, a surgical procedure carried out under general anaesthetic, where a surgeon inserts a small camera through a tiny cut in the abdomen. It is accurate, yet it is invasive, costly, and carries the usual risks of surgery.

The new tests will not remove the need for specialist care or surgery in every case. What they could offer is earlier clarity, fewer unnecessary invasive investigations, and a route that does not hinge on the availability of an expert ultrasound operator. Earlier answers also tend to mean earlier treatment, which can slow the progression of the disease.

How I Can Help

As a gynaecologist, I have seen how heavily a long wait weighs on women living with endometriosis. Non-invasive testing has been available privately in the UK ahead of this NHS guidance, and I am among the first specialists in the country to offer the EndoSure test. Women who would rather not wait for answers can arrange it with me now.

The test is straightforward from a patient's point of view. Small sensor pads placed on the abdomen record the electrical activity of the gut, and the appointment requires neither needles nor an operation. You stay fully clothed throughout, and no anaesthetic or recovery time is involved. The result gives us something concrete to work from when deciding what happens next.

A diagnosis is the beginning of the process rather than the end of it. I offer the care that follows, covering medical and hormonal management of symptoms alongside surgical treatment where an operation is the right course for you. I also treat the problems that often sit beside endometriosis, including pelvic pain and heavy or painful periods, and I provide wider gynaecological care such as hysteroscopic and vaginal surgery. Every plan is built around your symptoms, your priorities and your circumstances, and I will talk you through the options properly before anything is decided.

For wider information and peer support, the charity Endometriosis UK offers a helpline and local support groups.

To book an appointment or ask a question, please call my personal assistant on 020 8371 1510 or email secretary@rapidaccessgynaecology.co.uk.