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Two diagnostic technologies that could speed up NHS diagnoses of endometriosis in primary care have been recommended by the National Institute for Health and Care Excellence (NICE).
In draft guidance published on 7 July 2026, NICE recommended two tests: Endotest, which analyses a saliva sample, and Endosure, which measures electrical signals in the gut using sensor pads, to detect the condition.
Endometriosis affects around one in ten women of reproductive age in the UK, yet the average time to diagnosis is more than nine years. It is a chronic condition that occurs where tissue similar to the lining of the womb grows in other parts of the body — most commonly on the ovaries, fallopian tubes and bladder – and causes severe pain and inflammation.
In a statement accompanying the guidance, NICE said the tests “can be used in the NHS during a three-year period while additional evidence is collected on how well they work”.
“The tests can be used to diagnose endometriosis in primary care, where current diagnostic accuracy can be limited by the availability of other tests and variation in expertise,” it added.
Endotest works by analysing a saliva sample for microRNAs, which are biological markers that can indicate whether endometriosis is likely present.
Endosure is a 45-minute test that detects endometriosis by measuring electrical signals in the gut, using sensor pads on the abdomen after a patient has fasted and drank water.
“A third technology, DotEndo, requires more research before NICE can recommend the NHS to fund early use of it,” NICE said.
DotEndo is a blood test which measures biomarkers in the blood that show the presence of the disease.
A 2020 survey published by the All-Party Parliamentary Group on endometriosis revealed that 58% of more than 10,000 respondents reported visiting their GP more than ten times before receiving a diagnosis, and 53% went to A&E three or more times.
NICE’s guidance pointed out that delays in diagnosis result from late initial presentation, variation in expertise in primary care, delays in referral pathways and long waiting times for gynaecology services.
“The new technologies offer a less invasive, faster approach to receiving a diagnosis that does not rely on ultrasound operator expertise, potentially enabling earlier decision-making and reducing the need for unnecessary invasive investigations,” it said.
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 9 years and 4 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.”
Emma Cox, chief executive of Endometriosis UK, said: “For too long, those with endometriosis have faced unacceptable delays in accessing a diagnosis, especially if from ethnically diverse communities, and diagnosis times have been going up, not down, in the last decade.
“Speeding up diagnosis times is much needed and would be a major step forward in reducing disease impact and supporting those with endometriosis to live well with the disease. 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, and an end to pain and symptoms not being recognised.
“This is the perfect opportunity to support primary care colleagues with improved understanding of endometriosis, adenomyosis and menstrual health conditions and their symptoms.”
On 7 July 2026, study results published n the European Journal of Endocrinology revealed that people with endometriosis have a distinct pattern of hormones which could be identified by a blood test.
The researchers from the University of Edinburgh looked at hormone levels in the blood of 159 women with confirmed endometriosis and 57 women without the condition. Their analysis focused on androgens, including 11-oxygenated androgens — a group of hormones produced by the adrenal glands.
They found that women with endometriosis had high levels of oxygenated hormones.
Principal investigator Douglas Gibson, from the University of Edinburgh’s Centre for Reproductive Health, said: “These findings mark a significant breakthrough in our understanding of endometriosis. Traditionally seen as an oestrogen-driven disorder, our research challenges this view by showing different androgen levels in the condition. We are optimistic that this new insight will lead to earlier diagnosis and the development of innovative new treatments for those affected by endometriosis.”
