Patients with suspected endometriosis could soon be offered two non-invasive tests through GP services in England and Wales under new draft guidance aimed at reducing long waits for diagnosis.
The condition affects an estimated one in 10 women and occurs when tissue similar to the lining of the womb grows elsewhere in the body. It can cause significant pain and other symptoms, but it is often difficult to identify because symptoms can overlap with conditions such as irritable bowel syndrome.
The draft recommendation would allow GPs to offer either or both of two tests, where available, alongside existing clinical checks. One is a saliva test that looks for genetic material linked with endometriosis. The other uses sensor pads placed on the abdomen to measure electrical signals in the gut.
Health experts hope the tests could help more patients reach specialist assessment and treatment sooner. Current diagnosis can take many years, with some patients reporting waits of around nine years or longer before their symptoms are formally recognised.
The tests are not intended to replace all other diagnostic methods or to be used as the only basis for diagnosis. Instead, they are being considered as additional tools to help clinicians decide which patients may need further investigation or referral.
At present, the main NHS method for confirming endometriosis is laparoscopy. This is a surgical procedure carried out under general anaesthetic, in which a camera is used to look inside the abdomen and pelvis. While it can be important for diagnosis and treatment, it is more invasive than the new tests being considered.
The saliva test, called Endotest, is already being used in a pilot NHS study. The gut electrical signal test, known as Endosure, is part of a clinical study at Worcestershire Acute NHS Hospital Trust. For the gut test, patients fast for six to eight hours beforehand and then drink water during a 45-minute testing period.
If the draft guidance is adopted, access is still likely to vary at first. Not every GP practice will be able to offer the tests immediately, and their use will need to be overseen by healthcare professionals with expertise in endometriosis diagnosis and management.
The NHS will continue to collect evidence on how well the tests perform in practice. That includes how accurately they identify likely endometriosis, how they affect referral decisions, and whether they help patients receive treatment more quickly.
The practical impact for patients could be significant if the tests are shown to work well and become more widely available. For people with recurring pelvic pain, painful periods, bowel or bladder symptoms linked to their menstrual cycle, pain during sex or fertility problems, earlier recognition can make it easier to access appropriate care.
However, the draft recommendation does not mean that every person with symptoms will immediately be tested. Clinicians will still need to consider a patient’s symptoms, medical history and examination findings, and some patients may still need imaging, specialist review or surgery.
Ami Robertson, 23, has described experiencing endometriosis pain from the age of 16. She said she was repeatedly told her symptoms were likely to be caused by another condition, including irritable bowel syndrome, before she paid privately for checks that confirmed endometriosis and later had surgery.
She said the long process led her to question whether her symptoms were being taken seriously. “No one should have to wait years to be believed,” she said.
Another family, Sharan Uppal, 46, from Huddersfield, and her 15-year-old daughter Simran, also described years of difficulty before diagnosis. Sharan said she took her daughter to the GP many times and attended A&E several times before paying for the gut test, which came back strongly positive.
She said the result helped her return to the GP and seek a referral. For families managing repeated pain, school absence, work disruption or emergency appointments, a clearer route to assessment could reduce uncertainty and help services make earlier decisions.
Endometriosis UK welcomed the development but said testing would need to be matched with better awareness among primary care staff. Emma Cox, the charity’s chief executive, said access to the new tests should go “hand-in-hand with education of GPs and practice nurses” so that symptoms are recognised and patients can be referred promptly.
The draft guidance applies to the NHS in England and Wales. It is not yet a universal service, and availability will depend on final guidance, local arrangements and continuing evidence from NHS studies.
For now, the key change is that non-invasive testing for suspected endometriosis is moving closer to use in routine care. Patients should understand that these tests may support diagnosis, but they remain part of a wider clinical process that includes symptom assessment, specialist expertise and, where needed, further investigation.
