NICE Approves Two Endometriosis Tests for NHS - No Surgery Needed

The National Institute for Health and Care Excellence has approved two non-invasive tests for endometriosis on the NHS in England, marking a significant shift from a condition that has historically required surgery to diagnose. EndoSure and Endotest have each received a three-year conditional approval, during which additional evidence will be gathered before a final decision on permanent NHS commissioning. A third technology, DotEndo, was not approved and requires further research. The two approved tests work differently: Endotest analyses a saliva sample in a laboratory, checking for microRNA biological markers associated with endometriosis; EndoSure measures electrical signals in the gut using sensor pads placed on the abdomen, with the patient fasting for six to eight hours and drinking water during a 45-minute scan. Endometriosis affects around one in ten women of reproductive age in the UK, and the average time from symptom onset to formal diagnosis has exceeded nine years, meaning many women spend a decade in pain before receiving the correct answer.

Why This Matters

Until now, the only definitive diagnostic route for endometriosis was laparoscopy - keyhole surgery under general anaesthetic that carries its own waiting time and clinical risk. Reliance on surgical diagnosis contributed directly to the nine-year average delay, as patients were triaged, referred, re-referred and eventually placed on surgical waiting lists before anyone confirmed what was wrong. Both new tests are non-invasive and can be performed without a hospital admission. The three-year conditional approval allows NHS England to gather real-world performance data before the tests are formally embedded into clinical pathways. Clinicians can begin referring eligible patients from now, subject to local commissioning decisions by Integrated Care Boards.

What This Means for Patients

If you or someone you know has been waiting for endometriosis investigation or has had appointments delayed, the approval of these tests changes the available diagnostic pathway. Ask your GP about referral for EndoSure or Endotest at your next appointment. Availability will vary by ICB in the initial period. If you are already on a gynaecology waiting list for endometriosis investigation, you may be able to request an updated referral that includes these tests. You can compare gynaecology waiting times across NHS trusts using the gynaecology waiting times search, and under NHS Right to Choose you can ask your GP to refer you to the trust with the shortest wait.

How to Access Gynaecology Care Sooner

Gynaecology waiting lists remain some of the longest in the NHS. Search gynaecology waiting times by postcode to find which NHS trusts near you are treating patients fastest - and ask your GP to re-refer you there.

This article is for informational purposes only and does not constitute medical advice. Always speak to your GP or a qualified clinician before making changes to your care.