EndoFit topics
If you've ever felt like you had to prove your pain before anyone would take it seriously, this news matters.
For decades, women with endometriosis have faced the same exhausting cycle.
Symptoms begin.
Appointments follow.
Scans come back "normal."
You're told it's probably just bad periods.
Maybe IBS.
Maybe stress.
Maybe it's all in your head.
Months turn into years as you search for answers.
Now, the UK's National Institute for Health and Care Excellence (NICE) has taken a significant step towards changing that story.
It has recommended two new non-invasive tests — Endotest and EndoSure — for early use across the NHS in England while more evidence is gathered.
No, these tests won't replace specialists.
They won't replace surgery.
And they won't provide every answer.
But they could make something incredibly important happen much sooner.
Getting the right women onto the right diagnostic pathway.
And after decades of delayed diagnosis, that's a breakthrough worth talking about.
The NHS has recommended two new non-invasive technologies to help support the early identification of endometriosis.
These tests are designed to work alongside existing clinical assessment—not replace it.
Importantly, they are being introduced as part of a three-year evidence-generation programme. That means researchers will continue collecting real-world data while the tests are used in clinical practice to better understand where they fit within the diagnostic pathway.
The two tests are:
Endotest is a saliva-based test.
It analyses tiny biological molecules called microRNAs.
MicroRNAs help regulate how genes behave throughout the body. Researchers have found that certain patterns of these molecules appear to differ in people living with endometriosis.
Rather than confirming a diagnosis on its own, the test estimates the likelihood that endometriosis is present.
Think of it as another piece of the diagnostic puzzle.
EndoSure takes a completely different approach.
Instead of analysing saliva, it uses small sensors placed on the abdomen to measure electrical activity within the bowel.
The test takes around 45 minutes and provides results immediately after completion.
Because bowel function can be affected by endometriosis in some people, these electrical patterns may provide additional information that supports clinical decision-making.
Again, it isn't intended to replace specialist assessment.
It's designed to help clinicians decide what should happen next.
Whenever a new medical test makes headlines, it's easy to assume we've finally found "the answer."
That's not what's happening here.
And that's actually a good thing.
Endometriosis is an incredibly complex disease.
It doesn't look the same in every woman.
Some people have superficial disease.
Others have ovarian endometriomas.
Some have deep infiltrating disease affecting the bowel, bladder or surrounding pelvic structures.
Symptoms also vary enormously.
Someone with extensive disease may experience relatively mild symptoms.
Another person with very small lesions may live with debilitating pain.
That's why diagnosing endometriosis has never been straightforward.
A single test simply can't capture all of that complexity.
These new technologies aren't trying to do that.
Instead, they're aiming to improve something much earlier in the journey.
The moment when a GP asks:
"Could this be endometriosis?"
Helping answer that question sooner has the potential to change everything that follows.
Endometriosis affects an estimated 1 in 10 women and those assigned female at birth of reproductive age worldwide.
Yet many people still wait years before receiving a diagnosis.
During that time, life doesn't pause.
Careers are interrupted.
Relationships become harder.
Mental health suffers.
Exercise becomes difficult.
Plans are cancelled.
And perhaps most frustrating of all, many women begin doubting themselves because nobody can explain what's happening.
The challenge has never simply been that endometriosis is difficult to diagnose.
It's that the journey towards diagnosis is often filled with uncertainty.
The longer uncertainty continues, the more opportunity there is for symptoms to progress, confidence to erode, and quality of life to decline.
That's why improving the first step in diagnosis matters just as much as improving the final diagnosis itself.
For years, healthcare systems have largely relied on women recognising something is wrong, finding the confidence to seek help, and then navigating a complicated pathway that often depends on symptom recognition, imaging, referrals and, in some cases, surgery.
These new technologies represent something different.
Rather than asking women to repeatedly prove they're in pain, they're part of a broader movement towards giving primary care better tools to recognise endometriosis earlier.
It's a subtle shift.
But an important one.
Instead of asking:
"Can you prove you have endometriosis?"
We're beginning to ask:
"How can we identify women who may have endometriosis sooner?"
That change has the potential to reduce years of uncertainty for thousands of women.
It's equally important to understand what these tests don't do.
Neither Endotest nor EndoSure can tell doctors:
That's because endometriosis isn't a single, simple disease.
It's a chronic inflammatory condition that can affect multiple body systems, including the immune system, nervous system, digestive system and hormone signalling.
Diagnosis has always required clinical judgement.
These tests don't replace that judgement.
They support it.
And that's exactly how NICE intends them to be used.
Rather than replacing specialists, imaging or surgery, they're another tool that may help clinicians make better-informed decisions earlier in the diagnostic journey.
For women who've spent years feeling overlooked, that could be a meaningful step forward.
Although these tests are currently being introduced through the NHS in England, they're likely to be watched closely around the world — including here in New Zealand.
Like many countries, New Zealand continues to face significant challenges when it comes to diagnosing endometriosis.
Many women still experience years of symptoms before receiving answers. Recent New Zealand research has also highlighted that while awareness of national endometriosis guidelines exists, many GPs have not yet had the opportunity to fully implement or become familiar with them, reinforcing just how complex diagnosis can be.
That's not because healthcare professionals don't care.
It's because endometriosis is genuinely difficult to recognise.
Its symptoms overlap with numerous other conditions.
Ultrasounds can appear completely normal.
Blood tests don't provide a definitive diagnosis.
And every woman experiences the disease differently.
If technologies like Endotest and EndoSure prove effective in everyday clinical practice, they could eventually influence how other healthcare systems — including New Zealand's — approach earlier diagnosis.
That doesn't mean they'll become available overnight.
But it's another encouraging sign that researchers are looking beyond surgery alone and asking an important question:
How can we help women reach the right care sooner?
As exciting as these developments are, it's important to keep them in perspective.
Earlier diagnosis has enormous value.
Validation matters.
Being believed matters.
Having a name for what you're experiencing matters.
But diagnosis is the beginning of the journey — not the end.
Many women receive a diagnosis and are left wondering:
"Now what?"
Do I need surgery?
Should I change my diet?
Should I try pelvic floor physiotherapy?
What about exercise?
Stress?
Sleep?
Hormones?
Inflammation?
How do I know what's actually helping?
These are the questions we hear every day.
And they're the reason many women continue feeling overwhelmed even after finally receiving a diagnosis.
Because information isn't the problem anymore.
Knowing what to prioritise is.
At Endo45, we're genuinely excited by innovations that could improve the diagnosis of endometriosis.
Anything that helps women spend less time searching for answers deserves attention.
But our mission has always extended beyond diagnosis.
Because even after the diagnosis is made, many women are still left asking the same question:
"What do I do next?"
Endo45 was built to help answer that question.
Not by replacing your doctor.
Not by promising a cure.
But by helping you replace guesswork with clarity.
Our evidence-informed app helps you:
Because confidence doesn't come from doing everything.
It comes from understanding what matters most for your body.
For years, progress in endometriosis care has felt painfully slow.
But things are changing.
Researchers are developing new diagnostic technologies.
Healthcare systems are recognising the need for earlier diagnosis.
Awareness is growing.
Most importantly, the conversation is shifting.
We're moving away from asking women to simply endure years of pain while waiting for answers.
Towards finding better ways to recognise the condition earlier, support informed decisions, and improve quality of life.
That's something worth celebrating.
Not because these new tests solve every problem.
They don't.
But because every step that reduces uncertainty helps women reclaim something they've often lost along the way:
Time.
Confidence.
Choice.
Hope.
Not on its own.
The new Endotest analyses microRNAs in saliva to help estimate the likelihood of endometriosis. It is designed to support clinical assessment alongside a healthcare professional rather than replace specialist diagnosis.
No.
For some women, surgery may still be needed to confirm a diagnosis, assess the extent of disease, or treat endometriosis. The new tests are intended to improve the early stages of diagnosis—not replace the entire diagnostic pathway.
Not currently.
Endotest and EndoSure are being introduced within the NHS in England as part of an evidence-generation programme. Their future availability in New Zealand will depend on further research, regulatory decisions, and healthcare funding.
If you live in the UK, it's worth discussing them with your healthcare provider as NHS implementation progresses.
If you live elsewhere, these tests may not yet be available, but discussing your symptoms and concerns with your GP remains the best first step towards diagnosis and appropriate referral.
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