NICE recommends one saliva-based test to diagnose endometriosis

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By Daniel Pye

Only one technology has been approved for use by GPs to test for suspected endometriosis, according to new draft guidance from the NHS watchdog.

The National Institute for Health and Care Excellence said Endotest – a saliva-based test which detects a microRNA biomarker signature in the condition – can be used in primary care when clinical examination is normal and ultrasound imaging is negative or inconclusive for endometriosis.

NICE had been evaluating several technologies for diagnosing the condition.

Endotest should be used alongside standard practice, “not replace clinical judgement” and does not rule out referral if endometriosis is still suspected, the regulator said.

Endotest can be used in the NHS during a 4-year evidence generation period, NICE said.

The evidence for three other technologies which had also been evaluated: EndoSure, DotEndo and Endomkit, is too limited and more research is needed before these can be considered for NHS funding.

A consultation on the updated draft guidance is open until 5 October 2026, ahead of a final decision in November.