The move has been made in a bid to dramatically cut the time it takes for women to be told whether they have the condition.
Women with suspected endometriosis will no longer have to spend years trying to get a diagnosis thanks to new “game-changer” tests approved for use in the GP surgery.
In a bid to dramatically cut the time it takes for women to be told whether they have the condition, the National Institute for Health and Care Excellence (Nice) has given the green light to EndoSure and Endotest on the NHS.
With Endotest, women give a saliva sample which is then sent off to the lab to check for tiny biological markers called microRNAs. This indicates the presence of endometriosis.
Meanwhile, EndoSure can detect the condition by measuring electrical signals in the gut using sensor pads on the abdomen.
Women fast for six to eight hours beforehand and then drink water for 45 minutes during this test.
Endometriosis is a painful condition where cells similar to those in the lining of the womb (uterus) grow in other parts of the body.
The condition affects around one in 10 women of reproductive age in the UK, but Nice says the average time it takes to get a diagnosis is more than nine years.
The new draft recommendation approves the two tests for three years in the NHS, during which time additional evidence will be collected on how well they work. Final approval could then be given.
A third technology, DotEndo, requires more research, Nice said, before it can be approved.
None of the tests are designed to act as standalone diagnostic tests but should ensure women receive a diagnosis and treatment much faster.
In a survey of more than 10,000 women conducted by the All-Party Parliamentary Group on endometriosis, more than half reported visiting their GP more than 10 times before receiving a diagnosis.
More than half of women surveyed also said they had been to A&E because of their symptoms.
Delays in diagnosis can occur due to a variety of factors, including the expertise of medics in using transvaginal ultrasounds and long waiting times for hospital gynaecology services.
Current tests for endometriosis include ultrasound scans, MRI or a laparoscopy – where a camera is inserted through a tiny cut in the stomach.
Dr 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 nine years and four 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.
“Our draft guidance reflects our commitment to getting promising innovations to patients quickly, while making sure the evidence to support their wider use is built in a rigorous way.”
With Endotest, the lab result is returned to the GP or other healthcare professional to inform next steps in diagnosis and care of the patient.
EndoSure results are available as soon as the test is complete.
According to Nice, the tests are for women where endometriosis is still suspected even though they have a normal clinical examination and either negative or inconclusive imaging results, or where imaging has not been used.
Ami Robertson experienced symptoms of endometriosis from the age of 16 but was repeatedly told she had irritable bowel syndrome.
The 23-year-old Pilates instructor from Glasgow said: “I spent years being told my pain was something else entirely. I started to doubt myself, wondering if it was all in my head.
“When I finally had the test, it took less than an hour and gave me something I’d never had before: concrete evidence I could take to my doctor.
“For the first time, I was believed, and I could finally get the help I needed.
“Today my quality of life is night and day compared to before. No one should have to wait years to be believed.”
Simran Chavda began experiencing severe pelvic pain at 13, but repeated GP visits and A&E attendances failed to identify the cause.
The 15-year-old, from Huddersfield, said: “Getting my diagnosis honestly felt like the best thing in the world.
“Everyone kept saying it might be irritable bowel syndrome. I was sent to hospital multiple times and sent back home.
“When I finally found out what it was, I was so relieved because now I knew what the next step was. The test itself was easy, it wasn’t painful at all. Just drinking water and being monitored. Really simple.
“And I’m already starting to feel better after my surgery. I know it’s never going to go away completely, but I know I’m not going to be in pain all the time, and that means everything.”
Sharan Uppal, 46, mother of Simran, said: “We were hitting roadblocks everywhere. I lost count of how many times I took Simran to the GP.
“We ended up in A&E three or four times, spending over 10 hours on one occasion, and nobody would take ownership.
“When the test came back strongly positive, it gave me the empowerment to go back to our GP and push for a referral. That test opened doors for us to get Simran the help she needed at a time when NHS waiting times meant we couldn’t afford to wait.
“I would recommend it to anyone. It’s a quick, straightforward test that doesn’t hurt, and if it means someone finally gets the attention they need to start getting better, that’s a massive thing.”
Dr Gail Busby, consultant gynaecologist at Manchester University NHS Foundation Trust, said: “As a gynaecologist working with both adults and adolescents, I’ve seen first-hand how endometriosis can devastate young people’s lives, causing them to miss school, struggle through GCSEs and miss out on the experiences that matter most during those formative years.
“Too many of my patients have spent years being told their pain is normal when it isn’t.
“These tests are a game-changer because they give us answers much earlier, without the need for invasive surgery, and that means we can start the right treatment sooner.
“An earlier diagnosis doesn’t just change one person’s life, it frees up appointments and surgical slots for everyone waiting for care.”
Emma Cox, chief executive of Endometriosis UK, welcomed the tests, adding: “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.”
