EndoSure and Ziwig Endotest – everything I’ve read so far, and when will they be available?
For decades, getting a diagnosis of endometriosis has often meant years of debilitating symptoms, repeated GP visits, scans that come back “normal”, and, in many cases, laparoscopic surgery to confirm the condition.
That could finally be starting to change.
In July 2026, NICE announced that two innovative tests – EndoSure and Ziwig Endotest – will be made available through the NHS in England and Wales as part of a three-year evidence-gathering programme. While neither replaces clinical assessment, both represent a step towards faster, less invasive diagnosis.
If you’ve searched for either test, or wondered about going private for them, here’s everything you need to know.
What is an EndoSure test?
The EndoSure test is a non-invasive diagnostic technology designed to identify endometriosis without surgery.
Unlike saliva-based tests, EndoSure measures electrical signals generated within the bowel using adhesive sensor pads placed on the abdomen. The theory is that endometriosis changes gut nerve and muscle activity in measurable ways.
The test itself takes around 45 minutes. Beforehand, you’ll usually need to fast for six to eight hours and drink water according to the test instructions. Results are available immediately after the assessment rather than requiring laboratory processing.
Importantly, EndoSure is not intended to diagnose endometriosis on its own. Instead, it is used alongside your symptoms, examination and imaging to help clinicians decide on the next steps.
What is Ziwig Endotest?
The Ziwig Endotest takes an entirely different approach.
Instead of looking at electrical activity, it analyses a saliva sample for tiny biological molecules called microRNAs. Researchers have identified patterns of these molecules that are associated with endometriosis.
Using next-generation sequencing combined with artificial intelligence, the laboratory analyses these biomarkers to determine whether endometriosis is likely to be present.
The test has been developed for women aged 18 to 43 with symptoms suggestive of endometriosis, including:
- chronic pelvic pain
- painful periods
- pain during sex
- pain when opening the bowels or passing urine
- infertility
Unlike many investigations, the saliva test can usually be performed while taking hormonal medication and at any point during the menstrual cycle.
Are they accurate?
This is understandably one of the biggest questions.
Early evidence suggests that both EndoSure and Ziwig Endotest could significantly reduce diagnostic delays, which currently average around nine years in the UK. However, NICE has approved both technologies within a managed rollout so that additional evidence can continue to be collected before widespread adoption.
For the Ziwig Endotest specifically, published clinical studies have reported:
- Sensitivity greater than 97%
- Specificity greater than 93%
These are promising figures, although performance in everyday NHS practice will continue to be monitored.
Neither test is considered a replacement for a specialist assessment, and doctors will still consider your symptoms, examination findings and imaging before making a diagnosis or treatment plan.
How much are these tests?
The cost depends on where you access it.
As NHS rollout begins, eligible patients may be able to receive EndoSure through participating NHS services without paying privately.
If you’re considering private testing, prices vary between providers and may change over time. Historically, similar private endometriosis diagnostic tests have cost several hundred pounds, so it’s worth checking directly with your chosen clinic for current pricing.
Can you see endometriosis on an ultrasound?
Sometimes, but not always.
This is one of the biggest misconceptions surrounding endometriosis.
An experienced specialist ultrasound can identify:
- ovarian endometriomas
- deep infiltrating endometriosis
- endometriosis affecting the bowel or bladder
- adhesions in some cases
However, superficial endometriosis, which is the most common form, often cannot be seen on ultrasound at all.
That means it’s entirely possible to have a normal scan while still living with significant endometriosis.
Can endometriosis show on MRI?
Yes, but with limitations.
MRI is particularly useful for detecting:
- deep infiltrating endometriosis
- large endometriomas
- disease involving the bowel, bladder or pelvic ligaments
Like ultrasound, MRI may still miss superficial disease.
A normal MRI therefore does not rule out endometriosis, particularly if your symptoms strongly suggest the condition.
Increasingly, specialists combine MRI findings with symptom history, examination and, potentially, newer tests like EndoSure or Ziwig Endotest to build a clearer diagnostic picture.
Why we’re excited
For many women, the most frustrating part of endometriosis isn’t just the symptoms, it’s the wait for answers.
Repeated appointments, normal imaging, long surgical waiting lists and being told that painful periods are “just part of being a woman” have contributed to years of delayed diagnosis.
Non-invasive diagnostic tools have the potential to change that.
Although they won’t replace specialist care, they could help identify patients sooner, prioritise referrals and reduce the need for diagnostic surgery in some cases.
It’s an encouraging development for the estimated one in ten women affected by endometriosis – and hopefully just the beginning of faster, more accessible diagnosis.
On your reading list
If endo testing is a priority search, put these resources on your radar:
- Rapid endometriosis tests to be made available on the NHS in England and Wales (The Guardian’s big headline)
- Can you see endometriosis on an ultrasound? (The full 101 with advanced diagnostic experts ReceptivaDx™)
- These influencers with endometriosis are our ultimate support follows
