Endometriosis Diagnosis Without Surgery: New Non-Invasive Tests Explained

Woman looking hopeful, holding a blood test vial or saliva collection kit

In This Article:

·         The Problem with Current Diagnostics

·         Understanding Test Accuracy: Sensitivity vs. Specificity

·         The New Generation of Endometriosis Tests

·         Why These Tests Matter

·         The Challenges

·         What You Can Do Now

Quick Takeaways:

·         Current imaging misses ~50% of endometriosis cases, especially superficial lesions

·         EndomTest (blood test): 100% specificity, 46.2% overall sensitivity—first commercially available

·         Ziwig Endotest (saliva): Available in 30 countries, fully covered by French national health insurance

·         NextGen Jane & Hera Biotech (menstrual blood): Launching globally within the next year

·         AI & machine learning improving diagnostic accuracy

·         Non-invasive tests could end 7-10 year diagnostic delays

The Problem with Current Diagnostics

Right now, if you want a definitive endometriosis diagnosis, you're looking at laparoscopic surgery. Imaging (ultrasound, MRI) can detect some types of endometriosis, but they miss about half of cases—especially superficial lesions. [1]

That means years of waiting, invasive procedures, and delayed treatment.

My Story: Years of "Normal" Scans and a Body That Knew Better

I know what it's like to be told your imaging looks fine while your body is screaming otherwise.

Throughout my endometriosis journey, I had repeated transvaginal and abdominal ultrasounds. Not one of them showed anything abnormal. Not one.

So what happened instead?

Delayed care.Referrals to pelvic floor physiotherapy.A chronic pain yoga class.Being told that "running might help."

And the kicker? I was repeatedly told everything looked fine.

"Is it just because you're depressed and anxious?""Do you have premenstrual dysphoric disorder?"

The direct result of those "normal" scans was an increase in mental health prescriptions and various forms of pain relief—some of which were wildly inappropriate for pelvic pain.

I was prescribed so many opiates that it ended in emergency bowel surgery when the opiate-induced constipation (combined with hypermobility spectrum disorder) resulted in a twisted bowel.

Chronic constipation and hypermobility don't play nicely together. Nobody warned me about that either.

What They Found When They Finally Looked

When surgeons finally went in, they found endometriosis. On every single surgery.

Including in my ovarian tubes—something no imaging had ever detected.

After my hysterectomy, the pathology report revealed an additional diagnosis: adenomyosis. Something that had never been picked up before surgery, despite years of scans and symptoms.

Why This Still Makes Me Angry

The rage I feel about this isn't just personal.

It's about every other woman who continues to be gaslit by medical professionals instead of hearing:

·         "I didn't get that right."

·         "I need to do more research."

·         "I don't know—let me get back to you."

That rage is what fuels me when I advocate for my clients.

Because this shouldn't keep happening.

And that's why non-invasive diagnostic tests matter so much.

They could have caught what imaging missed.They could have prevented years of misdiagnosis, unnecessary prescriptions, medical trauma, and a twisted bowel that required emergency surgery.

They could have given me—and so many others—answers years earlier.

The New Tests: What's Actually Available (And What's Coming)

Within the next year, several companies are launching non-invasive endometriosis tests globally. [2] They analyse biomarkers—molecules in your blood, saliva, or menstrual blood that signal inflammation and disease.

Here's what you need to know:

Visual diagram explaining test accuracy with 2x2 grid (true/false positives/negatives)

Quick Explainer: Sensitivity vs. Specificity

·         Sensitivity = Does it catch people who actually have it?(High sensitivity = fewer false negatives)

·         Specificity = Does it correctly rule out people who don't?(High specificity = fewer false alarms)

Example:A test with 70% sensitivity and 100% specificity:

·         If it says yes → you almost certainly have it

·         If it says no → you might still have it (it only catches 70% of cases)

This is called a "rule-in" test—great at confirming, not ruling out.

Blood Tests

EndomTest (Kephera Diagnostics) – Already available in the US

·         Combines 2 blood biomarkers + 6 clinical variables (pain history, age at symptoms, etc.)

·         100% specificity (if positive, you almost certainly have it)

·         46% sensitivity (misses about half of all cases, especially superficial disease) [3,4]

·         What this means: If it's positive, believe it. If it's negative, keep investigating.

Proteomics International – Launching soon

·         Uses mass spectrometry to identify thousands of proteins in blood [2]

·         More sensitive tech than older tests

·         Aiming for global launch within a year [2]

Saliva Tests

Ziwig Endotest – Already on the market

·         Sold in 30 countries: fully covered by health insurance in France [2,5]

·         Validated on 200 patients so far; company preparing to publish results on 1,000 [5]

·         Concern: Some researchers want more validation in diverse populations [5]

Menstrual Blood Tests

NextGen Jane and Hera Biotech – Both launching soon

·         Analyse menstrual blood for mRNA, proteins, and microRNA [2]

·         Why menstrual blood? It contains endometrial tissue and immune cells with distinct biomarker profiles in endometriosis patients [6,7]

·         Side-by-side comparison of blood, saliva, menstrual blood tests

AI & Machine Learning

AI algorithms are being trained to:

·         Analyze ultrasound images and spot patterns humans miss [13]

·         Predict endometriosis risk using clinical history + symptoms [10,11]

·         Combine biomarkers with imaging for better accuracy [12]

Status: Some AI tools already in use; more in development [10,11,12,13]

         Abstract visualization of AI analyzing medical data, ultrasound images, or biomarkers

Urine Tests (Still in Research)

·         Uses infrared light + machine learning to detect molecular changes in urine [14]

·         Patient preference: In studies, urine tests were the most preferred option, followed by saliva and blood [15]

·         Not yet commercially available [14]

Why This Matters

1. Faster Diagnosis

No more waiting 7–10 years. These tests could identify endometriosis within weeks or months. [1,2]

For me, it took repeated "normal" ultrasounds, years of being told it was anxiety, and multiple surgeries.

A blood or saliva test could have caught it years earlier.

2. No Surgery Required

Just a blood draw, saliva sample, or menstrual blood collection. [2]

No waiting a year for a laparoscopy slot in the public system.No general anaesthesia.No surgical risks.

3. Earlier Treatment

Early diagnosis = earlier access to hormonal therapies, surgery, pelvic floor PT, nutrition support, and mental health care. [2]

Instead of years of yoga classes and "maybe try running" while your disease progresses.

4. Proof

A positive biomarker test is biological evidence.

Not "maybe it's anxiety."Not "you're too sensitive."

Proof that something is wrong.

That's the validation so many of us are desperately seeking.

The Challenges

Validation: Many tests validated on small, homogeneous populations—we need larger, more diverse studies [5]

Sensitivity for superficial disease: Blood/saliva tests better at detecting deep disease than superficial lesions [4]

Cost & access: Will Medicare or private insurance cover these? Will low-income patients have access?

Regulatory approval: Some tests available overseas but not yet approved in Australia

What You Can Do Now

✅ Ask your provider about EndomTest or Ziwig—some are already available✅ Document your symptoms in detail (pain, severity, triggers, impact)✅ Seek a specialist who's more likely to know about emerging tests✅ Don't accept "normal" imaging as final—if symptoms persist, push for further investigation

If You've Been Waiting for Diagnosis:

·         Don't give up – These tests are coming, and they could change your diagnostic journey

·         Advocate for yourself – Ask about non-invasive testing options; push for imaging if you haven't had it

·         Connect with community – Join endometriosis support groups to learn what tests others are accessing

·         Hold providers accountable – If they dismiss you, find someone who won't

The Bottom Line

The future of endometriosis diagnosis is non-invasive, fast, and evidence-based. Blood, saliva, menstrual blood, and urine tests—combined with AI and machine learning—are revolutionising how we detect this disease.

Within the next year, several of these tests will be available globally. And that means:

·         Faster diagnoses

·         Less invasive procedures

·         Earlier treatment

·         Better outcomes

·         Validation of your pain

You deserve a diagnosis that doesn't require surgery. You deserve a test that's accessible, affordable, and accurate. You deserve to be believed.

And you deserve medical professionals who say, "I don't know, let me find out" instead of "it's all in your head."

The future is coming. And it's going to change everything.

         Woman smiling, holding test results, looking relieved and validated

Have you heard about any of these tests? Would you try a non-invasive diagnostic test if it were available? Drop your thoughts in the comments—I want to hear what you think.

Struggling with diagnostic uncertainty? Book a free discovery call to discuss your symptoms and how nutritional support can help while you navigate diagnosis and treatment.

Health Advice Disclaimer

This content is for educational purposes only and is not medical advice. The information provided is based on peer-reviewed research and general health information. It is not a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.

Every person's health situation is unique. If you suspect you have endometriosis or are considering diagnostic testing, please consult with your doctor, gynaecologist, or qualified healthcare practitioner. They can assess your individual circumstances, medical history, and needs to provide personalized recommendations.

If you experience any concerning symptoms or side effects, seek immediate medical attention from a healthcare professional.

Rebekah Sutton is a nutritionist specializing in chronic illness, neurodivergence, and trauma-informed care. She works with people navigating endometriosis, diagnostic uncertainty, and post-surgical recovery.

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References

[1] Obgyn.onlinelibrary.wiley.com. Time to Diagnose Endometriosis: Current Status, Challenges. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.17973

[2] MIT Technology Review. New noninvasive endometriosis tests are on the rise. 2025. https://www.technologyreview.com/2025/10/21/1125327/endometriosis-tests-noninvasive/

[3] Contemporary OB/GYN. Noninvasive blood test offers new diagnostic approach for endometriosis. 2025. https://www.contemporaryobgyn.net/view/non-invasive-blood-test-offers-new-diagnostic-approach-for-endometriosis

[4] Kephera Diagnostics. EndomTest validation study. 2025. (Oxford Endometriosis CaRe Centre biobank, UK)

[5] NEJM Evidence. Ziwig Endotest interim validation study. https://evidence.nejm.org/doi/10.1056/EVIDoa2200282

[6] Obgyn.onlinelibrary.wiley.com. Advances in non-invasive diagnostic tools for endometriosis. 2025. https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70412

[7] Frontiersin. Emerging frontiers from diagnostic tools to stem cell therapies. 2025. https://www.frontiersin.org/journals/cell-and-developmental-biology/articles/10.3389/fcell.2025.1623959/full

[8] PMC. Circulating microRNAs and endometriosis. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12538115/

[9] Human Reproduction. The role of small extracellular vesicle-miRNAs in endometriosis. 2023. https://academic.oup.com/humrep/article/38/12/2296/7329304

[10] Journal of Minimally Invasive Gynecology. Utilizing Artificial Intelligence: Machine Learning Algorithms to Develop a Preoperative Endometriosis Prediction Model. 2025. https://www.jmig.org/article/S1553-4650(25)00165-7/abstract

[11] PMC. Current Status and Future Potential of Machine Learning in Endometriosis. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12122278/

[12] Human Reproduction. Artificial intelligence-based tissue segmentation and cell identification. 2025. https://academic.oup.com/humrep/article/40/3/450/7933285

[13] PMC. The application of ultrasound artificial intelligence in endometriosis. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12078975/

[14] PMC. A machine learning approach towards endometriosis diagnosis using urine. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12450736/

[15] Sciencedirect. Patient preferences for non-invasive diagnostic tests. 2025. https://www.sciencedirect.com/science/article/pii/S2949838425000167

[16] World Economic Forum. How addressing nine women's health conditions could boost the global economy by $400 billion. 2025. https://www.weforum.org/stories/2025/01/how-addressing-nine-women-s-health-conditions-could-boost-the-global-economy-by-400-billion/