The traditional journey to an endometriosis diagnosis often takes 7 to 10 years and involves invasive surgery (laparoscopy). As of 2026, a breakthrough saliva test is fundamentally changing this process by offering a non-invasive, highly accurate alternative.
The primary technology on the market is the Ziwig Endotest®, which has recently received significant clinical validation.
How the Saliva Test Works
The test does not look for "endometriosis cells" in your saliva. Instead, it analyzes microRNA (miRNA)—small molecules that regulate gene expression.
The "Signature": Researchers identified a specific "signature" of 109 microRNAs that are uniquely altered in women with endometriosis.
The Technology: It uses Next-Generation Sequencing (NGS) to read these molecules and Artificial Intelligence (AI) to interpret whether the pattern matches an endometriosis profile.
The Result: It provides a clear Positive or Negative result, typically within a few days to weeks.
Accuracy and Clinical Evidence
Recent data published in NEJM Evidence (December 2025) has confirmed the test's high performance in symptomatic women aged 18–43:
| Metric | Accuracy Rate | What it means |
| Sensitivity | 97.3% | Ability to correctly identify those with the disease. |
| Specificity | 94.1% | Ability to correctly identify those without the disease. |
| Overall Accuracy | ~96.6% | High reliability compared to traditional ultrasound or MRI. |
Availability and Cost (Current Status 2026)
While the test is a "game-changer," accessibility depends on your location:
France: Currently leading the way. The test is reimbursed by the national health system and available in over 100 hospitals for women whose imaging (ultrasound/MRI) is inconclusive.
United Kingdom: Available through private clinics (e.g., TDL Pathology, Midland Health). Prices typically range from £400 to over £1,000, often requiring a doctor's prescription or consultation.
United States / Other Regions: Availability is expanding, but it often remains in a "private-pay" or clinical trial phase as it awaits broader regulatory approvals (like the FDA).
Restrictions: Most validations currently limit the test to women aged 18 to 43 who are not pregnant and do not have a history of cancer or HIV.
When should you consider it?
This test is generally intended for symptomatic individuals—those suffering from chronic pelvic pain, severe period pain, or infertility—particularly when standard scans like ultrasounds or MRIs come back "normal."
A Peer-to-Peer Note: This test is a massive win for patient advocacy. It means you might no longer need "exploratory surgery" just to prove your pain is real. However, because it's still relatively new, your primary doctor might not be familiar with it yet.
Would you like me to help you find a specialized clinic in your area that offers this test, or help you draft a letter to your doctor to discuss it?
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