Endometriosis Diagnosis & Treatment

It’s important to ask your GP to refer you to a healthcare professional with experience in Endometriosis for appropriate assessment. Different tests can detect different forms of the condition, and no single scan can rule it out completely.

• Ultrasound: Detects ovarian cysts (endometriomas) and deep Endometriosis but is highly dependent on operator skill. If Endometriosis is not found, and your symptoms continue, ask for an MRI.

• MRI: An MRI can help identify deep infiltrating endometriosis, particularly when organs like the bowel or bladder are affected.

• Laparoscopy: A laparoscopy is currently considered the gold standard for diagnosing endometriosis because it allows specialists to directly see and biopsy any endometriosis tissue. Even if your ultrasound and MRI results come back normal, you can still discuss the possibility of a laparoscopy with your healthcare provider if your symptoms persist.

The NHS are guided by an organisation called NICE on standards of care. Read the NICE guidelines for Endometriosis diagnosis and treatment so you know what the reccomendations are.

There are also a number of Endometriosis specialist centres in the UK. Your GP or gynaecologist has to make the referral to these clinics. However, it’s good to find the closest one to you and look at their website. Find BSGE Accredited Endometriosis Centres in the UK

Diagnosis - the Paid For Routes

Endometriosis can only be definitively confirmed through surgery. However, doctors can make an informed diagnosis based on a thorough medical evaluation, gynaecologist support, and scans. Due to long NHS wait times and a shortage of NHS Endometriosis specialists, this process can, unfortunately, take a considerable amount of time.

However, there are alternative paths to diagnosis that you can consider but these do cost money.

Option 1 – Non-Invasive Endometriosis Tests

Endometriosis diagnosis is often slow and invasive, with laparoscopy still the gold standard. New non-invasive tests may offer faster, less invasive options. While not all doctors are on board yet, and more validation may be needed, these are promising developments worth knowing about.

Endosure
Endosure is a UK-based test designed to detect biomarkers linked to Endometriosis. Like Ziwig, it claims to offer quicker, less invasive diagnosis. Maybe another couple of lines - heard any negatives? Cost and how to get. LINK

The Ziwig Endotest
Developed in France, this saliva-based test claims to detect Endometriosis with over 97% sensitivity and 93% specificity — more accurate than ultrasound, MRI, or even laparoscopy. The Ziwig test needs a medical referral from your doctor (or they can recommend a doctor you can use). It costs around £850 and is only currently available at The Doctors Laboratory in London. LINK

Bettii Recommends:
These tests are new and have not yet been fully adopted by the medical community. We recommend discussing these tests with your doctor or clinical specialist first. Ask them to review and give you their considered opinion before purchasing.

Option 2 – Using In-Person Private Healthcare

As NHS wait times grow, more people are turning to private healthcare. If you already have private insurance or can afford to pay out-of-pocket, it’s an option worth considering, but research is essential.

Private healthcare can offer quicker access to consultations, tests, diagnostics, and surgical procedures. Some private hospitals specialise in Endometriosis care and pain management.

Always confirm with your insurance provider if Endometriosis is covered and what specific services (e.g. scans, tests, surgeries) are included. Keep in mind that even with private cover, there may still be out-of-pocket fees.

Bettii Tips:

• Speak to your GP: Ask about private healthcare options and how they may affect your NHS access.

• Still accept the NHS gynaecologist appointment: It may still be necessary to see the NHS gynaecologist and wait times can be long so get yourself onto the list. You can always cancel.

• Shop around: Explore clinics, enquire about costs and payment plans. They are usually very friendly and rarely pushy.

• Private consultation: Consider using private healthcare just for a private consultation to get expert or second opinions. You can then be referred back to the NHS with a clear plan.

• Consider your budget: Determine what you can afford. You might speed up diagnosis by doing some tests privately then return to the NHS for more expensive procedures.

Getting the best from your doctors appointment

Engaging with the Medical Profession Can Be Tough

We get it. Talking to doctors about your pain and other symptoms isn’t always easy. That’s why preparation and confidence are key, even when you are going down the private route. Read our 'Making Yourself Heard' (LINK) guide for Endometriosis to prepare for your appointment and learn what to do if you dont feel listened to.

1. Hormonal treatments: These aim to reduce or stop periods, which can slow the growth of Endometriosis. Options include the combined pill, progestogen-only methods (like the injection, implant, or mini pill), the hormonal coil (IUS), or GnRH analogues.

2. Pain relief: prescribed options such as mefenamic acid or naproxen.

3. Surgery: This may involve removing or destroying patches of Endometriosis tissue (laparoscopic excision or ablation), or in more severe cases, removing affected organs like part of the bowel or womb (hysterectomy). Surgery can help, but it isn’t always a permanent solution.

4. Specialist care: If your endometriosis affects organs like the bowel or bladder, you may be referred to a specialist Endometriosis centre for expert treatment.