LivingCare Launches Ziwig Endotest®, A Saliva Test For Endometriosis
Oct 14, 2026
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Published on
14/10/2026
The LivingCare Group
NICE has published updated draft guidance on technologies for diagnosing endometriosis in primary care, and it now recommends one of them. Ziwig Endotest, a non-invasive saliva test, can be used in the NHS during a four-year evidence generation period as an option to diagnose endometriosis in primary care, under stated conditions [1]. The guidance is still draft: its consultation closed on 5 October 2026, and NICE expects to publish final guidance in January 2027 [1].
Nine years and four months - that is the average time it now takes to receive an endometriosis diagnosis in the UK [3], in a condition that affects around one in ten women of reproductive age [2]. Not all of that wait is a queue. Confirming endometriosis has usually meant a laparoscopy, a surgical procedure under general anaesthetic, and that is a high bar to clear before anyone gets an answer.
NICE's draft recommendation is precise, and the precision matters. Ziwig Endotest "can be used in the NHS during the evidence generation period as an option to diagnose endometriosis in primary care", a period NICE sets at four years, and only when endometriosis is suspected, a clinical examination of the abdomen and pelvis is normal, and ultrasound is negative, inconclusive, declined or not suitable [1].
Two qualifiers travel with that sentence, and neither is decoration. The first is that this is draft guidance: it was open for public consultation from 15 September to 5 October 2026, NICE's committee meets again on 18 November 2026, and publication is expected on 21 January 2027 [1]. The second is the evidence generation period itself. NICE is supporting use while further evidence is gathered, which is a different thing from settled NHS practice.
The first draft, published in July 2026, recommended two technologies: Ziwig Endotest and EndoSure. The updated draft recommends Ziwig Endotest alone, over a four-year evidence generation period rather than the three years first proposed. EndoSure now sits alongside DotEndo and Endomkit among the technologies NICE says need more research before NHS funding [1]. NICE announced the first draft on 7 July 2026 [2].
What makes this draft matter to anyone currently waiting is less the technology than where NICE has placed it in the pathway. The test it describes would sit in primary care, near the point symptoms are first raised, rather than at the end of a queue for surgery. For a condition where the wait is measured in years, that is a change in the order things happen, not a faster version of the same route.
"For too long, women with endometriosis have had to live with pain and uncertainty while waiting for answers - often for years at a time. The development of a diagnostic treatment that can accurately analyse the risk of endometriosis through a simple saliva sample represents a really important shift in how we think about diagnosis, and has the potential to be genuinely pivotal for women's health.
"Introducing Endotest as part of the diagnostic pathway means earlier answers, less time living with unexplained symptoms and potentially avoiding invasive procedures where they are not required."
Dr Becky Mawson, General Practitioner with Special Interest in Women's Health at LivingCare
A diagnosis is not only a name for the pain, either. Endometriosis can affect fertility, and our article on understanding endometriosis and its impact on fertility looks at that side of it.
NICE is careful about what is not yet known, and it is worth reading that part as closely as the recommendation. Its draft states that the diagnostic accuracy of Ziwig Endotest in primary care, including the risk of false-positive and false-negative results, remains unclear [1]. It also says the test should be used alongside standard practice and should not replace clinical judgement.
The line that matters most to anyone being tested is the one about negative results. The clinical experts NICE heard from stated that a negative result in primary care should not be a reason to deny a referral where endometriosis is still suspected [1]. If your symptoms continue, the route onward stays open, and what happens next is a conversation with your clinician rather than the end of the matter.
NICE's draft is about NHS primary care. Privately, the test is already available: LivingCare offers Ziwig Endotest at Canon Medical Arena in Sheffield, where there is no GP referral needed and both self-pay and insured patients are welcome. Suitability is confirmed by a clinician first, and your result is talked through with you at a follow-up appointment.
What the test involves, who it is suitable for and how to prepare for the sample are set out on our Endometriosis Saliva Test (Ziwig Endotest®) page and in our article LivingCare Launches Ziwig Endotest®, A Saliva Test For Endometriosis. If you are not sure whether the test is your right next step, a women's health consultation is the place to start, and our women's health service covers the wider assessment and care that may follow. When you are ready, you can book your appointment online.
Does this mean Ziwig Endotest is available on the NHS now?
Not yet. The recommendation sits in draft guidance. Its consultation closed on 5 October 2026, and final guidance is expected in January 2027. Even once published, a recommendation of this kind sets the conditions for NHS use while evidence is gathered rather than confirming the test as settled NHS practice.
What does a four-year evidence generation period actually mean?
It means NICE is supporting use in the NHS while the evidence gaps it has identified are filled. Data is collected during that window and the technology is looked at again at the end of it. It is a conditional recommendation with a review built into it, not a final one.
Which other technologies did NICE assess?
The updated draft names DotEndo, Endomkit and EndoSure as needing more research before NHS funding [1]. EndoSure had carried a recommendation in the July draft and no longer does.
Is the test LivingCare offers the same one NICE has assessed?
Yes, it is the same test. NICE's assessment is about how it would be used in NHS primary care, under the conditions set out above. LivingCare offers it privately, and the draft status of the guidance does not change what the test involves or what your clinician does with your result.
Medically reviewed by: Dr Becky Mawson, General Practitioner with Special Interest in Women's Health. Last reviewed: 13/10/26.
This article is for general information and is not sponsored content.
