The Saliva Test Revolutionising Endometriosis Diagnosis
Endometriosis affects an estimated 1 in 10 women and people assigned female at birth, often causing years of pain, misdiagnosis, and uncertainty. Traditionally, diagnosis has relied on clinical evaluation, imaging, and, in many cases, invasive laparoscopy. Despite these efforts, the average diagnostic delay still hovers around 7–10 years. But a groundbreaking new tool is set to change that: a non-invasive saliva test that uses microRNA (miRNA) profiling and artificial intelligence to detect endometriosis with astonishing accuracy.
Why Diagnosis Has Been So Difficult
Endometriosis is a complex and heterogeneous disease with symptoms that are often normalised or dismissed—painful periods, pelvic pain, fatigue, and gastrointestinal symptoms. Imaging tools like ultrasound or MRI can miss subtle or superficial lesions. Even laparoscopy, the gold standard for diagnosis, is not foolproof and is associated with risks and delays.
The frustration for clinicians and patients alike lies in the uncertainty: when imaging is negative but symptoms persist, many patients are left in diagnostic limbo. Some undergo unnecessary treatment, while others struggle without any.
A Game-Changer: Saliva miRNA Testing
Enter a revolutionary approach—miRNA profiling in saliva. MicroRNAs are small, non-coding RNA molecules that regulate gene expression. They are remarkably stable in body fluids and have been shown to play a role in inflammation, immune response, and hormone regulation—all of which are key elements in endometriosis pathophysiology.
In a landmark French study published in 2022, researchers analysed saliva samples from 200 symptomatic women using next-generation sequencing and artificial intelligence. They identified a unique signature of 109 microRNAs that reliably distinguished women with endometriosis from those without.
The results were stunning:
Sensitivity: 96%
Specificity: 100%
This means the test could correctly identify endometriosis in 96% of true cases, and rule it out in 100% of those without the disease.
Validated and Ready for Use
This saliva-based test is already in use in the UK, offering a fast, simple, and highly accurate diagnostic option. It's particularly useful when imaging is inconclusive or when patients are not yet ready to undergo surgery.
A 2023 external validation confirmed the test’s robustness, with slightly adjusted but still impressive sensitivity (96%) and specificity (95%). It has been adopted in multicentre trials and is now being explored as a predictive tool for treatment response and fertility outcomes.
A New Diagnostic Pathway
This innovation allows clinicians to propose two distinct diagnostic routes:
Imaging First: When imaging confirms deep or clear lesions, diagnosis is straightforward. But when imaging is inconclusive, the saliva test can provide a much-needed answer—without delay or surgery.
Empirical Treatment First: If treatment fails to relieve symptoms, the saliva test can help determine whether endometriosis is truly the underlying cause, helping to avoid unnecessary treatments or identify when a more aggressive intervention is needed.
Beyond Diagnosis: Personalising Treatment and Fertility Planning
In addition to confirming diagnosis, this miRNA platform is being developed to:
Predict treatment response
Assess infertility risk
Explore applications in adolescent populations to catch the disease earlier
Extend to other gynaecological and even non-gynaecological diseases
Limitations and Future Outlook
While this test is a breakthrough, it is not a screening tool for the general population. It is intended for symptomatic individuals—those whose signs suggest possible endometriosis. It is also not yet widely available outside Europe and awaits further external validation.
Nevertheless, this miRNA saliva test offers what no current tool can: a highly accurate, non-invasive, and patient-friendly way to close the diagnostic gap, reduce suffering, and personalise care.
Final Thoughts
Endometriosis can no longer hide behind inconclusive scans or dismissed symptoms. Thanks to the power of molecular science and artificial intelligence, we now have a clear, objective diagnostic tool that brings hope to millions.
For clinicians, it’s a new tool in the diagnostic arsenal. For patients, it could be life-changing.
While diagnostic tools like mRNA testing for endometriosis are evolving, symptom relief can also be supported by lifestyle changes. Read my guide to dietary antioxidants for endometriosis and how they may help modulate inflammation and oxidative stress.
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It’s a non-invasive diagnostic tool that analyses microRNA (miRNA) molecules in saliva using artificial intelligence. These molecules form a unique “signature” in people with endometriosis, allowing accurate detection without surgery.
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Clinical studies show the saliva miRNA test has a sensitivity of up to 96% and a specificity of up to 100%, meaning it can correctly identify almost all true cases and avoid false positives in people without the disease.
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This test is designed for people with symptoms suggestive of endometriosis—such as pelvic pain, painful periods, fatigue, or digestive symptoms—especially when imaging results are inconclusive or surgery is not immediately planned.
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Yes, this test is currently available via our partner laboratory The Doctor’s Laboratory
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Laparoscopy remains the surgical “gold standard” for visual diagnosis, but it is invasive, carries risks, and can delay diagnosis. The saliva miRNA test offers a quick, safe, and accurate alternative for many patients, especially in the early diagnostic pathway.
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Yes. Research is underway to use miRNA profiles to predict treatment response, guide fertility planning, and even detect endometriosis in adolescents earlier.
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No. It is not intended for the general population. It is for people with symptoms where endometriosis is suspected.
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Not entirely. Imaging, clinical evaluation, and sometimes surgery will still be used. However, the saliva miRNA test can fill the gap for patients who would otherwise face long delays or invasive procedures before diagnosis.
About the Author
Dr Georgina Standen is a Women’s Health GP and Medical Director of Sirona Health. She specialises in all aspects of women’s health, including menstrual health, PMS (premenstrual syndrome), PMDD (premenstrual dysphoric disorder), menopause, contraception, and hormone balance. Her approach combines evidence-based medicine with personalised, compassionate care to empower women in every stage of life.
Sirona Health provides women’s health consultations in Stroud, Cirencester, Tetbury, Fairford, Lechlade, Calne, Corsham, Chippenham, Malmesbury, and Bath, as well as secure online appointments nationwide.