Ziwig Endotest® – A New Non-Invasive Test for Endometriosis
For many women, getting an answer to the question “Could this be endometriosis?” can take time. At West Wales Women’s Wellbeing, we combine careful listening and specialist clinical expertise with advanced diagnostic tools to help provide a clearer understanding of your symptoms.
We are pleased to offer Ziwig Endotest®, an innovative saliva-based molecular test designed to help diagnose endometriosis.
Endotest is not used as a standalone test. Where appropriate, it is considered alongside your symptoms, medical history and specialist gynaecological ultrasound to provide a more complete picture and help guide the next steps in your care.
What is Ziwig Endotest®?
Ziwig Endotest® is a non-invasive saliva-based molecular test designed to help diagnose endometriosis.
The test analyses tiny molecules called microRNAs (miRNAs) found in saliva. A specific combination of these microRNAs is analysed using advanced molecular techniques and an algorithm to determine whether the resulting molecular signature is consistent with endometriosis.
This provides a different type of information from an ultrasound scan.
How Does Ziwig Endotest® Work Alongside Specialist Ultrasound?
Ziwig Endotest®and specialist ultrasound provide different but complementary information.
Ziwig Endotest® looks at the biology.
It looks for a molecular signature that is consistent with endometriosis.
Specialist ultrasound looks at the anatomy.
It can help identify and assess where endometriosis may be present and how it may be affecting the pelvic organs.
A detailed specialist ultrasound can assess for conditions and features including:
- Ovarian endometriomas
- Deep endometriosis
- AdenomyosisPelvic adhesions
- Reduced movement between pelvic structures
- Abnormal ovarian position
- Possible bowel or bladder involvement
- Other ovarian or pelvic abnormalities that could explain your symptoms
Ultrasound can therefore help identify and map disease in a way that a saliva test cannot.
Importantly, a normal ultrasound does not rule out endometriosis. Some forms of endometriosis, particularly superficial disease, may not be visible on ultrasound.
For some women, therefore, an additional molecular test may provide another useful piece of information when symptoms remain suggestive of endometriosis despite normal or inconclusive imaging.
Who Might Endotest Be Suitable For?
Ziwig Endotest® may be considered for women within its validated age range who have symptoms suggestive of endometriosis.
These may include:
- Significant period pain
- Persistent or recurrent pelvic pain
- Deep pain during intercourse
- Pain when opening your bowels
- Cyclical bowel symptoms
- Pain when passing urine
- Cyclical urinary symptoms
- Fertility difficulties associated with symptoms suggestive of endometriosis
- Persistent symptoms despite previous normal investigations
- Symptoms strongly suggestive of endometriosis despite normal or inconclusive ultrasound
There are specific eligibility criteria for Ziwig Endotest®. Your consultant will consider your symptoms, medical history and previous investigations to determine whether the test is appropriate for you.
What Happens At West Wales Women’s Wellbeing?
Your assessment starts with your symptoms and your individual experience.
1. Consultation
Your consultant will discuss your symptoms and medical history, including how your symptoms relate to your menstrual cycle and any bowel, bladder, sexual or fertility symptoms.
2. Specialist Ultrasound
Where appropriate, you will have a detailed gynaecological ultrasound to assess for endometriosis, adenomyosis, ovarian conditions and other possible causes of pelvic symptoms.
3. Ziwig Endotest®
If Ziwig Endotest® is appropriate for you, your consultant will explain what the test can tell you, its limitations and how the result may influence your care.
The test itself requires a saliva sample.
4. Bringing the Information Together
Your Ziwig Endotest® result is not considered in isolation. Your consultant will consider:
Your symptoms + your medical history + your ultrasound findings + your Endotest® result
Together, this information can help provide a clearer understanding of your individual situation.
5. Deciding What Happens Next
Depending on your findings and your priorities, your next steps may include:
- Reassurance or monitoring
- Pain management
- Hormonal treatment
- Fertility adviceFurther imaging
- Referral to a specialist endometriosis service
- Consideration of surgery where appropriate
Does a Positive Ziwig Endotest®Mean I Will Need Surgery?
No.
A positive Ziwig Endotest® result does not automatically mean that surgery or laparoscopy is required.
Your consultant will consider the result alongside your symptoms, the impact of those symptoms on your life, your ultrasound findings, fertility plans, previous treatments and whether deep or complex disease is suspected.
For some women, having additional diagnostic information may help move treatment and management forward without surgery being required simply to establish whether endometriosis is likely to be present.
What if My Endotest is Negative?
A negative result can provide useful information, but no investigation should be interpreted on its own.
Your result will be considered alongside your symptoms, medical history and ultrasound findings.
If your symptoms remain unexplained, your consultant can consider whether another gynaecological, gastrointestinal, urinary, musculoskeletal or pain-related condition could be contributing.
Our aim is not simply to provide a positive or negative test result. It is to understand what may be causing your symptoms and help you decide what to do next.
Modern Diagnostics, Personalised Care
At West Wales Women’s Wellbeing, we believe that the most useful diagnostic approach is not always about choosing a single test.
For some women, consultation and specialist ultrasound may provide the information needed. For others, ultrasound may identify disease requiring further specialist management. And for some women, symptoms may remain strongly suggestive of endometriosis despite normal or inconclusive imaging.
Where appropriate, combining:
Clinical assessment + specialist ultrasound + molecular testing
can provide additional information to help guide your care.
Our aim is to provide expert consultant-led assessment, advanced diagnostics and a clear, personalised plan, helping women access the right information and appropriate care closer to home.
An Evolving Approach to Endometriosis Diagnosis
The National Institute for Health and Care Excellence (NICE) is currently carrying out an early-use assessment of technologies for the rapid diagnosis of endometriosis, including Ziwig Endotest®.
The current recommendations are draft recommendations while further evidence is collected and should not be interpreted as final NICE guidance.
Endotest is not intended to replace appropriate clinical assessment or pelvic imaging. It is an additional diagnostic tool that should be interpreted alongside your symptoms, examination, imaging and other investigations.
Find out more about the latest NICE assessment
Find Out Whether Ziwig Endotest® Could Be Appropriate For You
If you are experiencing symptoms that may represent endometriosis, you can arrange a consultant-led assessment with West Wales Women’s Wellbeing.
Depending on your individual circumstances, your assessment may include:
Specialist consultation
Detailed endometriosis ultrasound
Ziwig Endotest®
Your consultant will discuss which investigations are appropriate for you and explain what your results mean for your individual care.
Our aim is not simply to perform another investigation. It is to help you find an answer