A saliva test that claims it can spot endometriosis with AI, no surgery needed.

A saliva test for endometriosis is making headlines. Here's what Australian experts actually found.

You've probably seen it by now. A saliva test that claims to spot endometriosis using artificial intelligence, no surgery required. For anyone who's waited years for an answer, it's the kind of headline that's hard to scroll past.

Around one in seven Australian women aged 18 to 45 live with endometriosis, and many wait six to eight years just to hear the word said out loud by a doctor.

The Ziwig Endotest, developed by French company Ziwig, analyses microRNAs (tiny molecules in saliva) using AI, looking for patterns linked to endometriosis. Its manufacturer claims the test can accurately identify 97 per cent of people who have the condition, and 93 per cent of people who don't. Right now, it's available in France and the UK, but only under a specialist's care, as part of larger trials designed to test claims that, so far, have mostly come from smaller studies funded by the manufacturer itself. In Australia, no such trial has even been applied for. Ziwig didn't respond to the ABC's request for comment on that.

Australian experts who've looked closely at the test are cautiously optimistic. Cautious being the key word.

"It's a probability test," says Dr Alex Polyakov, gynaecologist and medical director of Melbourne's Genea Fertility. "It combines all the different markers to provide a statistical assessment." As he puts it, "it's not really designed as a diagnostic test."

Dr Marilla Druitt, speaking on behalf of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, calls it "a great first step." But she's not ready to call it settled either, saying there isn't yet enough real world data to justify introducing it here, and that promising results in small trials don't always hold up once a test meets the "messy world" of everyday clinical use.

There's a separate shift already underway in how endometriosis is diagnosed in Australia, and it's worth knowing about regardless of what happens with the saliva test. Last year, RANZCOG updated its guidelines to state that laparoscopic surgery is no longer required as a first line option. Patients presenting with symptoms are now recommended to have a transvaginal pelvic ultrasound instead, a procedure Dr Jodie Avery, of Adelaide University's Robinson Research Institute, calls current best practice. She notes it takes real skill to spot endometriosis on a scan, not every sonographer is trained for it, and with Medicare rebates now available for the scans, she's calling for more investment in that training so access doesn't come down to which clinic you happen to walk into.

Maybe the most important thing in all of this isn't which test wins. It's that you don't have to wait for any of them. Dr Druitt is clear that pain shouldn't be left untreated while a diagnosis is pending. Most patients don't walk in with suspected endometriosis, they walk in with pelvic pain, and the longer that pain goes unaddressed, the harder it becomes to treat. Dr Polyakov agrees an unclear ultrasound doesn't mean there's nothing there, and it doesn't mean surgery is the only next step either.

Margaret Whinnett knows that wait firsthand. She was 12 when her symptoms started, heavy, irregular periods, days she couldn't get out of bed, and nearly two decades passed before she had an answer. When she finally had laparoscopic surgery two years ago, it revealed endometriosis in her bladder, uterus, ovary and bowel. She woke up from a surgery meant to help her feeling, in her words, ten times worse.

Two years on, she says her health is much better, though her journey, including with fertility, is ongoing. What she wants for other women isn't another headline about a breakthrough. It's tools that actually work, backed by real evidence, that don't cost two more weeks of pain just to access.

That's the standard worth holding every new development to, this one included.

If you're in the middle of your own wait right now, for a scan, a referral, or just to be believed, the ground under this is shifting, even if it isn't shifting fast enough yet. In the meantime, what you track still matters. Ovum helps you connect your symptoms, appointments, medications and cycle over time, so that whenever your answer does come, you walk in with the evidence already in hand.

Sources: ABC News, RANZCOG