Gynaecological ultrasound

A gynaecological ultrasound or transvaginal ultrasound is a non-invasive scan of the organs in the female pelvis. It does not use any radiation but instead uses high-frequency sound waves delivered via a handheld ultrasound probe.

Signs of needing a gynaecological ultrasound

A transvaginal ultrasound is usually recommended to investigate symptoms suspected to originate in organs or tissues in the pelvis. This includes the womb, ovaries and fallopian tubes. 

Signs you may need a gynaecological ultrasound include: 

• Heavy periods, painful periods or irregular periods
• Pain during sex
• Pelvic pain
• Vaginal bleeding between periods or after menopause

A gynaecological ultrasound is used to help diagnose a range of conditions that can cause pain and affect your fertility. This includes:

• Ovarian cysts — fluid-filled sacs on or in your ovaries
• Uterine fibroids — non-cancerous growths of muscle tissue on or in your womb
• Uterine polyps — non-cancerous growths within your womb that are made from tissue lining the womb

It can also help diagnose certain types and signs of endometriosis. Endometriosis refers to the abnormal growth of tissue that lines the womb in other areas of the body. A transvaginal ultrasound can help diagnose: 

• Deep infiltrating endometriosis — an advanced type of endometriosis that invades organs such as the bowel and bladder
• Ovarian endometriomas — fluid-filled sacs on or in the ovaries that contain blood and endometrial tissue; they are a symptom of endometriosis
• Ovarian adhesions — scar tissue that causes the ovaries to stick to surrounding tissues and organs; they are also a symptom of endometriosis

A transvaginal ultrasound can also detect an ectopic pregnancy and whether an intrauterine device is positioned correctly. 

Alternative treatment options 

A transvaginal ultrasound is a non-invasive scan as it does not involve making any cuts into the body. However, it is an internal scan because the ultrasound probe is inserted into the vagina. 

If you do not want to have an internal scan, you can have a transabdominal ultrasound scan. This involves passing an ultrasound probe over your lower abdomen and pelvis. 

You will need to have a full bladder during a transabdominal ultrasound scan. This helps reposition the organs in your abdomen to get a clearer view of your reproductive organs. A full bladder helps move the bowel out of the way — gas in the bowel can interfere with the clarity of ultrasound images. 

Is a gynaecological ultrasound right for you?

A gynaecological ultrasound can help diagnose the cause of persistent pelvic pain, fertility problems and heavy, irregular and/or painful periods in adult women. 

However, it is not recommended for those aged under 16. For those aged 16–18 years, a paediatric assessment is needed before a scan can be recommended. 

You can have a transvaginal ultrasound while you are having your period. 

An ultrasound scan involves passing a handheld probe over the part of your body to be imaged. High-frequency sound waves are released from the probe into your body. The sound waves are beyond the range of human hearing and are completely painless. 

As the sound waves encounter boundaries between tissues, they bounce back and are detected by the ultrasound probe. These signals are sent to a computer where they’re processed into real-time, grayscale images of the inside of your body. The images are then displayed on a computer screen. 

A transvaginal ultrasound is carried out in 2 parts. For the first part of your scan, you can remain clothed with your pelvis exposed. You will be asked to lie down, and a small amount of gel will be applied to your pelvis. The ultrasound probe will then be moved across your pelvis.
Next, you will be asked to empty your bladder and will be given privacy to change into a hospital gown. 

For the second part of your scan, you will be asked to lie down with your legs parted. Your pelvic area will be covered with a sheet. A slim, transvaginal ultrasound probe, which is about the width of a thumb, will be covered in a single-use protective sheath and coated in a sterile gel. 

The transvaginal probe will be gently inserted into your vagina and moved around to capture images of your pelvic organs. 

The scanning process for each part of your scan takes a few minutes to complete.

How to prepare for your gynaecological ultrasound 

You can eat as normal before a gynaecological ultrasound. However, you will need to follow the guidance of your care team when it comes to drinking fluids. 

In general, you will be asked to stay well-hydrated in the 24 hours preceding your scan — you should, therefore, avoid drinking alcohol as this can dehydrate your body. 

On the day of your scan, empty your bladder an hour and a half before your scan appointment. Then, drink 1 litre of water and do not empty your bladder until your care team tells you to during your scan appointment. 

As you will be asked to remove all clothing from the waist down and change into a hospital gown, it is recommended that you wear loose, comfortable clothing that is easy to change out of. 

If you are feeling anxious about your scan, you can bring a friend or family member with you.

Who will be involved? 

Your scan will be performed by a highly trained radiologist, ie a doctor who specialises in medical imaging. Your care team will also include an experienced imaging assistant who will be your chaperone and support you throughout your scan.

How long does the scan take?

The scanning process only takes a few minutes. However, your entire scan appointment may take up to 30 minutes, depending on what your radiologist is looking for and how clear the images are.

Is the scan painful?

You may experience some mild discomfort when the probe is pressed down on the outside of your pelvis (for the external part of your scan) and when it is inserted into your vagina (for the internal part of your scan). 

However, the scan is not painful unless you are already experiencing pain due to an underlying health condition.

Is the scan safe?

Yes, a gynaecological ultrasound scan is considered to be very safe. It does not use any radiation or contrast agents. The sound waves used are harmless and do not cause any pain. 

What happens straight after the scan? 

You will be given some paper towels to clean off any gel from your pelvis and will be given privacy to change back into your clothes. You can then return to your usual activities. 

The doctor who requested your transvaginal ultrasound scan will receive your results within 2–5 working days of your scan. 

You can then arrange a follow-up appointment with your doctor to discuss your results and what they mean in your particular case. You can also ask your doctor for a copy of your results.