The Transvaginal Ultrasound Scan

What Is a Transvaginal Ultrasound?

A transvaginal ultrasound also called an endovaginal ultrasound, is a type of pelvic ultrasound used by doctors to examine the female reproductive organs such as the uterus fallopian tubes ovaries, cervix, and vagina.

“Transvaginal” means “through the vagina.” This is an internal examination.

Unlike a regular abdominal or pelvic ultrasound, where the ultrasound probe rests on the outside of the pelvis, this procedure involves your doctor or sonographer inserting an ultrasound probe about 2 or 3 inches into your vaginal canal.

Transvaginal ultrasound might also be offered at the early weeks of pregnancy, when the abdominal imaging approach is suboptimal and more information about foetal viability and wellbeing is required.

We regularly perform transvaginal scans during our private pelvic scan and early pregnancy scan.

When is the vaginal ultrasound performed?

There are many reasons why a transvaginal ultrasound might be necessary, including:

In pregnancy

In the first trimester of pregnancy to evaluate for any signs of ectopic pregnancy

monitor the heartbeat of the fetus

look at the cervix for any changes that could lead to complications such as miscarriage or premature delivery

examine the placenta for abnormalities

identify the source of any abnormal bleeding

diagnose a possible miscarriage

confirm an early pregnancy

In Gynaecology

To evaluate the pelvic organs after

Abnormal pelvic examination

Pelvic pain

Unexpected vaginal bleeding

Infertility

Exclude cysts, masses or fibroids

To evaluate the ovaries for evidence of polycystic disease

To evaluate the endometrial cavity

Inflammatory disease

As part of the follicular tracking scan

How should I prepare for a transvaginal ultrasound?

No preparation is required for this private ultrasound.

Once you’re in the examination room, you will have to remove your clothes from the waist down and be covered with a paper sheet or gown.

What happens during a transvaginal ultrasound?

When it’s time to begin the procedure, you lie down on your back on the exam table and bend your knees. There may or may not be stirrups.

The ultrasound transducer will be covered with a probe cover and sterile lubricating ultrasound gel, and then inserts into your vagina.

You might feel some pressure as your sonographer inserts the transducer. This feeling is similar to the pressure felt during a Pap smear when your doctor inserts a speculum into your vagina, but not as bad.

Once the transducer is inside you, high-frequency sound waves bounce off your internal organs and transmit pictures of the inside of your pelvis onto a monitor.

The ultrasound probe will be moved in different directions to obtain the best ultrasound images possible.

If you prefer, you may insert the transducer yourself, otherwise, the person conducting the examination will do this.

A third person may be present during the examination, acting as a chaperone if required by the sonographer or yourself.

You may request the examination to be stopped at any time during the procedure.

Can you do a vaginal ultrasound if you are a virgin?

As the probe needs to be inserted in the vagina, the examination is contraindicated If you are a virgin (Virgo intacta; hymen intact). Other types of ultrasound imaging such as transabdominal ultrasounds (through the abdomen) or a  transrectal (through the rectum) ultrasound might be a viable alternative. (You can find more information at https://clinicaltrials.gov/ct2/show/NCT04858919 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719089/ )

Does a pelvic ultrasound hurt a virgin?

Transvaginal ultrasound is not indicated if you are a virgin in the UK as it can be painful. Please note that there is a lot of outdated information online about transvaginal ultrasounds and virginity. We follow NHS guidelines, and we are not writing an article just from the information we found online.

What is the risk of a transvaginal ultrasound?

There are no known risks from the sound waves used in an ultrasound scan. Unlike some other scans, such as CT scans, ultrasound scans don’t involve exposure to radiation External and internal ultrasound scans don’t have any side effects and are generally painless, although you may experience some discomfort as the probe is pressed over your skin or inserted into your body.

Read more about what is an ultrasound scan.

If you’re having an internal scan and are allergic to latex, it’s important to let the sonographer or doctor carrying out the scan know this so that they can use a latex-free probe cover.

Performing transvaginal ultrasounds on pregnant women is also safe, for both mother and fetus. This is because no radiation is used in this imaging technique.

Are there any after-effects of a transvaginal ultrasound?

There are no after-effects of a transvaginal ultrasound. You will be able to resume normal activities.

How long does a transvaginal ultrasound scan take?

The scan should normally be completed within 5 to 10 mins.

When an internal ultrasound can detect pregnancy?

The best time to confirm pregnancy with an internal scan is from 6 weeks.

Why can’t my ovaries be seen on a transvaginal ultrasound?

It is very common for the bowel to obscure the ovaries.

Is an internal vaginal ultrasound necessary during a routine pregnancy ultrasound?

It is only necessary if the abdominal ultrasound is inconclusive.

Can I have an internal ultrasound if I am bleeding?

It is absolutely fine to have an ultrasound while you are bleeding, as far as you are comfortable with that.