A transvaginal ultrasound, also known as an endovaginal ultrasound, is a common diagnostic imaging procedure used to examine the female reproductive organs. This test uses high-frequency sound waves to create detailed images of the uterus, ovaries, fallopian tubes, cervix, and vagina. While the prospect of any internal examination can cause anxiety, it is helpful to understand the physical sensations and process involved regarding comfort and expectations.
Understanding the Typical Feeling
The central concern for most people undergoing this procedure is whether it will cause sharp pain. For the majority of patients, a transvaginal ultrasound is not painful, though it often involves a sensation of distinct pressure and mild discomfort. This feeling is frequently compared to the internal pressure experienced during a routine pelvic examination or a Pap smear, but without the speculum opening the vaginal canal.
The discomfort felt is primarily due to the movement of the probe, or transducer, against the internal pelvic structures. The sonographer must gently angle the probe to capture clear images of all organs, which can cause transient pressure as the device makes contact with the cervix or pushes slightly against the uterus or ovaries. This deep pressure is necessary to visualize structures like the ovaries, which are positioned deeper within the pelvis.
It is important to distinguish between this expected pressure and actual, sharp pain. If a patient is experiencing true pain, it may signal an underlying condition like a cyst, endometriosis, or pelvic inflammatory disease, which the ultrasound is intended to diagnose. Patients should always communicate immediately with the technician if mild discomfort escalates into genuine pain.
What Happens During the Examination
The transvaginal ultrasound is performed by a sonographer or physician while the patient is lying on an examination table, often with their feet placed in stirrups, similar to a standard gynecological exam. The patient is usually asked to undress from the waist down and is provided a gown or a sheet for draping. The procedure generally requires an empty bladder to achieve the clearest view of the pelvic organs, although specific instructions may vary.
The transducer itself is a thin, wand-like device, typically smaller in diameter than a standard speculum and often likened to the size of a tampon. Before insertion, the probe is covered with a protective sheath, often latex-free, and a sterile, water-based lubricating gel is applied generously to ensure the smoothest possible entry. The technician then gently inserts the lubricated probe only a few inches into the vaginal canal.
Once inserted, the probe transmits high-frequency sound waves that bounce off the internal organs, with the returning echoes creating real-time images on a monitor. The sonographer carefully rotates and adjusts the angle of the probe to survey the entire pelvic cavity, including the uterus, endometrium, and ovaries. The exam itself is relatively brief, typically lasting between 15 and 30 minutes, depending on the complexity of the required images.
When is This Type of Ultrasound Required
A transvaginal ultrasound is often necessary because the internal placement of the probe allows for a much closer and more detailed view of the pelvic organs compared to an external, or transabdominal, ultrasound. It is a common tool for investigating the cause of unexplained pelvic pain or abnormal vaginal bleeding. The procedure is frequently used to check for the presence of benign growths, such as uterine fibroids, ovarian cysts, or polyps.
In the context of reproductive health, the scan helps assess potential causes of fertility challenges or to monitor the size of ovarian follicles during treatment. For early pregnancy, a transvaginal scan is used to confirm the location of the pregnancy, check the fetal heartbeat, or investigate potential complications like an ectopic pregnancy or signs of miscarriage. It is also an effective way to check the proper placement of an intrauterine device (IUD).
Practical Steps to Ensure Comfort
Patients can take several proactive steps to help minimize any potential discomfort during the examination. A simple yet effective strategy is to practice slow, deep breathing techniques to relax the pelvic floor muscles, which can otherwise involuntarily tense up during insertion. Communicating any feeling of dryness or resistance allows them to apply more gel, which can significantly improve comfort upon insertion.
The most important step is to maintain open communication with the sonographer throughout the entire process. Patients should feel empowered to voice any discomfort or pain they experience. The technician can temporarily pause the procedure or adjust the angle of the probe to ease the sensation of pressure upon request.