Transvaginal ultrasounds are solidly on the list of medical procedures no one wants but you’ll probably need at some point anyway. This type of ultrasound can be useful if your doctor needs to get a good look at your uterus, ovaries, fallopian tubes, cervix, or general pelvic area, according to the U.S. National Library of Medicine. The catch is that a medical professional has to insert a decent-sized tool into your vagina to capture those images.
If you’re wary of getting a transvaginal ultrasound, we can’t blame you. Hopefully, reading details about what the procedure entails will make the whole thing less worrisome. Here’s what to know about transvaginal ultrasounds, plus what to expect before, during, and after.
There are a few common reproductive health-related reasons why your doctor might suggest a transvaginal ultrasound.
If you’re in the first trimester of pregnancy, your doctor may have you do one of these to take stock of the developing fetus, Suzanne Fenske, M.D., assistant professor of obstetrics, gynecology, and reproductive sciences at Mount Sinai Health System, tells SELF. “It just helps us see things better than an external ultrasound,” she says. The fetus is so small in the first trimester that it can be hard to pick up on with a transabdominal ultrasound that goes over your belly.
Whether or not you’ll get an ultrasound in the first trimester depends on factors like your age (people who are 35 and up tend to have ultrasounds sooner), as well as whether you’ve had a past history of difficult pregnancies, Jessica Shepherd, M.D., a minimally invasive gynecologist at Baylor University, tells SELF. It even just depends on your ob/gyn’s practice and preference; some will give you a transvaginal ultrasound at six weeks, while others tend to wait until later in your pregnancy when a transabdominal ultrasound can get the job done.
Your doctor may also recommend a transvaginal ultrasound if you’re experiencing pelvic pain, they have felt a mass in that region, or you’re having abnormal bleeding that warrants further exploration, Robert Troiano, M.D., radiologist and specialist in obstetric and gynecologic ultrasound at NewYork-Presbyterian and Weill Cornell Medicine, tells SELF. For example, a transvaginal ultrasound can be helpful when diagnosing conditions like uterine fibroids, endometrisois, and an ectopic pregnancy. Finally, some providers may just tack it on to your annual ob/gyn exam to give them a more thorough picture (literally) of your reproductive health and anatomy.
You typically won’t need to do much prep before your transvaginal ultrasound, but definitely ask your doctor if you should pee beforehand.
Your doctor may want you to show up with a partly full or empty bladder, according to the U.S. National Library of Medicine, so it’s good to ask what they prefer in advance. It depends on what they want to look at; filling your bladder a bit can be helpful by pushing your intestines out of the way without obscuring organs like your uterus and ovaries, Dr. Fenske explains, but this may not be necessary for your situation.
You may also want to wear loose clothing to the appointment, the Mayo Clinic says. You should have the option to change into a paper gown, but sometimes you can just remove your underwear and whatever clothing item you’ve got on your bottom half. Wearing loose clothing makes it more likely that you can just push up a dress instead of taking the whole thing off, for instance.
After you’ve either changed into a gown or removed the clothing on your bottom half, you’ll lie down on an exam table with your knees bent, have the lower half of your body covered with a sheet, and typically rest your feet in stirrups, Dr. Troiano says. (It should feel similar to your position when you’re getting a Pap smear done.)
When you’re ready to go, the person performing the test will get out the probe, also known as a transducer.
The transducer is basically a wand that goes inside your vagina to do the ultrasound. It’s just a few centimeters wide (with the tip being wider than the rest) and about 12 inches long, Dr. Shepherd says, but only the top few inches will actually go into your vagina. Before insertion, the probe will be covered with a condom (to keep it fluid-free) and lubricating gel (to make it easier to put inside you so it’s as comfortable as possible), Dr. Fenske says.
As for what kind of feedback to expect during the test, it can vary based on who is doing it. Ultrasound technicians are typically trained to keep their faces blank and not give away any information, Dr. Shepherd says—instead, they’ll give the test results to the doctor, who will interpret them and tell you. However, some technicians at private practices may give you reassurance that everything is OK if things are looking good, she adds, and doctors might also let you know what they see as soon as they see it. Since it depends so much on the practice and the situation, it can be helpful to ask what you can expect beforehand.
During the procedure itself, you should feel pressure at most, not pain, Dr. Fenske says. Obviously, having anything placed in your vagina during an exam probably won’t feel great, but Dr. Shepherd notes that a transducer typically doesn’t feel as uncomfortable as a speculum during a Pap smear. That said, if you have a pelvic pain condition like vaginismus or vulvodynia, you may experience more pain during this procedure. If you’re worried about pain or you feel it during the exam, definitely tell your doctor.
Once it’s inside you, the probe sends out sound waves that bounce off of structures in your body and transmits the waves to a computer, which creates pictures of your insides. The person performing the ultrasound then views these pictures on a TV monitor, which you may or may not also be able to see. Some doctor’s offices have another monitor set up so you can see everything, while others won’t allow you to get a view. It might be helpful to ask beforehand what you can expect so it doesn’t take you off-guard if you ask to take a peek but can’t.
During the exam, the medical professional will move the probe around a little to get a better look at your insides, the U.S. Library of Medicine says, so that might feel uncomfortable as well.
A transvaginal ultrasound usually takes anywhere from a few quick moments to around 45 minutes.
The length of time really depends on why you’re getting the ultrasound. If they’re just looking for a heartbeat during pregnancy, you could be in and out very quickly, Dr. Fenske says. If they’re looking for something like fibroids or another medical condition, though, the ultrasound could be on the longer side.
Once your ultrasound is done, the ultrasound technician or doctor will remove the probe and leave the room so you can get dressed.
They might also give you wipes to clean off any residual ultrasound gel, Dr. Troiano says. (If they don’t and you’d like one, ask if they have any available.)
You may have an appointment with your doctor right after the ultrasound to go over the results, Dr. Fenske says, or if the results require a bit more interpretation, it could take a couple of days.
Otherwise, you should be good to go. You don’t need to do any sort of special after-care once you’re done with a transvaginal ultrasound, Dr. Troiano says.
All in all, a transvaginal ultrasound is usually a pretty simple procedure.
If you’re still worried about how it’s going to go, be sure to ask your doctor or the ultrasound technician about any lingering questions you have. Like any other kind of physical exam, you can also request that they tell you everything they’re going to do before they do it. Your vagina deserves to be in good hands.