WHEN WOULD I NEED A TRANSVAGINAL ULTRASOUND?

For symptoms of pelvic pain, abdominal pain, unusual vaginal bleeding, difficulty conceiving, or other menstrual problems such as heavy or irregular periods, it’s important to speak with your health care practitioner. Your doctor may order a variety of tests to investigate the cause for these types of symptoms, including medical imaging such as a pelvic ultrasound with transvaginal ultrasound.  

An ultrasound is a safe, versatile, and fast diagnostic imaging exam that uses high frequency sound waves transmitted through a transducer (probe) to produce images of your organs, tissues, and blood vessels.  

• Pelvic ultrasounds assess your kidneys, reproductive organs, and the surrounding area. At the end of a transabdominal pelvic ultrasound a transvaginal ultrasound is routinely added to get more detailed pictures.  It does not indicate that any abnormalities were seen during the exam.  

• A transvaginal ultrasound examines the internal pelvic cavity and the organs within it, including the cervix, uterus, and ovaries. This type of ultrasound can reveal abnormal structures and growths in your pelvic area, which may indicate a condition or disease. 

WHAT IS THE DIFFERENCE BETWEEN A PELVIC ULTRASOUND AND TRANSVAGINAL ULTRASOUND?

A pelvic ultrasound is performed with a full bladder. During the exam sonographer will apply warm, non-scented ultrasound gel to your skin on your lower abdominal area before using a transducer to visualize the organs and surrounding area in your pelvis. 

Whereas a transvaginal ultrasound (also known as an endovaginal ultrasound) uses a long, narrow transducer that looks like a wand is inserted into the vagina. This allows for a more detailed visual of the organs and the soft tissue inside the pelvic cavity. 

A transvaginal ultrasound takes between 6-15 minutes. If you are having your period, the ultrasound can still be done. Prior to the exam, you will be asked to empty your bladder and will be given privacy to remove your clothes from the waist down and cover yourself with a large sheet. The sonographer will explain the procedure in detail and answer any questions to make sure you understand and consent to the exam.  

For the exam the transducer is covered in a plastic sheath with lubricating gel that will be gently inserted into the vagina. Depending on your preference, you may be given the option to insert the transducer yourself, or the sonographer may do it for you. The sonographer will move the transducer around to capture photos. You may experience mild to moderate pressure while the sonographer takes the images, but the exam should not be painful. If you experience any pain or would like to discontinue the exam at any time, please let the sonographer know.  

WHEN IS A TRANSVAGINAL ULTRASOUND PERFORMED?

Your doctor may order this imaging to: 

• Investigate pelvic pain or abnormal bleeding – If you are experiencing ongoing pelvic discomfort, irregular periods, or heavy bleeding, a transvaginal ultrasound can help identify the cause. It may detect uterine fibroids, ovarian cysts, or other structural changes. 

• Evaluate early pregnancy – This imaging is often used in early pregnancy to confirm viability, assess gestational age, and rule out concerns such as ectopic pregnancy. 

• Assess infertility – It may be part of an infertility workup to evaluate ovarian follicles, uterine lining, or detect anatomical abnormalities that could impact conception. 

• Monitor known conditions – If you’ve previously been diagnosed with fibroids, ovarian cysts, or endometriosis, your physician may use periodic transvaginal ultrasounds to monitor changes. 

• Check Postmenopausal bleeding – Any bleeding after menopause warrants investigation. A transvaginal ultrasound helps assess the thickness of the endometrial lining and check for abnormalities. 

• Follow-up after abnormal tests – If a lab test, pelvic exam, or other imaging has shown something concerning, a transvaginal ultrasound may provide additional insight.
   

WHAT HAPPENS AFTER MY EXAM? 

The technologist will not be able to provide any details or give any results upon completion of the exam.  

Your images will be reviewed by a radiologist who will compile a medical report that is sent to your doctor within 24 hours, sooner for urgent requests.  

Your doctor will receive your medical report from the radiologist and discuss next steps with you, such as a treatment plan or the need for further diagnostic imaging or lab tests to ensure an accurate diagnosis. 

Mayfair Diagnostics has 14 locations  across Calgary which provide ultrasound services, as well as one in Cochrane and one in Regina. For more information about our services, please visit our services page. 

REFERENCES: 

Cleveland Clinic (2025) “Transvaginal Ultrasound.” my.clevelandclinic.org. Accessed June 4, 2025. 

John Hopkins Medicine (2025) “Pelvic Ultrasound.” www.hopkinsmedicine.org. Accessed June 4, 2025. 

Inside Radiology (2025) “Transvaginal Ultrasound.” www.insideradiology.com.au. Accessed June 4, 2025. 

RadiologyInfor.org For Patients (2025) “Pelvis Ultrasound.” www.radiologyinfo.org. Accessed June 4, 2025.