Gynaecological Ultrasounds

What is a gynaecological ultrasound?

An ultrasound scan uses high-frequency sound waves to create images of structures inside your body.

Unlike X-rays and CT scans, ultrasound does not use ionising radiation. It is widely used in gynaecology because it can provide detailed images of the pelvic organs without the need for an invasive operation.

A pelvic ultrasound can examine:

• The womb
• The lining of the womb (endometrium)
• The cervix
• The ovaries
• The area around the ovaries and fallopian tubes
• Pelvic masses or cysts
• Fluid within the pelvis
• The position and appearance of pelvic organs

Ultrasound can also be used to monitor a known condition or help your specialist decide whether further investigation or treatment is needed.

Why might I need a gynaecological ultrasound?

There are many reasons why your consultant may recommend an ultrasound.

You may be offered a scan if you have:

• Heavy or prolonged periods
• Irregular or abnormal vaginal bleeding
• Bleeding after the menopause
• Bleeding between periods
• Pelvic pain
• Pain during sex
• A suspected ovarian cyst
• Fibroids
• Endometriosis
• Difficulty becoming pregnant
• A suspected pelvic mass
• Symptoms affecting the bladder or bowel
• An abnormal examination
• A concern identified during another investigation

Ultrasound can also be used to monitor a condition that has already been diagnosed and assess whether it has changed over time.

What can a gynaecological ultrasound detect?

Ultrasound can identify a wide range of changes affecting the reproductive organs.

Fibroids

Fibroids are common non-cancerous growths that develop in or around the womb.

An ultrasound can help identify their size, number and location and assess whether they may be contributing to symptoms such as heavy periods, pelvic pressure or pain.

Ovarian cysts

Ultrasound is commonly used to investigate ovarian cysts.

It can show whether a cyst appears simple or more complex and can provide information about its size and appearance.

If a cyst has concerning features or its nature is unclear, your consultant may recommend additional imaging or investigation.

Changes to the womb lining

Ultrasound can assess the thickness and appearance of the endometrium.

This can be particularly important when investigating abnormal or postmenopausal bleeding.

Depending on your symptoms and scan findings, further investigation such as hysteroscopy and endometrial biopsy may be recommended.

Endometriosis

Ultrasound can sometimes identify signs of endometriosis, particularly when performed by someone experienced in assessing for the condition.

It may identify ovarian endometriomas or some forms of deep endometriosis.

However, a normal ultrasound does not rule out endometriosis. Further assessment may be required depending on your symptoms and examination findings.

Pelvic masses

Ultrasound can identify masses affecting the uterus, ovaries or surrounding pelvic structures.

Further investigation may be required to determine exactly what a mass represents.

Transabdominal ultrasound

A transabdominal ultrasound is performed by moving an ultrasound probe over the lower abdomen.

You will normally lie on your back while the sonographer applies ultrasound gel to your skin and gently moves the probe across your abdomen.

A transabdominal scan can provide an overview of the pelvis and may be particularly useful when looking at larger pelvic structures or masses.

You may be asked to have a reasonably full bladder beforehand because this can help provide a clearer view of the pelvic organs. Your clinic will give you specific preparation instructions.

Transvaginal ultrasound

A transvaginal ultrasound (TVUS) is an internal scan that provides detailed images of the womb, ovaries and surrounding pelvic structures.

A slim ultrasound probe is gently inserted into the vagina.

The probe does not enter the cervix or womb.

Because the probe is positioned closer to the pelvic organs, a transvaginal scan can provide clearer and more detailed images than scanning through the abdomen for many gynaecological problems.

You will be asked for your consent before an internal scan is performed.

Will I need both types of ultrasound?

Sometimes.

Your specialist or sonographer may recommend a transabdominal scan followed by a transvaginal scan.

The two approaches provide different views of the pelvis and can complement each other.

A transabdominal scan can provide a broader overview, while a transvaginal scan can give more detailed images of the womb, endometrium and ovaries.

The type of scan you need will depend on your symptoms and the information your specialist needs.

What happens during a transvaginal ultrasound?

If an internal scan is recommended, the procedure will be explained to you beforehand and you will be asked for your consent.

You will normally be given privacy to undress from the waist down and will be covered with a sheet.

The ultrasound probe is covered with a protective sheath and lubricant.

The probe is then gently inserted into the vagina.

The sonographer may move the probe slightly to obtain images of the womb, ovaries and surrounding structures. Measurements and images may be recorded as part of the examination.

You remain in control throughout the examination and can ask for the scan to stop at any time.

Is a transvaginal ultrasound painful?

Most women tolerate a transvaginal ultrasound well.

You may experience some pressure or mild discomfort when the probe is inserted or moved.

If you have pelvic pain, endometriosis, vaginal dryness or another condition that makes internal examinations uncomfortable, tell the person performing your scan before it begins.

They can explain each stage and make adjustments where possible.

You can ask for the examination to stop at any point.

Can I have a transvaginal ultrasound if I have never had sex?

This is something you should discuss with your clinician before the examination.

A transvaginal ultrasound is an internal examination and may not be appropriate or acceptable for everyone.

If you do not want an internal scan, you should tell your healthcare professional. A transabdominal ultrasound may be an alternative, although it may not provide the same level of detail for some gynaecological conditions.

Do I need a chaperone?

For an internal examination, you should be offered appropriate support and a chaperone in accordance with the clinic's policy.

You can also ask questions about the examination before it begins and discuss any concerns you have.

Your dignity, privacy and consent are important throughout the procedure.

How should I prepare for my ultrasound?

Preparation depends on the type of scan you are having.

For a transabdominal ultrasound, you may be asked to attend with a full bladder.

For a transvaginal ultrasound, you will generally be asked to empty your bladder beforehand.

You should follow the specific instructions provided by the clinic, as preparation requirements can vary depending on the reason for your scan.

Can I have an ultrasound during my period?

Yes.

A pelvic ultrasound can often be performed while you are having your period.

In some circumstances, the timing of the scan within your menstrual cycle may be relevant to the information your clinician is looking for.

If you are unsure whether your appointment should go ahead during your period, contact the clinic beforehand.

Is a gynaecological ultrasound safe?

Ultrasound is considered a very safe form of medical imaging and does not use ionising radiation.

A transvaginal ultrasound is also considered a safe diagnostic examination.

As with any intimate examination, you should be given an explanation of what will happen and asked for your consent before the examination.

What happens after the scan?

There is normally no recovery period following a pelvic ultrasound.

You can generally return to your normal activities immediately afterwards.

If you have had a transvaginal scan, you may notice a small amount of lubricant afterwards.

The images will be reviewed and reported according to the arrangements of your clinic or imaging service.

Will I get my results immediately?

This depends on where and how your scan is performed.

Sometimes the person performing the ultrasound may be able to explain what they can see during or immediately after the examination.

In other situations, the scan will be formally reported and the results sent to your consultant or referring clinician.

Your consultant will then explain what the findings mean in the context of your symptoms and medical history.

Importantly, an ultrasound image needs to be interpreted alongside your symptoms, examination and other test results. A scan is not always able to provide a definitive diagnosis by itself.

What happens if the ultrasound is abnormal?

An abnormal ultrasound does not automatically mean that you have cancer or another serious condition.

Many common gynaecological conditions can produce changes on ultrasound, including fibroids, ovarian cysts and adenomyosis.

If something requires further investigation, your consultant will explain what has been found and what should happen next.

Depending on the findings, you may be advised to have:

• A repeat ultrasound
• Blood tests
• MRI
• Hysteroscopy
• Endometrial biopsy
• Colposcopy
• Laparoscopy
• Further specialist assessment

The appropriate next step depends on the findings and your symptoms.

Can an ultrasound rule out cancer?

No test can rule out every gynaecological cancer on its own.

Ultrasound can provide valuable information about the womb, ovaries and other pelvic structures and may identify features that require further investigation.

However, if there is a concern about cancer, your specialist may recommend additional imaging, biopsy or surgery.

For example, an ultrasound may identify an ovarian mass, but further assessment may be necessary to determine whether it is benign or malignant.

Similarly, when investigating postmenopausal bleeding, ultrasound may be an important part of the assessment but further investigation may be recommended depending on the findings and symptoms.

Ultrasound and postmenopausal bleeding

Any bleeding after the menopause should be assessed.

A transvaginal ultrasound may be used to examine the womb and measure the thickness of the endometrium.

Depending on the ultrasound findings and your symptoms, further investigation such as hysteroscopy and biopsy may be required.

An ultrasound therefore forms part of the diagnostic pathway rather than necessarily providing the final diagnosis.

Ultrasound and ovarian cysts

Ultrasound is one of the main investigations used when an ovarian cyst is suspected.

The scan can assess:

• The size of the cyst
• Its location
• Whether it is fluid-filled or contains solid areas
• The appearance of its walls
• Whether there are internal structures
• Whether there is fluid elsewhere in the pelvis

Your specialist will consider these findings alongside your age, symptoms and medical history.

Many ovarian cysts are benign and may disappear without treatment, while some require monitoring or further investigation.

Ultrasound and fibroids

Ultrasound can help identify fibroids and determine:

• How many are present
• Where they are located
• Their approximate size
• Whether they distort the cavity of the womb

This information can be particularly useful when deciding whether treatment is necessary and which treatment may be most appropriate.

Depending on the size and position of the fibroids, an MRI may sometimes provide additional information.

Ultrasound and fertility

Ultrasound can be an important part of fertility assessment.

It can assess the womb and ovaries and may identify conditions such as fibroids, ovarian cysts or some forms of endometriosis that could affect fertility.

Ultrasound can also be used to monitor ovarian follicles and the lining of the womb in certain fertility treatments.

The appropriate assessment will depend on your individual fertility history and treatment needs.

Ultrasound and endometriosis

A specialist pelvic ultrasound can provide valuable information when endometriosis is suspected.

In some women, ultrasound may identify an endometrioma or signs of deep endometriosis.

However, a normal scan does not mean that endometriosis has been excluded. Symptoms remain an important part of the assessment, and further investigations such as MRI or, in selected cases, laparoscopy may be considered.

When might I need an MRI instead?

MRI uses magnetic fields and radio waves to create highly detailed images of the pelvis.

It may be recommended when ultrasound does not provide enough information or when your specialist needs a more detailed assessment of a particular condition.

MRI can be particularly useful for assessing more extensive endometriosis and certain complex pelvic conditions.

Ultrasound and MRI are complementary investigations rather than competing tests. Your consultant will recommend the most appropriate imaging based on your symptoms and suspected diagnosis.

Why specialist interpretation matters

An ultrasound is only one part of your medical assessment.

The significance of a finding depends on factors such as:

• Your age
• Your symptoms
• Your menstrual history
• Whether you have gone through the menopause
• Your previous medical history
• Examination findings
• Previous imaging
• Blood test results
• Your individual risk factors

This is why ultrasound findings should always be interpreted in their wider clinical context.

Gynaecological ultrasound at Gynae Solution

At Gynae Solution, ultrasound is used as part of a wider specialist assessment of women's health.

Mr Jafaru Abu is a Consultant Gynaecologist and Gynaecological Oncology Surgeon specialising in complex gynaecological conditions, including ovarian, cervical and endometrial cancers.

A scan may be used to investigate symptoms, clarify a suspected diagnosis, monitor an existing condition or help plan treatment.

Where further investigation is required, your results can be considered alongside other diagnostic tests to develop a clear and personalised treatment plan.

Book a consultation

If you have been experiencing pelvic pain, abnormal bleeding, heavy periods, ovarian symptoms or another gynaecological concern, a specialist consultation can help determine whether an ultrasound or other investigation is appropriate.

At Gynae Solution, we aim to make every stage of your assessment clear, comfortable and personalised, helping you understand what your symptoms may mean and what happens next.

Related services

• Ovarian cysts
• Fibroids
• Endometriosis
• Post menopause bleeding
• Hysteroscopy
• Menstrual disorders
• Pelvic pain

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