Transvaginal Ultrasound: What to Expect & Why It's Done

A transvaginal ultrasound - sometimes called an internal ultrasound - uses a slim, specially designed probe placed gently into the vagina to image the uterus, ovaries, and surrounding pelvic structures at close range.

Because the probe sits much closer to those organs than one moving over your abdomen, the images are significantly clearer and more detailed. It's a routine, everyday examination in Australian imaging clinics, usually performed as part of a pelvic ultrasound.

Common reasons include:

• Investigating pelvic pain, heavy or irregular bleeding • Getting a clearer view of the ovaries and uterine lining than an abdominal scan can provide • Checking suspected fibroids, polyps, or ovarian cysts • Early pregnancy - confirming dates, location, and heartbeat when the pregnancy is still too small to see well from the outside • Fertility tracking and IVF monitoring

In most of these situations, the transvaginal view answers the clinical question more reliably - which can save you a repeat scan later.

You'll be asked to empty your bladder, undress from the waist down in private, and lie on the examination bed with a sheet over you.

The sonographer covers the slim probe with a protective sheath and gel, then gently inserts it a few centimetres into the vagina, angling it slightly to image each structure. The scan usually takes 10-20 minutes.

A few things you're always entitled to:

• The scan only happens with your informed consent - the sonographer will explain it first • You can ask for a chaperone, or bring a support person • You can ask for a female sonographer when booking - most clinics accommodate this • You can ask to stop at any time

For most people it's not painful - the usual description is pressure or mild discomfort, similar to or less than a cervical screening test. The probe is slim (much smaller than a speculum) and only inserted a few centimetres.

If you have a condition that makes internal examinations painful, or you feel anxious about the scan, tell the clinic when you book and the sonographer on the day. They can go slowly, explain each step, or discuss alternatives with your referring doctor. You can decline the internal scan entirely - the trade-off is simply that abdominal images may be less clear.

Yes. Transvaginal ultrasound is safe at every stage of pregnancy and is especially common in early pregnancy, when the baby is too small to see clearly through the abdomen.

It uses sound waves, not radiation, and the probe doesn't reach or disturb the pregnancy. If you're having an early dating scan, it's worth knowing an internal scan may be offered - it's routine, and it often turns an inconclusive early scan into a clear answer.

Preparation is simple - and almost the opposite of the abdominal scan:

• Empty your bladder just before the scan (the clinic will tell you when) • If you're having a combined pelvic ultrasound, you'll need a full bladder first for the abdominal part, then you'll be asked to empty it • Wear comfortable, two-piece clothing • You can attend during your period if needed - just tell the clinic when booking, as timing sometimes matters for the clinical question

Bring your referral, Medicare card, and any previous pelvic imaging.

A transvaginal scan is usually billed as part of a pelvic ultrasound rather than as a separate test. With a valid referral and Medicare card, many clinics bulk bill it - no out-of-pocket cost - while others charge a gap commonly up to around $100.

Prices and billing policies differ clinic to clinic, so compare before you book. Search ultrasound clinics near you on Radly, check bulk-billing notes on each profile, and request a booking online with your referral.