Women's Health Imaging: Pelvic, Breast & Bone Scans

Many of the most common imaging tests in Australia relate to women's health - from pelvic ultrasounds investigating period pain in your twenties, to pregnancy scans, breast screening from midlife, and bone density checks after menopause.

Knowing what each test involves takes much of the anxiety out of the referral. This guide covers the big four: pelvic ultrasound, breast imaging (mammogram, ultrasound, and MRI), DEXA bone density scans, and the national screening programs available to you.

As always, this is general information rather than medical advice - your GP is the right person to decide which test suits your symptoms and history. When it's time to book, you can use Radly to compare clinics across Victoria, including bulk billing, prices, and opening hours.

Pelvic ultrasound examines the uterus, ovaries, and surrounding structures. It's commonly ordered for heavy or painful periods, irregular bleeding, pelvic pain, suspected fibroids or ovarian cysts, and fertility investigations.

There are two approaches, often used together:

• Transabdominal - the probe moves over your lower abdomen. You'll usually need a full bladder, which lifts the bowel out of the way and improves the images. • Transvaginal (internal) - a slim probe is gently inserted into the vagina, giving much clearer, closer images of the uterus and ovaries. It's done with your consent, in privacy, and you can ask for a chaperone or decline it - though image quality is often better.

The scan takes around 20-40 minutes and is frequently bulk-billed with a referral. Timing in your cycle sometimes matters, so follow the clinic's booking instructions.

Three tests cover most breast imaging, each with a different role:

• Mammogram - a low-dose breast X-ray, and the most effective screening test for detecting breast cancer early. Briefly uncomfortable due to compression, but quick. • Breast ultrasound - no radiation; particularly useful in younger women with denser breast tissue, and for working out whether a lump is a fluid-filled cyst or solid. Often done alongside a mammogram. • Breast MRI - reserved mainly for women at high risk (for example, strong family history or a BRCA gene mutation) and certain diagnostic situations. Medicare rebates apply only in specific circumstances.

If you find a lump or notice a breast change at any age, see your GP promptly - investigation of symptoms uses a combination of examination and imaging tailored to you, not just one test.

BreastScreen Australia is the government-run program providing free screening mammograms to eligible women, with no referral needed. In Victoria you book directly with BreastScreen Victoria - eligibility, screening intervals, and locations are set by the program, so check the current details on the official BreastScreen Victoria website.

Screening is for women with no breast symptoms - if you have a lump, pain, nipple discharge, or skin changes, see your GP instead, as you need diagnostic imaging rather than screening. See our BreastScreen vs diagnostic mammogram guide for how to tell which path applies to you.

Women at higher risk due to family history may be advised to start earlier or screen differently; your GP can help map out the right schedule for you.

After menopause, falling oestrogen levels accelerate bone loss, which is why osteoporosis is far more common in women. A DEXA scan (bone densitometry) is the standard test - a quick, very low-dose X-ray of the hip and spine that takes about 10-20 minutes, fully clothed, with no injections.

Your result is reported as a T-score comparing your bone density to a healthy young adult, which helps your doctor assess fracture risk and decide whether treatment is worthwhile.

Medicare rebates apply in specific situations - including everyone aged 70 and over, and younger patients with risk factors such as early menopause, long-term steroid use, or a previous minimal-trauma fracture. If you don't meet the criteria, a privately billed DEXA is relatively inexpensive compared with other scans. Ask your GP whether and when a DEXA makes sense for you.

A few practical points make these appointments smoother:

• Timing - some pelvic ultrasounds are best done at a particular point in your cycle, and mammograms are more comfortable in the week or two after your period. Ask when booking. • Preparation - full-bladder instructions for pelvic scans, and no deodorant or powder on mammogram day. • Preferences - you can ask for a female sonographer or radiographer when booking; most clinics accommodate this for intimate examinations. • Continuity - bring or nominate previous breast imaging so the radiologist can compare year on year.

Costs vary between clinics, so use Radly to compare imaging providers near you, check which ones bulk-bill, and find appointment times that fit around work and family. Your GP can talk through any of these tests before you book.