Transvaginal Ultrasound for Ovarian Cysts

Transvaginal Ultrasound: The "Gold Standard" for Ovarian Cysts

Ovarian cysts are a common condition affecting the ovaries and usually don’t cause any symptoms. However, when these cysts do cause symptoms, such as pelvic pain and abdominal bloating, a transvaginal ultrasound is the gold standard imaging tool for diagnosis.

Here, we’ll explore how a transvaginal ultrasound works, how to prepare for your transvaginal ultrasound and what to expect during and after your scan.

Understanding transvaginal ultrasound

What is a transvaginal ultrasound and how is it performed?

An ultrasound scan is a type of medical imaging that uses high frequency sound waves (ultrasound) to create real-time images of the soft tissue in the female pelvis.

The sound waves are released by an ultrasound probe or transducer that’s passed over the part of the body being investigated. The sound waves bounce off boundaries between different tissues and areas of different densities.

The reflected sound waves are detected by the ultrasound probe. These signals are turned into digital, greyscale images on a screen. As over 1,000 reflected sound waves can be detected in one second, this allows for live images to be created.

In a transvaginal ultrasound scan, the ultrasound probe is a thin, wand-like device that’s gently inserted into the vagina. This allows images of pelvic organs, such as the ovaries, womb, fallopian tubes and other reproductive tissues, to be created.

As the transducer is inserted into your body, a transvaginal ultrasound scan is also known as an internal ultrasound scan.

Difference between transvaginal and abdominal ultrasound

An abdominal ultrasound examination can also be used to create images of the female reproductive system.

It’s also called a transabdominal scan or external scan. The ultrasound probe is not inserted into your body but instead passed across your lower abdomen.

A transabdominal scan may not detect subtle changes, such as small ovarian cysts. This is because the images created are of a lower resolution than those created during an internal scan (transvaginal ultrasound).

Clinical applications of transvaginal ultrasound examinations

Diagnosing ovarian cysts

If your doctor suspects that you have ovarian cyst pain, they may recommend that you have a transvaginal ultrasound of your pelvis. This provides clearer images of your ovaries than a transabdominal ultrasound and can pick up smaller cysts.

Ovarian cysts are fluid-filled sacs in and on the ovaries. Most women develop ovarian cysts as a natural part of their menstrual cycle. These are called simple cysts or functional cysts. They’re not harmful, usually don’t cause symptoms, and often go away on their own within 2 months.

However, some ovarian cysts do not form as part of the menstrual cycle. They can be caused by:

Abnormal cell production
Endometriosis
PCOS, now renamed PMOS
Pelvic inflammatory disease (PID)

In the majority of cases, such as in PMOS, these ovarian cysts still don’t cause symptoms. However, in a minority of cases, they can cause ovary cyst pain if they are large, become twisted or burst.

Fewer than 1 in 100 ovarian cysts turn into ovarian cancer. Ovarian cysts that could become cancerous usually occur after menopause.

Transvaginal ultrasound for PCOS diagnosis and as a fibroid scan

A transvaginal ultrasound scan can help diagnose PCOS (polycystic ovary syndrome) by detecting ovarian cysts. However, PCOS does not always cause ovarian cysts. This is part of the reason why PCOS was renamed polyendocrine metabolic ovarian syndrome (PMOS) in 2026.

Transvaginal ultrasound can also be used to diagnose uterine fibroids. These are solid growths in or on the womb (uterus). They are not cancerous, and it’s exceptionally rare for them to become cancerous.

How to prepare for a transvaginal ultrasound scan

You don’t need a full bladder for a transvaginal ultrasound scan. You may even be asked to empty your bladder before your scan.

If you’re on your period, you can still have the scan. However, if you use tampons, you’ll be asked to remove your tampon. You may want to wear a sanitary pad instead on the day of your scan.

You can eat, drink and take any medications and supplements as usual.

As you’ll be asked to undress from the waist down, you may want to wear loose, comfortable clothing that’s easy to remove.

What to expect during transvaginal ultrasound

When you arrive for your scan, the procedure will be explained to you, and you’ll be asked to sign an informed consent form.

You will be provided with a chaperone during your scan. This will be another member of staff who is not performing the scan but will be with you throughout the whole process. You can also bring along a friend or family member to be with you during your scan.

You will be asked to undress from the waist down and/or change into a hospital gown. You will lie down on an exam table, with your knees bent, legs parted, and feet placed on the table. If needed, you may be asked to change into different positions to help get a clearer view of your reproductive organs during your scan.

The ultrasound probe will be cleaned and wrapped with a protective cover. A lubricating gel will be applied to the probe before it is gently placed into your vagina.

The probe will be inserted about as far up as a tampon. This means it will not pass through the opening of your womb (cervix). It will be moved gently and rotated to create images of your ovaries, womb and surrounding soft tissue from different angles.

Is a transvaginal ultrasound painful or uncomfortable?

You may feel slight discomfort when the ultrasound probe is inserted, as well as some pressure when it is moved around. However, a transvaginal ultrasound scan is not usually painful or very uncomfortable.

If you feel uncomfortable during your scan, you can ask the person performing your scan (the sonographer) to stop at any time.

A transvaginal ultrasound scan usually takes around 20 minutes.

What happens after your scan

You will be given paper towels to clean off any lubricating gel from your genital area. You will then be able to get dressed in private, and can return to your normal activities.

You may experience some light vaginal bleeding after your scan and may want to wear a panty liner for the rest of the day. Any bleeding should stop within 24 hours.

At Vista Health, we aim to email you a full report with your results within 3 working days of your scan. Your results can also be sent to your NHS GP. Alternatively, you can book a private GP appointment with Vista Health to discuss your results.

Your GP will explain any abnormal findings and, if needed, discuss whether you need other tests and treatment.

Uncover the cause of your pelvic pain

If you have unexplained symptoms, such as pelvic pain or abdominal bloating, find out what’s going on with a private ultrasound scan of your pelvic organs.

You don’t need a letter from a referring doctor. Simply self-refer and book online at one of our nationwide clinics to get the clarity you need at a time that suits you.