A gynecological ultrasound is a diagnostic test that has meant a great advance in women’s health because it allows the organs of the pelvis to be studied with an ultrasound probe, in a safe and non-invasive way.
Despite this and the fact that it is a widely used technique, “there is still a lot of ignorance around it,” says the Dr. Cristina Rosgynecologist at .
How to practice it, can it only be carried out if the woman is menstruating? Can’t it be done in women who have not had penetrative sex?… These are some of the questions and doubts that are still raised in gynecological consultations and to which the specialist answers.
1- Is the ultrasound only performed vaginally?
No. Gynecological ultrasounds can be of three types:
-
ultrasound scans transabdominal It is performed by placing the ultrasound probe on the abdomen.
-
ultrasound scans transvaginal. In these cases, the probe is placed inside the vagina, achieving a very clear view of the pelvic organs, which is why it is the most used.
-
ultrasound scans transrectal. This type of ultrasound, which is performed through the rectum, “is used when the organs of the pelvis need to be seen in detail and a transvaginal ultrasound cannot be performed; for example, in women who have a very narrow vaginal entrance, those who have not had sexual relations, those who find it uncomfortable or those who do not want to”, explains Dr. Ros.
2- Is the ultrasound part of a conventional gynecological examination?
No. Ultrasounds are not part of a conventional gynecological exam.
-
“If there are symptoms suggestive of a disease or suspicion during a physical examination (for example, abdominal palpation or vaginal examination), this test can be requested at any time in the woman’s life,” explains the expert.
The reason it is not always performed is that there is no evidence that “an examination changes the prognosis of diseases such as ovarian or endometrial disease in asymptomatic women”, quite the opposite of what happens with a mammogram or cytology.
3- Can you harm the female sexual organs if you do too many?
We have already seen that it is an innocuous test, which does not use radiation but sound waves, so “as many ultrasounds can be performed as necessary without having any negative effect on the patient.”
4- Can’t I have an ultrasound if I have my period?
It is best to perform this test right after finishing the . The reason is that “this is the best time to study any disease in the uterine cavity, because the endometrium is very thin,” explains the gynecologist.
For example, if what the specialist wants is to see if the woman ovulates, the best time to do this imaging test is 2 weeks after the period. This way you can clearly see “the hole left by ovulation in the ovary”.
But there are cases in which the period is not an impediment, but the moment for the specialist to study, in addition to anatomy, the function of the organs of the female reproductive system.
“In fact, for women with persistent bleeding or who bleeds during the , it is better to do the test during the bleeding, even though it is done transvaginally,” the doctor details.
5- It is not indicated for women who have not had penetrative sex
This is one of the points where there are more false beliefs. So Dr. Ros clarifies that “for girls or adolescents who need this type of test, but who have not had a sexual relationship, an abdominal ultrasound is first attempted with a full bladder.”
In the event that the specialist does not achieve a sufficiently good image of the pelvic organs in this way, he may recommend performing the test transvaginally or transrectally with an empty bladder.
-
“Women who have not had penetrative sex often have a preserved hymen, so it can be difficult to insert the transvaginal catheter. If it does not easily enter the vagina, the transrectal route is considered.
This type of ultrasound is not painful and thanks to it you can obtain images practically the same as those of vaginal ultrasound. “In addition, no type of intestinal preparation is necessary,” adds the gynecologist.
But if the vaginal probe can be inserted without pain, even with an intact hymen, this option is preferred.
6- Is it only used to see the uterus and ovaries?
One of the advantages is that this type of imaging test allows us to observe not only the uterus and ovaries, but also other pelvic organs such as the bladder and rectum. And it is that there are gynecological pathologies, such as endometriosis or uterine cancer, which can affect these organs.
-
“In addition, women with urinary or fecal problems, for example, can undergo a gynecological ultrasound to evaluate the bladder walls and the movements of the urethra or the sphincters in the anus,” adds the gynecologist at the Hospital Clinic.
Also non-gynecological diseases (tumors of the pelvis) can be diagnosed by means of a gynecological ultrasound.
7- Is it enough to diagnose any disease of the female reproductive system?
Although the test provides a lot of information, sometimes additional tests are needed to diagnose pathologies or infertility problems.
-
“For example, this test is not useful to study cervical infection by the human papillomavirus, unless this infection triggers a cervical tumor”, explains Dr. Ros.
If lesions compatible with tumors are seen in the ovaries and uterus, it will be a pathologist who, through a tissue sample, makes the final diagnosis.
Regarding infertility problems, “ultrasound can study the ovarian anatomy and make an indirect calculation of the ovarian reserve; however, the quality of the eggs cannot be determined”, so other types of tests will have to be carried out.