Pelvic Ultrasound
A pelvic ultrasound is one of the most common and useful imaging tests we use in women’s health. It creates detailed pictures of the uterus, ovaries, and other pelvic organs using harmless sound waves — no radiation is involved.
Pelvic ultrasound can be done either through the abdomen (transabdominal) or through the vagina (transvaginal). For most gynecologic concerns, we prefer the transvaginal approach because it gives much clearer, more detailed images of the uterus and ovaries. We sometimes combine both methods during the same visit when needed.
Why Do We Recommend a Pelvic Ultrasound?
We often suggest this test when you have symptoms such as pelvic pain, abnormal or irregular bleeding, or when something unusual is found during a pelvic exam. It is also helpful for investigating causes of infertility, checking the position of an IUD, evaluating fibroids or ovarian cysts, or assessing the lining of the uterus — especially in women with postmenopausal bleeding.
What Are We Looking For During a Pelvic Ultrasound?
The scan lets us see the size, shape, and texture of the uterus and ovaries, measure the thickness of the uterine lining, identify cysts or fibroids, look for fluid in the pelvis, and check whether everything appears normal. In many cases, it helps us understand the reason for your symptoms and decide on the best next steps.
How the Test Is Done (Transvaginal Ultrasound)
The procedure is quick — usually 5 to 10 minutes — and performed in a comfortable outpatient setting.
You will be asked to empty your bladder before the scan. You lie on the exam table in a position similar to a regular pelvic exam. A thin, wand-shaped probe is gently inserted into the vagina after it is covered with a disposable sheath and lubricant. The probe is moved carefully to obtain the best images from different angles.
Most women feel only mild pressure, and the test is generally well tolerated. No special preparation is usually needed, though we may give you specific instructions depending on the reason for the scan.
What Can TVS Detect?
Transvaginal ultrasound is excellent at showing fibroids, ovarian cysts, polyps in the uterus, thickening of the endometrial lining, and the presence of fluid or other abnormalities. It is particularly valuable for evaluating abnormal bleeding and for checking IUD position.
What TVS Cannot Detect or May Miss
While TVS is very helpful, it has some limitations. It may not always detect superficial endometriosis, very small lesions, or early cancers with complete certainty. In some cases, especially if there is scarring, gas in the bowel, or if you carry extra weight, the images may be less clear. When findings are uncertain, additional tests, such as a CT scan, MRI or a biopsy may be indicated for a more complete picture.
Is Pelvic Ultrasound Safe?
Yes. Ultrasound uses only sound waves and has no known risks. It is considered safe for women of all ages.
Key Takeaway
Transvaginal pelvic ultrasound is a simple, comfortable, and highly informative test that helps us understand what is happening inside the pelvis. It is always optional and is performed only when it can truly add useful information to guide your care.
If you are experiencing pelvic pain, abnormal bleeding, or have other concerns, please schedule a consultation. We will discuss whether a pelvic ultrasound would be helpful for you and answer any questions you may have in a supportive way.
References
1. American College of Obstetricians and Gynecologists. Ultrasound exams. ACOG Frequently Asked Questions. Washington, DC: ACOG; 2025. Available from: https://www.acog.org/womens-health/faqs/ultrasound-exams.
2. American Institute of Ultrasound in Medicine. AIUM practice parameter for the performance of ultrasound of the female pelvis. J Ultrasound Med. 2024. doi:10.1002/jum.16556.
3. Berek JS, editor. Berek & Novak’s gynecology. 17th ed. Philadelphia: Wolters Kluwer; 2025.
4. American College of Obstetricians and Gynecologists. The role of transvaginal ultrasonography in the evaluation of the endometrium of women with postmenopausal bleeding. Committee Opinion No. 734. Obstet Gynecol. 2018;131(5):e124-9. (Reaffirmed 2023).
Maternal–Fetal Medicine Specialist in Bangkok
Dr. Narisra Srikureja Firer (Dr. Niti)
Dr. Niti is a Bangkok-based OBGYN with subspecialty training in Maternal–Fetal Medicine (MFM). She provides comprehensive care for women across all stages of life, including pregnancy care, deliveries, and general gynecological conditions.
She dedicates her time to private practice at Ruamjairak Hospital and Mission Hospital, and serves as a Maternal–Fetal Medicine Consultant at a large government tertiary care center.
To read Dr. Niti’s full bio, click here.
