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Transvaginal Gynaecological Ultrasound

Transvaginal gynaecological ultrasound is a safe, painless and highly accurate imaging exam used to assess the female pelvic organs in great detail. By allowing close visualisation of the uterus, ovaries and endometrium, it is frequently used in the investigation of gynaecological symptoms and for clinical follow-up.

What is a Transvaginal Gynaecological Ultrasound and what is it for?

A transvaginal gynaecological ultrasound (also known as endovaginal ultrasound) uses high-frequency sound waves (ultrasound) to produce real-time images of the female pelvic organs through the insertion of a probe into the vaginal canal.

Because it provides a closer view of pelvic structures, this exam is particularly useful for:

  • Assessing the uterus, including the myometrium and cervix;
  • Evaluating the endometrium (thickness, appearance and possible abnormalities);
  • Visualising the ovaries and identifying ovarian cysts;
  • Detecting adjacent pelvic changes, when visible.

How much does a Transvaginal Gynaecological Ultrasound cost?

The price of a transvaginal gynaecological ultrasound is €65 on a private basis. However, X-Clinic has agreements with:

  • ADSE (the patient only pays a co-payment of €8), ADM GNR, SAD PSP;
  • Insurance companies: Médis, Multicare, Advance Care, Allianz, Saúde Prime, Future HealthCare, SS CGD, SAMS Quadros, SAMS, Montepio, RNA, Generali, Mudum, MGEN, Aegon, Vitória, Una Seguros, and others;
  • Health plans: Medicare, Saúde Prime, Future HealthCare, Continente Wells, ACP, and other health plans.
  • Protocols: X-Clinic has agreements with several clinics and institutions that allow you to have the exam done at very competitive rates. In the case of a transvaginal (endocavitary) gynecological ultrasound, the protocol price is €48.

The final price varies depending on the healthcare system or insurance you choose.

How is it performed?

During a transvaginal gynaecological ultrasound, the patient lies on an examination table in a dimly lit room to facilitate image assessment.

The doctor uses a transvaginal (endocavitary) probe, which is properly covered and lubricated, and gently inserts it into the vagina to obtain detailed images of the uterus, ovaries and endometrium.

The images are viewed in real time on a monitor and interpreted by an imaging specialist. The exam usually lasts between 15 and 30 minutes.

What does it detect?

Transvaginal gynaecological ultrasound may help identify and assess:

  • Uterine fibroids;
  • Endometrial polyps;
  • Ovarian cysts;
  • Endometrial abnormalities (such as thickening);
  • Findings compatible with certain forms of endometriosis (depending on location and visibility);
  • Structural abnormalities of the uterus and ovaries;
  • Other relevant pelvic findings, when visible.

In which cases is it indicated?

This exam is commonly requested in situations such as:

  • Abnormal uterine bleeding;
  • Pelvic pain;
  • Menstrual irregularities;
  • Suspected pathology of the uterus, endometrium or ovaries;
  • Assessment and follow-up of cysts and fibroids;
  • Infertility investigation and ovulation monitoring, when applicable.

Preparing for a Transvaginal Gynaecological Ultrasound

For this exam, the following recommendations apply:

  • Empty bladder (ideally urinate before the exam);
  • No fasting is required;
  • You may take your usual medication.

Whenever possible, bring previous exams (ultrasounds, laboratory tests and/or medical reports) as well as the exam referral.

Where to have it done?

A transvaginal gynaecological ultrasound can be performed at X-Clinic (Av. Eng. Duarte Pacheco, nº 26 – mezzanine floor, 1070-110 Lisbon) or at NRD (Avenida Columbano Bordalo Pinheiro, nº 11-B, ground floor, 1070-060 Lisbon – near Praça de Espanha).

Transvaginal Gynaecological Ultrasound

Does transvaginal gynaecological ultrasound hurt?

Generally no. The exam may cause mild discomfort, particularly in cases of pelvic pain, inflammation or muscle tension, but it is usually well tolerated.

When will I receive the results?

A preliminary comment may be provided immediately after the exam, but the final written report, prepared by the doctor, will be available within a maximum of 7 days.

Do I need to fast?

No. Fasting is not required for this exam.

Can this ultrasound be performed during menstruation?

Yes, it can, depending on the purpose of the exam. 

For the assessment of abnormal bleeding or pelvic pain, it may be performed during menstruation. 

For endometrial evaluation (e.g. polyps) or fertility assessment, it may be preferable to schedule the exam on specific days of the cycle, according to medical guidance.

Is transvaginal gynaecological ultrasound safe during pregnancy?

In general, yes, when medically indicated and performed by trained professionals. It does not use radiation. In early pregnancy, it may be used to assess the uterus and confirm location and viability, depending on the clinical situation.

Are there any risks associated with gynaecological ultrasound?

The risks are very low. The exam does not use ionising radiation. Mild discomfort may occur during the procedure and, rarely, light spotting, particularly if the cervix is sensitive.

How long does the exam take?

A transvaginal gynaecological ultrasound usually takes between 15 and 30 minutes.

Can I have this exam if I have never had sexual intercourse?

It depends. Transvaginal ultrasound may not be the first option if you have never had sexual intercourse. In such cases, a suprapubic pelvic ultrasound or another appropriate approach may be recommended. It is advisable to mention this information when scheduling or at reception so the most suitable option can be arranged.

Does this ultrasound replace CT or MRI scans?

Not always. It is often the first imaging exam requested, but it may be complemented by other imaging methods (such as MRI or CT) when necessary, depending on the clinical suspicion.

Do I need to have a full bladder?

No. For transvaginal gynaecological ultrasound, the usual recommendation is an empty bladder (urinating before the exam) to improve comfort and image quality.