Transvaginal Ultrasounds & Endometriosis

Diagram of a transvaginal ultrasound

You may have heard that you can’t see Endometriosis on an imaging study.  Well, this is true…BUT, it’s not to say that imaging studies are useless in helping to suspect/diagnose Endometriosis.  They can spot things that may indicate Endometriosis is present…One such tool is a transvaginal ultrasound (aka TVU, TVS, or TVUS).

Have you ever heard of, or had, a transvaginal ultrasound? Let me tell you : it’s not the ultrasounds you see in the movies.  No cold cream squished onto my belly with a technician rubbing a scanner along my abdomen. Nope…imagine if you will : squishy cold cream rubbed onto the tip of a rather large probe…and said probe is shoved up your hoohaw (yes, that’s a technical term).  It allows a better look at your organs around your feminine bits.  It’s not the most comfortable procedure in the world…and can downright hurt at times. But…

TVUs may be useful in spotting Endometriomas, ovarian immobility, abnormal ovary size, deep-infiltrating Endo lesions, or ovaries that are out of place (one may be higher than the other or fixed to the uterus, indicating adhesions).  Pain, tenderness, or sensitivity during the ultrasound may also be an indicator of deep-infiltrating Endometriosis lesions or Endometriomas.  TVUs are proving especially useful in trying to predict the severity of Endometriosis prior to surgery.

However, all that being said, transvaginal ultrasounds are no guarantee as an accurate diagnostic tool in spotting Endometriosis.  They are only as good as their operator.  Or, in most cases, Endometriosis isn’t visible in an imaging study.  Always feel free to ask for a second opinion.  Always.

So…if you are suffering from the symptoms of Endometriosis, please know that you may have nothing unusual show up on a transvaginal ultrasound.  Just because they can’t see it, or the indicators that it’s there, doesn’t mean you don’t have it.  It may just mean that it’s not showing up.

However, studies have shown that transvaginal ultrasounds can be powerful diagnostic pre-operative tools in helping confirm suspicious of Endometriosis.  Consider it one more tool in our little bag of tricks!

Continue to always push for your treatments.  Advocate for yourself.  Be heard.


American Institute of Ultrasound in Medicine – (Article; 2012) Sonography Should Be the First Imaging Examination Done to Evaluate Patients with Suspected Endometriosis

BioMed Central – (Article; April 2013) Ultrasound Mapping of Pelvic Endometriosis: Does the Location and Number of Lesions Affect the Diagnostic Accuracy? A Multicentre Diagnostic Accuracy Study

European Journal of Obstetrics & Gynecology and Reproductive Biology – (Abstract; Feb. 2016) Update on the Ultrasound Diagnosis of Deep Pelvic Endometriosis

Middle East Fertility Society Journal – (Abstract; Sept. 2014) Prediction of Endometriosis by Transvaginal Ultrasound in Reproductive-Age Women with Normal Ovarian Size

Clinical Obstetrics and Gynecology (Article; June 2011) Invasive and Non-Invasive Methods for the Diagnosis of Endometriosis

Ultrasound in Obstetrics & Gynecology (Abstract; Aug. 2010) Value of Transvaginal Ultrasound in Assessing the Severity of Pelvic Endometriosis

Ultrasound in Obstetrics & Gynecology (Article; 2009) Transvaginal Sonography for the Assessment of Ovarian and Pelvic Endometriosis : How Deep is Our Understanding?

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

3 thoughts on “Transvaginal Ultrasounds & Endometriosis

  1. The operator is key. I’ve had countless vaginal sonograms and until two weeks ago NEVER knew what adenomyosis was much less that I was suspected of having it. The clues have been there all along, but a good detective was lacking. Thanks for educating us so we know what to ask for!

    Liked by 1 person

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