TMI: Tales From a Transvaginal Ultrasound

Transvaginal. This was not a word that either existed in my vocabulary prior to having just such a scan, or that my GP thought to mention as she referred me for an ultrasound with a breezy, “I’m sure they won’t find anything, but it’s best just to check." The reason for the referral was that my period had turned into a homicidal maniac and the Pill was having little to no effect on it. It was time to start exploring other options, including a range of growths, cysts, wonky bits and tumours benign or otherwise that might be the cause of the problem. 

Partly to find out exactly what might be found and partly to find out just what the scan would entail, I turned to Dr Google. It was here, thanks to the search terms ‘ultrasound’ and ‘period problems’, that the word ‘transvaginal’ first made its triumphant entry into my consciousness, about six weeks before it made one into my vagina. 

As it turned out, this was around the same time that certain elements of the Republican Party in the US were embarking on a noble mission to educate the world on gynaecological matters by trying to make transvaginal ultrasounds mandatory for women seeking an abortion. As such, it was relatively easy to find women who were arguing against this by sharing their own experiences of transvaginal ultrasounds. In this context, recurrent phrases included 'medical rape' and 'monster dildo probe'. These were not things that I wanted to read, much less have done to me. It sounded painful, invasive and incredibly embarrassing. Although forewarned is forearmed, I was therefore somewhat nervous as I made my way to the local hospital. What actually happened, however, was neither painful nor invasive - and the most awkward part of the whole thing was when my right ovary went temporarily AWOL. 

This is how the scan went in 10 simple, pain- and embarrassment-free steps:

1. I nearly wet myself. This was not due to the fear of the “monster dildo probe”, but because an hour prior to a scan you have to drink 1.5 litres of water and I have a small bladder at the best of times. This would have been embarrassing, but wasn’t.

2. I nearly wet myself, version 2. Once called into the consulting room and introduced to the nurse and the nice (female) doctor, I then had a transabdominal scan, the sort that they give to pregnant women. This happens exactly like it does on TV, except expectant mothers are generally shown as joyous and/or serene, not wondering if they are about to watch their own bladders rupture on the ultrasound monitor. And while the gel really is that cold, another difference is that the transducer (the thing they hold on your stomach) is not used to glide gently over your skin, but is pressed in quite hard. Right on your painfully full bladder. On the monitor, my insides looked like a grey Ordnance Survey map, and the doctor could have, quite frankly, told me that I was gestating sextuplets as long as I was then able to go to the loo. This was uncomfortable, but mostly due to the bladder situation.

3. I was finally allowed to wee! Before moving on to the transvaginal scan, I was allowed to go and use the bathroom. This was the Best Wee Ever.

4. I prepared to meet the probe. Back in the room, and now looking a lot less like the pregnant women in the waiting area now my bladder was no longer distended, I was instructed to remove my pants, skirt and tights. I then hopped back on the bed and covered my lower half with the paper sheet thing that is always provided for these sorts of occasions. So far, so like any other pelvic exam. Had I not been used to pelvic exams, this would probably have been a bit embarrassing, but such are the perks of having a problem uterus.

5. I meet the probe. Once I was settled on the bed, the doctor showed me the probe and explained what would happen. The probe, which was to be inserted into my vagina, was perhaps 30cm long. This does not mean that all 30cm had to fit inside me, the length was to give the doctor room to hold and manipulate it properly. Girth-wise, it was probably as wide as a regular tampon and a half. Maybe two tampons at the very outset. While it did look very phallic, it was in no way “monster” in size. Here are some things that are wider than the probe and that you may insert into your vagina: one of more fingers, a mooncup, a penis, and actual dildo. The doctor explained that it would be inserted into my vagina up to my cervix and then gently moved around so that the various parts of my reproductive system could be examined in greater detail than allowed through the transabdominal scan. This was reassuring.

6. The probe prepares to meet me. Before inserting it, the doctor put a condom on the probe. An ordinary, NHS issue condom of the sort that are handed out in Family Planning clinics. There is nothing funnier than a phallic object wearing a condom that is clearly too big, flapping around. Then it was rolled around in so much lube that it spent the rest of the day squelching out of me and gently inserted. I was assured that it shouldn’t hurt and that if it was painful at any point, all I had to do was say and we could stop. Again, this was reassuring, and in the case of the condom, quite funny.

7. Cervix, meet probe. Although I was aware that the probe had been inserted, it was only when the end of it bumped into my cervix that I really felt it. Personally (and I'm probably not alone in this), I don’t like anything touching my cervix, so there was a bit of discomfort. At no point, however, was it painful, difficult or more than mildly embarrassing. The doctor then moved the probe around systematically, keeping a commentary so I knew what she was doing and what was being checked. With each movement, I could feel the probe against my cervix. This was a bit uncomfortable, not painful or even that invasive feeling.

8. My right ovary goes missing. After five or ten minutes, the doctor said, “OK, I’m just going to check your right ovary and then we’re done here”. There was some more movement against my cervix, and then some more, this time a little bit more insistent. This was a bit more uncomfortable, a sort of weird pushing feeling. Then it was announced that my right ovary could not be found and a second opinion would have to be sought. The nurse was dispatched to find another doctor. 

9. I discuss Greek tragedy while a doctor holds an ultrasound probe in my vagina. It took about ten minutes to find another doctor, conversation had to be made and this was what I was studying at the time. I do not think that this is a typical part of a transvaginal scan. This was weird, and not something I mentioned in any of my essays.

10. My ovary is located. The second doctor arrived and took over the probe. To be honest, this was probably the most uncomfortable part of the whole thing, as it sort of felt like she was digging under my cervix to try and find the missing ovary. It was eventually located hiding behind my uterus. I was shown it on the monitor, as proof that it was there, but it just looked like more grey swirls. This was again uncomfortable, and a bit awkward as it was quite a small room and my knee kept getting in the way of the second doctor.

After this, the probe was withdrawn and I was allowed to clean up and put my clothes on. The doctor assured me that it didn’t look like there was anything there that shouldn’t be, but this would be confirmed with my GP once the images had been reviewed. Then I went home. Sadly, I was not given a picture of my uterus to flash around in the manner of an expectant parent. This had been the bit to which I had been most looking forward.

Since then, I have had a further two scans, both to check the position of my Mirena coil after the strings that you’re meant to be able to check went missing. Clearly, I have something of a talent for losing things around my uterus. Bar the case of the missing ovary, every single scan has followed roughly the same format, never painful and never anything to be scared of. If it is either of those things, then the doctor will stop and reassess the situation. 

In short, transvaginal ultrasounds are neither as embarrassing nor as scary as they sound. But every once in a blue moon, they can be a great source of comedy.