Pelvic ultrasound is an imaging examination of the lower abdomen and pelvis. A sonographer or other appropriately trained professional uses a probe to create images with sound waves, not ionising radiation. The appropriate scan approach, its likely contribution and its limits should be clear before you proceed.[1]
This page explains the examination in plain language. It cannot decide whether a scan is right for you, interpret a result or replace assessment when symptoms are urgent.
Why a pelvic ultrasound may be requested
A clinician may request pelvic imaging for a focused question. This can include persistent pelvic pain, heavy or irregular bleeding, a suspected ovarian cyst or fibroid, a pelvic mass, or follow-up of a known condition. The scan result sits within a wider clinical assessment and may not give one final explanation for symptoms.[1]
| Question a scan may help with | What may be assessed | What remains important |
|---|---|---|
| Pelvic pain | Uterus, ovaries and visible structural changes. | Pain can have several causes, and a normal scan does not exclude all of them. |
| Bleeding changes | The uterus, endometrium and ovaries where relevant. | A result needs to be interpreted with age, symptoms and clinical history. |
| Suspected ovarian cyst | Ovarian appearance and the characteristics of a visible cyst. | The next step depends on the imaging findings, symptoms and clinical context. |
| Suspected endometriosis | Endometriomas, some deep disease and other possible pathology. | Normal imaging does not exclude endometriosis. |
Two approaches to pelvic ultrasound
A pelvic ultrasound may be performed over the lower tummy, through the vagina, or sometimes with both approaches. The method should match the clinical question, your preferences and what you consent to.[1] [2]
Transabdominal scan
A probe moves across gel on the lower tummy. You may be asked to attend with a full bladder because this can improve the view of some pelvic structures. Preparation varies, so follow the clinic's instructions rather than relying on general advice.
Transvaginal scan
A covered probe is gently placed in the vagina to obtain closer images of some pelvic structures. It is an optional internal examination. You can ask questions, decline it or ask for it to stop at any point.
Consent, dignity and comfort
You should be told what the examination involves and have the opportunity to ask questions before it begins. For an internal scan, consent is ongoing. You can decline, pause or stop the examination, and you can ask about a chaperone or having someone with you, subject to the clinic's arrangements.[1] [2]
Ultrasound does not use ionising radiation. Most people tolerate it well, but pressure on an already painful area or an internal probe can cause temporary discomfort. Tell the person performing the scan if you are uncomfortable so they can respond appropriately.[1] [3]
What a scan cannot settle on its own
A pelvic ultrasound may be useful in suspected endometriosis because it can identify ovarian endometriomas, some deep disease and other possible causes of symptoms. NICE advises that normal examination and ultrasound findings do not rule out endometriosis. Further assessment or referral may still be appropriate when symptoms persist or affect daily life.[4]
A scan also does not replace urgent assessment for sudden severe pain, heavy bleeding with dizziness or fainting, possible pregnancy-related pain or bleeding, or feeling acutely unwell. These symptoms require the appropriate urgent-care route rather than a routine scan booking.
Preparation, reporting and next steps
Preparation is not one-size-fits-all. A full bladder may be requested for an external scan, and an internal scan may need different preparation. Tell the clinic about any accessibility needs, discomfort with internal examinations or other factors that could affect the appointment. The clinic confirms suitability, the appropriate route, preparation, reporting and follow-up arrangements at booking.[1]
A result may be discussed at the appointment or reported to the clinician responsible for your care, depending on the pathway. If an abnormality is identified, the appropriate next step can include further discussion, repeat imaging, gynaecology assessment or another referral route. It depends on the result and the wider clinical picture.
Frequently asked questions
What does a pelvic ultrasound look at?
A pelvic ultrasound may assess the uterus, lining of the womb, ovaries, bladder and surrounding pelvic structures. The exact question depends on your symptoms and the type of scan. It cannot answer every cause of pelvic symptoms.
What is the difference between a transabdominal and transvaginal scan?
A transabdominal scan uses a probe on the lower tummy and often needs a full bladder. A transvaginal scan uses a covered probe in the vagina and may provide a closer view of some pelvic structures. The appropriate approach is discussed before the examination and depends on consent and clinical context.
Can I decline an internal scan?
Yes. An internal scan is your decision. You can ask questions, decline it, change your mind or ask for the scan to stop. The clinician or sonographer can discuss whether an external scan or a different assessment route may be more suitable, recognising that the information obtained may differ.
Does a normal pelvic ultrasound rule out endometriosis?
No. NICE advises that normal examination or ultrasound findings do not exclude endometriosis. A clinician considers the result together with your symptoms, examination and the wider assessment.
How should I prepare?
Preparation depends on the examination route and the clinical question. A full bladder may be requested for an external scan, while an internal scan may have different instructions. The clinic confirms the relevant preparation at booking.
When will I receive my result?
Reporting and follow-up arrangements depend on the selected pathway and clinical context. The clinic confirms them at booking. A scan result may lead to a discussion with the referring clinician or to further assessment where appropriate.
Related assessment and support
References
- [1]NHS: Ultrasound scan, reviewed 25 February 2025
- [2]Guy’s and St Thomas’: Transvaginal ultrasound scan, published March 2024
- [3]Princess Alexandra Hospital: Pelvic ultrasound patient information leaflet, reviewed 18 March 2026
- [4]NICE guideline NG73: Endometriosis: diagnosis and management, updated 11 November 2024
Sources checked 27 August 2026. This page provides general information and does not replace individual medical assessment.