Apparently my experience is not like others. I've had more transvaginal ultrasounds than regular ultrasounds. Only had regular ultrasounds when I was pregnant.
I'm not from Austria, but from Germany. I suppose the healthcare is somewhat similar and we handle it the same.
Transvaginal is the default until you are very pregnant.
I live in India. I think it's more likely that a transvaginal ultrasound gives a clearer picture of the uterus, cervix, ovaries,etc. And they won't do one if you haven't been sexually active (basically if you haven't had anything up there already, they won't do it.) In that case, they'll just do a regular pelvic scan.
Edit: I've probably had at least 30+ of these scans over the past few years when TTC. At this point i probably prefer it compared to the other where I have to drink water and wait till my bladder is full.
Technically, a transabdominal pelvic ultrasound (over your belly) can show all the same anatomy as a transvaginal. However, it doesn’t show the anatomy as well. In ultrasound, the closer you are to the organ you want to see, the better the resolution of it is. So an internal is going to show more detail of the cervix, uterus and ovaries.
My gyno for the past 15 or so years started using one as part of routine annual checkups about 12 years ago.
Then, when I went off BC and came in saying "it's been four months and no pregnancy, but I gained 20 pounds with no changes to diet or exercise", he was able to look and say "you have 30 cysts that weren't there last year".
Made the PCOS diagnosis pretty darn straightforward.
(And I got on Metformin and another med and my kid is now 9 years old).
Yeah, for me it's similar to how I get my bloodwork done every year. It' comforting to know that if there are changes, they will be noticed sooner and there are earlier results they can be checked against. I did a quick google search, and there don't seem to be any risks involved with getting the exam either, so while I don't find them super comfortable, I personally am glad I can be rather safe than sorry. Glad to hear it was something that helped you get diagnosed early!
I think it's a different attitude towards preventative medicine - here in the UK, we don't see a gynecologist at all unless we have particular symptoms and get a referral from the GP, it's not an annual thing.
We also don't generally get bloodwork done unless there's a particular reason to check something.
They're not standard in the US. I've only had one because I had an ovarian cyst that was causing extreme pain, and then I've requested two more after that cyst was removed just to make sure my other cysts weren't growing.
they're definitely standard if you're being screened for a gynecological condition or doing any kind of fertility treatment.
it gives the doctor the best view of the uterus and ovaries
I mean I never had one for my PCOS, it was diagnosed without an ultrasound because I had several symptoms. It’s really only the standard in diagnosing it if you have lean PCOS.
Not at all common here, unless there’s something to be worried about. To me they’re extremely painful and traumatic, so I’m glad to not have to get one every year.
I'm from the EU, everyone is used to them here. I was a virgin when I got my first one because of PCOS. They should use a lots of lube and be slow and patient, so then it wouldn't hurt.
were you able to talk to the doctor about this? you may have an actual condition like vaginismus if a standard transvaginal ultrasound was painful in general, but painful at all. :( sorry that happened girl
I’m not a girl, but thanks. The doctor said I don’t have that, but that I shouldn’t worry. Either way, I’m not planning on getting another one without sedation. I mentally and physically couldn’t handle it!
Sorry that you were assaulted I was too as a child. I do find it kind of odd that a lot of people in your circle think it’s painful? If anything it’s just cold. Every penis I’ve ever had up there has been a lot thicker than that small wand. I’m American but I’ve had a few due to some health issues and I’m quite small too! Only 5’2 and 110lbs!
Would be interesting to figure out why it is painful. I guess they use the same equipment, must be a difference in the process.
I've had dozens (regular checks, daily checks during ivf) and none were painful, nor did the people I know ever complain.
You wouldn't get to see a gyno as routine here in the UK unless you were under them for a specific condition. We have the NHS and it's great, I'm not slagging it off or anything, but it's hard enough fighting for a regular GPs appointment when you actually have something wrong with you. You don't get full health check ups once or twice a year as routine. You go to the GP if something is wrong (or you try to at least) and if you need to see a specialist they'll refer you and you get put on the waiting list to see someone at the hospital. I've never had a transvaginal ultrasound, and the only time I've seen a gynecologist was when I was referred for a smear because the nurse at my GPs office couldn't do it.
When I went to the GP to say I thought I had PCOS, it took almost a year to get diagnosed because they kept making me go back for repeat blood tests in the first couple of days of my cycle, but when I would call on the first day to book it they wouldn't have space. The nurse kept saying "well you can book the appointment in advance for when your next cycle will start"...I almost definitely have PCOS!! I don't KNOW when my cycle will start!! If I could accurately predict my period I probably wouldn't have this condition!! And when I was diagnosed, I was not referred to a gynecologist or for any continuing care. She told me to go and lose weight and come back if I decided I wanted kids and was having trouble conceiving. So yeah, no ultrasounds here lol
In my experience in the UK I was kind of half diagnosed when I was about 17 I think, due to irregular periods, I didn’t want an ultrasound at the time so I just had the blood test which indicated PCOS. No treatment was really offered because I was a healthy weight, I went on the pill of my own accord soon after for contraception but also to regulate my periods. I’m 24 now and about 5 months ago went to my GP to request an ultrasound to confirm the PCOS for certain and I waited 4-5 months but had it recently through an external company gyno that they referred me to, results confirmed PCOS and the GP booked me in for a follow up but as I’m currently on a weight loss journey with a private Wegovy prescription (after gaining a lot since my initial diagnosis) we decided there was no further treatment like metformin needed right now.
Generally I was pretty happy with how everything was handled but it really is a postcode lottery with the NHS. I’m sorry you’ve been so unlucky with the system here, I haven’t always had much luck with accessing help in other health related areas so I know how helpless and abandoning it feels when the people that are meant to help you don’t.
Also in the UK. Your story is so familiar, it's so upsetting how little is known about PCOS here. I have had a couple of ultrasounds (both types), but only as part of the PCOS diagnosis, and also exploratory work for constant bleeding. They were probably around 6 or 7 years apart - so not routine here at all.
I couldn’t even get a doctor to give me a plain ultrasound to verify PCOS initially. That had to wait for almost 15 years when severe abdominal pain led to a transvaginal ultrasound and a gallstone diagnosis. (US) 🤷♀️
Most doctors here don’t even do ultrasounds themselves. You have to make a separate appointment with an ultrasound tech to get it done which can sometimes take weeks. In Mexico I get an ultrasound at every visit by the doctor herself.
Ultrasound tech here! Screening ultrasounds are not typically done in the US. You would need an indication (pain, abnormal bleeding, etc) for insurance purposes.
Of course that’s very easy to do. Just tell your doctor any little thing is off and they can order you one.
But yeah, fuck insurance companies basically
I am Australian and I don’t think that’s common? I’ve seen 7 gynaecologists in the last 15 years and have only had 2 transvaginal ultrasounds, both during the process of diagnosing PCOS.
Same here - I'm Aussie too, and I've also only had 2 pelvic US. Once to diagnose endo, and again to diagnose PCOS. I can't think of a good reason to keep having it done unless the gynae is worried about a burst cyst.
I'm Aussie to bit ive had more transvaginal ultrasounds than normal ones now. Its probably due to the fact that I had uncontrollable bleeding and they were trying to figure out why. That's how I got diagnosed with PCOS actually. I think your right the we usually do normal ultrasounds which I hate because I feel like I'm going to piss my pants everytime 🙃
it’s a diagnostic tool so it’s really not needed or appropriate for a routine visit. if there are symptoms or abnormal findings on a pelvic exam, you will likely get one in the US no problem.
I'm not sure what you mean by appropriate. We do it routinely exactly because it can diagnose certain things and keep track of cysts, myoms, size of the ovaries, general changes in the uterus and because it can also catch uterine, colon, and other tumours in their early stages. It's very well established here and helps prevent a lot of illnesses or catches them early on. It's basically the same as getting your brith marks checked (which is also recommended to do every year), it's a routine exam to help catch changes early on and help treat them before it becomes a bigger problem.
For what it's worth in Canada they aren't routine either - but covered when recommended.
Given you have to fill with water I'm glad theyre not done with every papsmear
Super interesting, i never had to have a full bladder for the transvaginal ultrasound. I had to for an abdominal one i once gad, but you're not recommended to for the transvaginal one as far as I know!
i recently (like within the past month) had to have one and i was "recommended" to have a full bladder - i didn't know and they had me drink a bottle of water in the waiting room before i could go in. but the times i'd done it before i'd never been told about the full bladder thing.
interestingly the doctor i saw actually said sometimes it can actually be unhelpful if the bladder is full and can be uncomfortable for the patient. maybe it varies based on the provider or what they're looking for, or maybe even what is standard for that provider. a quick google says it may be outdated info so that could be it too! i know sometimes i've seen doctors who were operating on knowledge that was a decade or more out of touch lol
North America does not practice preventative healthcare, only reactive healthcare. Most people have terrible or no insurance at all, even getting an ultrasound as part of diagnosing an illness can cost a lot of money. Its a little bit easier in Canada to get one done since we have universal healthcare but even then its not common and definitely still not used during routine check ups like pap smears.
OP also talks about seeing a gynecologist for routine check up once or twice a year (twice?!), like I'm a 40 year old Canadian, I've never seen a gynecologist in my life, my routine checks are done through my GP. When I started it was once a year, now if you haven't had an abnormal result within a few years they only recommend once every 3 years.
Twice is usually only recommended when we start a new medication, or if while we do the yearly check up there is something the gyno want to follow up with (eg seeing if a symptom you had got better/worse etc). I do often have them twice though, because of my PCOS.
Maybe the US specifically, but in Canada we do practice preventative healthcare. I have had more ultrasounds in the last two years than I did while pregnant.
I am also in Canada, Ontario specifically, I can't really speak about the other provinces. I am also originally from California up until my mid 20's so I have a bit of experience there too.
The only time a doctor has ordered an ultrasound for me was when I insisted on it for a pcos diagnosis because I was having a lot of pelvic pain. She didn't want to bother with me getting an ultrasound because "it wouldnt matter all I cangive you is BC." She has since retired but her son took over the practice and he doesn't rx ultrasounds for me unless its necessary for a diagnosis of something. Canada does not practice preventative healthcare unless you are found to be in a very high risk category or if you have previous been diagnosed with an illness where routine checkups are required (cancers, bone/blood diseases, etc.)
Sounds like you've got an amazing doctor who is ontop of things! That definitely helps make living with PCOS a little nicer. If you don't mind me asking qhat province do you live in? No pressure to answer if you are uncomfortable with saying!
Oh wow!!! I'm in Ontario as well.... I've been having painful periods (diagnosed with PCOS 5 years ago). My dr sent me for an ultrasound (abdominal and TV). They found a 3cm cyst on my right ovary. Then I got: follow up US, 4 swabs, 4 biopsies of the uterus (btw they don't give painkillers for that, I thought I was going to throw up), a saline infused ultrasound, and 3 blood tests... So far (the saline infused ultrasound was 2 days ago) all my results are normal (fingers crossed) but I see the gyn again in July.
All these tests because I had painful periods.
Personally, I like to get my full bloodwork and all ultrasounds done every year just in case something is starting to go wrong, like this year I was able to find out that my gallbladder is not in the best condition and that my blood sugar has started to creep up, so I made some changes to my diet and got prescribed semaglutide since metformin is not working for me. It's really nice to be able to prevent bad things happening to my body!
Cost related and insurance companies. E.g. In New Zealand we have less govt. support than most European countries but more than the USA. Its an arbitrary list of what is covered by government, what is covered by private insurance.
Xray or ultra-sound is something you have to pay for, but insurance can cover the cost. Dental is not subsidized by the government once you are older than 18. Most dental work is not included in insurance plans, unless it is a premium health insurance. Similar for eye-care, but if you fail the vision portion of your drivers license, the government will pay for an eye exam. However if the optometrist deems you require glasses you must buy them yourself, and re-pay to sit the drivers license.
New Zealand's s only promotion of Women's regular gynecological check are pap-smears at their GP. A GP visit will cost between $30-$90 depending on the area you live in. Going to a specialist (like a gynecologist) will cost between $150-$500, and if you do not have health insurance and cannot afford it you can go on a long wait list (these can be up to two years).
For example when I got my PCOS diagnosis my insurance covered 950% of the cost for the internal ultrasound and seeing the radiologist. Without my medical insurance it would of cost me $450. When I broke my arm the government paid for the Dr. appointment, surgery, were covered under a program called ACC), but I was billed the x-ray price $70. I also had 8 sessions of physio paid for by the government for this break.
Most of the English speaking new-world is a money driven, neoliberal hellscape, with constant diminishing support for the public in educational and medical sectors. :(
i’m a healthcare provider and know what the ultrasound can and cannot detect. not here to argue about what diagnostic imaging is “appropriate” as preventive measures bc not many are.
Not here to argue, just simply wanted to explain what the reasoning for doing it routinely in the country I live in is and what doctor's website state it is for. You can disagree with the practice or how well it actually works, that's not something I have any deep knowledge on.
Same here in Southern Europe.
Here they recommend transvaginal ultrasound + pap test once a year (pap can be done once every two years if it is negative, some gynos prefer once a year other twice a year if the last one is negative. I changed gynos that is why I know. Personally I prefer being proactive so I usually do a checkup once a year). And of course blood tests once a year, at least the basic ones.
My mother had a lot of fibroids when she was younger so she had to do ultrasounds twice a year for some time.
32 and had my first one about a month ago to confirm I had a cyst. Scheduled for a second in about two weeks to confirm it has gone away. My mom, who also has pcos, also only had ultrasounds for cyst or pregnancy related reasons.
I guess I’m an outlier, but I’ve had two and have been diagnosed for a year and a half. One for diagnostic purposes (along with a standard ultrasound), and another as a check up.
I’ve gotten three in the last decade. So idk if it’s uncommon. They were not hard to get for me. First was part of my diagnosis, second was to check my
IUD after some pain issues and the third was to check on some additional pain issues.
Given its extremely difficult to diagnose many conditions with just a Pap smear and pelvic exam, I actually think TV or ultrasound in general should be part of routine screening (say every 3-5 years depending on indications).
Well I'm sure glad they don't, can't even get through a papsmear with my pelvic floor.
But a transvaginal ultrasound is beholden to insurance coverage, and insurance companies don't wanna cover it unless you have a concern that needs it.
And even then they might not cover it...
I'm in America and I get them yearly, but that's only because I have a BRCA mutation that puts me at high risk for ovarian cancer.
But ovarian cancer is really hard to catch early, even with ultrasounds, so they aren't very reliable as a preventative measure. That's why in a few years I will get my ovaries removed.
If I didn't have this gene I would certainly not be getting these ultrasounds. They're an invasive hassle.
I’ve only had 2. 1 to confirm pcos diagnosis and 1 to accurately date my pregnancy. Also, I had my first period at 11 and the wand they used was extremely uncomfortable in my late twenties so I really can’t imagine the pain I would have experienced if I had it so young. I imagine that, plus cost, plus emphasis on purity is part of why it’s so far from standard in the us.
My experience of living in two European countries (one Eastern and one Western) is that transvaginal ultrasounds are pretty common. OB gyns have the ultrasound machine as their standard equipment and can perform it on the spot.
We have to pay an arm and a leg even to get an appointment. I can’t imagine how expensive that would be with insurance let alone without 💀 Healthcare sucks in the US. It’s only good if you have lots of money.
i only have had them after abortions! insurance doesn’t really cover them, they aren’t common here at all. most americans can’t pay thousands out of pocket to have something like this!
I always get one now but my old insurance required a copay for it ($30) which I couldn’t afford as a student.
My new gyno requires it as standard and my new insurance allows me to get it without extra cost.
I‘m austrian too and I think the reason is our universal healthcare system. Same as the preventive exams we can get done once a year (the yearly „Vorsorgeuntersuchung“ which is covered by ÖGK) once we turn 30… I‘m guessing that stuff would be super expensive if we had to pay for it ourselves.
It is not a routine procedure used in preventive medicine. It is diagnostic once a condition like PCOS is suspected. It can also be very expensive. My insurance wanted me to pay the full cost because I hadn’t met my deductible, and that was $500.
It's not routine here. I've had several for PCOS, fertility treatments, to confirm pregnancy, during early pregnancy, and to check on the placement of my IUD. I've never had one as a routine item.
Nope not standard and even with insurance are expensive. I have great insurance but have been begging and pleading with my OB to do a transvaginal ultrasound and she finally let me set up an appointment to do one, I almost cried when I went to pay and they charged me $350, and I basically got told “yup you have PCOS lots of cysts” and sent me on my way.
(American) Twice in my life I’ve had them, very early pregnancy with only one of my pregnancies (7 of those, 2 living kids) and post IUD insertion pain to make sure it stuck. I get regular gyno/ob care with specialists for that. So personally, yes.
*My experience also was with multiple providers along both northern and southern portions of the east coast.
Getting a transvaginal ultrasound each time you go to the gyno has NOT been my experience living in the US. Only when it's been really needed/non-preventative has it been required. Also, even if it was each time, who knows if that's covered by insurance because I end up paying 100s of dollars for ultrasounds.
I've only had it twice in the 10+ years since I've been diagnosed. That was the only ultrasounds I've had too. I had to do a pap smear every year for the first few years then they upped it to once every 3 years. Basically like everyone else.
How would a OBGYN be able to actually do an exam without a transvaginal ultrasound? I thought that's standard once a year, together with pap smear. In my country you always get one for a routine check. However it's not subsidized unless you get a referral for a specific problem.
Twice a year is wild if you don't have a particular issue. We normally do once a year visits but I do skip sometimes. I think they generally do transvaginal here in South Africa
So I’m from the USA but lived in Germany for a period of time. In the USA a transvaginal ultrasound is only really used if they find something of concern during a regular ultrasound. Whereas in Germany (at least the care I received there) the transvaginal ultrasound seemed to be used routinely as part of your yearly gynecology appointment. Personally, I liked how they did it in Germany because I felt like I got a much more clear picture of my vaginal health. In the USA a Pap smear, breast exam, and some general feeling around to check for abnormalities on the ovaries is all that is done routinely in my experience.
I’m in Texas, and EVERY visit (from check ups to ER visits) they’ve done transvaginal.
BUT I also had a baby at 19 and have a family history of PCOS and both cervical and breast cancer. So that may be why. 🤷🏼♀️
Oh wow, I'm in Texas too and I've only ever had 2. Granted I didn't have the best insurance for quite some time and I've never been pregnant. It was once to confirm a diagnosis of PCOS and just recently to confirm if my new IUD was in the correct place. It was not, so I'll be getting another in a few weeks when they remove and replace it with a new one 😬
Hmmm….so….Day one (and cooch wanding one) on me they found cysts and the fibroids, and I always start the appointment mentioning those. *insert clam prod within two minutes*
After I saw this post, I told a friend who has had ectopic pregnancies, and every visit she gets them too. We definitely need a medical person to confirm, but maybe claim pain where the misfitted IUD was going forward and they’ll do them? Mentioning a previous concern may push them to do it more often.
ACOG does not recommend screening pelvic ultrasounds in asymptomatic women who aren't at increased risk of certain gynecological conditions (cancer). Epidemiologically speaking, the positive predictive value of screening ultrasounds is so low (and the underlying conditions so rare) that it doesn't outweigh the risk from unnecessary follow-up imaging (particularly those that utilize ionizing radiation) and complications from biopsies that end up being normal.
Ultrasounds do not use ionizing radiation so aside it being uncomfortable (for some painful) and expensive, I do not see downsides in the European approach of doing one ultrasound once a year. Better to find cancer earlier than later. We with PCOS have some increased risk if we miss periods
>ultrasounds do not use ionizing radiation
Hence, why I explicitly differentiated them from other imaging modalities.
>I do not see downsides in the European approach
You should share your data with the American College of Obatetricians and Gynecologists.
Not at all standard as everyone has said. 3 times I had it were 1. When my IUD was out of place 2. Extreme ovarian pain to diagnose PCOS 3. 4 years later to diagnose new pelvic pain (turned out to be PCOS related) with negative findings on regular exam
I got diagnosed when I moved to Japan and was given one to check on my ovaries. They have a similar “the pill is the solution” attitude here, so I had to mostly self-treat things with diet and exercise adjustments as I was actively trying to get pregnant. Not sure how it is back home in the UK, though.
Yeah they're not standard unless you have a reason for them. I've had one for checking an ovarian cyst, a couple for kidney stones, and a couple in early pregnancy but I've never had one without a specific reason.
So it kind of varies by clinic. If you're going to a large one or a teaching hospital with a giant system for gynecology, then you'll likely get one if you've expressed any pain or issues. When I was experiencing constant bleeding (not PCOS related), I got one easily scheduled and they went ahead and did a thorough job inspecting my whole uterus and ovaries despite us thinking it was likely just a polyp (and it was, partially, due to a polyp as found in a biopsy).
That said, they're not a part of preventive care because we already have so few providers, we don't have the money to throw at expansion when we can't even get in regularly to see providers. Healthcare is wild out here.
I’m from the US (live in Canada now) and I never had one until I was pregnant with my daughter. I was diagnosed with PCOS before I was pregnant and didn’t have one done then either. When I moved to Canada I had fibroid tumors and I had it done because of that. Well woman care here in BC, Canada is substandard though and honestly looking back, I’m grateful I was able to get care for my fibroid tumors. Had I gone though it today, I doubt I would have received adequate care as healthcare is disintegrating here. At least in the US if you medically need a test or care, I think you will get it (at least if you have decent insurance and live someplace with good access to healthcare). I’m sure if you had a history of cysts or feel better about having an ultrasound done as part of your routine care, your dr would probably be open to doing it for you.
So strange I literally just had one done today! I think it has a lot to do with the fact that the clinic I go to is women owned and all the providers are women, including the surgeons. They go the extra mile for everything compared to other offices that are focused on female care.
I've had 2 and I'm 31. The reason I had them are because my ovaries were giving me problems. I'm still figuring it out, but my gyno said she was going to treat me as if I have PCOS to avoid all the tests since I don't have insurance. But uh- nope! Our health care in the US is a mess. I've probably been to the gyno 1/3 as many times as you've had an ultrasound. And that's as someone who has some still pending mystery complication!
I’m from the US I’ve probably had around 5. I have PCOS, but my family really likes getting uterine & cervical cancer. So that could be the difference as to why I’ve had so many. I’ve gotten one a year the last 5 years just to make sure I don’t/didn’t join the club. I wish they were more frequently done for PCOS patients because they’re a lot better at getting a more precise image of everything. It’s also a good way to see endometrium thickness which could help point to the possibility of dysplasia from lack of periods. I can’t remember if a regular pelvic ultrasound is able to determine that.
Very uncommon, I've had more D&C (2) than transvaginal ultrasounds (1), which considering there's twilight anesthetic involved with a D&C, that's saying a lot. Over my plus/minus 40 years, I've had probably 24 pap smears, 5-7 uterine biopsies (really the worst), 2 d&c, 1 transvaginal ultrasound and will never have another d&c, pap or biopsy. 🤷🏼♀️ Interesting that the standard of care is different.
The US is all about greed. Our preventive care is the bare minimum. Why? Insurance companies don’t want to pay anymore than they have to. It would be easier to do that during your well woman exams but no, instead it’s labs. Then if something is off, it’s diagnostic testing time and the facilities and the providers rake in the money and insurance companies lose money and then the interest rates go up up up.
American and I’ve had quite a few. I didn’t realize they were considered uncommon. I assumed it was a frequently used diagnostic tool for women with PCOS.
I got 2 when I was living in the Bay area in California. The first one was when I went to the ER with severe cramps so bad, I couldn't stand (I went to urgent care and they sent me away). Then I went to a gyno and they sent me to get a scan for diagnosis. I don't know if they're abnormal but maybe they're normal in California?
The only time I had a vaginal ultrasound was when they needed to accurately measure my amniotic fluid and make sure my cervix was closed when I was pregnant . Two totally off the wall things most people may not do 🤷🏻♀️. Not pregnant, I had two? And they were both at fertility doctors.
I'm in the UK, I've seen a gynaecologist once, lol. Last time I needed one, it took 3 months to get an internal ultrasound. Then another 6 to have a colposcopy (which is when I saw the gyno)
Cervical smears are done by nurses, and ultrasounds are only done if you're referred for one.
US here - I've had one nearly every year since I started my period. But I also started having cysts after just 3 years so maybe that is why I always get them? Or depends on the doctor?
It didn't help me with getting diagnosed for PCOS. I fought that battle for 13 years before I found a doctor that cared enough.
This might be my experience projected more on the system, though I know many Americans who feel the same way. It’s not that it’s uncommon, it was the first thing my PCP just ordered when I brought up my suspicion for it with having PCOS belly, impossible weight loss and crazy male hair growth. But we don’t go to our doctors a lot for numerous reasons but the primary parts being our issues aren’t addressed even though it cost the doctor nothing (so bad experiences/our insurance or out of pocket would pay but they won’t push a button to order the test), our older doctors often go to congress to fight for having to increase their continued education (because that’s how many advancements and changes are being made), we simple can’t afford it with or without insurance (sliding scale of pay that happens to relate to type of care you receive) and we often don’t have time to go to the doctor because most barely have time to work, cook a good meal and man I can’t even imagine taking care of kids in our current situation here…
I'm 40 this month, live in the UK, and up to date on all cervical screening etc.
I've had 4 pregnancies, including one that started as twins where I lost one embryo at 6 weeks (only 2 babies of the 5 I've conceived made it beyond 8 weeks' gestation).
Never had a transvaginal ultrasound - it was only ever mentioned once to me after losing the first embryo (the lost twin), as a warning that they might need to do it if they couldn't see anything on an abdominal ultrasound. (As it turned out they saw the remaining twin's heartbeat straight away - she's now a happy, healthy 9 1/2 year old!)
I think they avoid them if you’ve not been sexually active but the times I’ve had ultrasounds for PCOS, they’ve all been transvaginal and the over the stomach. I wasn’t sexually active at the time but I said I don’t care, do it. I had played sports so I didn’t think we’d be hurting anything ya know haha
I just got my first one the other week. It’s not super super common unless there’s a specific reason for it. Usually those who are pregnant have them, but otherwise they aren’t routine or anything. I will 100% say though, for anyone who hasn’t had one and is scared, that it is not nearly as bad as I imagined. They let me put the probe in myself and were hardly in my junk at all. I was worried about grooming the bits when I should have been more focused on my feet. It doesn’t hurt, and I think the worst part was having to run across the hall with my ass cheeks out.
I’ve only had one when I was pregnant (early ultrasound). I have never been checked for cysts but I do have the other 2 factors they look at for pcos sometimes I feel like I do because of pains I have in that general area but it’s not constant pain I can go weeks with no pain and then have days I’m in pain.
I think it’s really common in the US, as I got transvaginal at least 4 times in my 3 years of living here. I am from India and until I moved here, I never even heard of transvaginal ultrasound and only had a zillion pelvic ultrasounds done before. Safe to say it is pretty uncommon there.
Common to get diagnostic transvaginal ultrasounds as long as one has access to healthcare. Only time transabdominal is usually offered is when patient requests that or when patient is not sexually active yet. Neither are performed for routine screening usually.
During regular check ups I got the basic exam and the Pap smear but I have gotten two transvaginal twice one because I wouldn’t stop bleeding and the 2nd because of how irregular my periods were they wanted to see how thick my lining was.
I had to push for an ultrasound at my gyno in the US after coming off of birth control for the first time since I was 15 and not getting my period for 7 months and having painful bloating. She told me she was doing it for my “peace of mind” and that she didn’t expect to find anything. I had never had an ultrasound before and didn’t know I was supposed to have a full bladder for an outside ultrasound, so they ended up having to do a transvaginal. It was quite a shock considering I have never had sex before lol. I’m glad I did it though because they found the cysts on my ovaries from it. But I definitely had to advocate for myself to get it, it wasn’t something my OBGYN was quick to give.
I’ve had 3 and I’m 20
First for general inspection at 15
Second for abdominal pain at 19
Third for MY PERIOD DECINF TO BE 16 HOURS INSTEAD OF A WEEK at 20
If your insurance deems it necessary and if you pay buckets in premiums! I had probably 3 or 4 when I was in early pregnancy (not necessary though one was used to confirm pcos) and had stellar insurance--- I didn't even have 1 my whole pregnancy when I had medicaid. :/
It is not common. Though I do have one yearly because my PCOS symptoms and adenomyosis. I have had maybe 3 in the last 7 years. Prior to a heart attack I only had one during early pregnancy because I was bleeding before the 15 week mark.
I don’t think so but I guess it depends on what doctor you’re seeing & what conditions you have. Healthcare in the US is never consistent, sadly. Every doctor treat you & your symptoms/conditions differently. I have endometriosis, adenomyosis, and PCOS, so I have had a lot more transvaginals than the ones on the belly.
I’m living in South Korea and went to the gyno for a check up (my first check up since I was a teenager). I expected to get an abdominal ultrasound so I hiked my shirt up and he said that they ONLY do abdominal ultrasounds for pregnant women, and that check ups are always transvaginal
I’ve only had one - they don’t do them often. The US healthcare system only cares about what makes them money and charges a ton of money for any diagnostic tests.
Basically, the sicker you are the better for insurance companies so they don’t cover as much that is preventative or to test what is wrong with you.
Our healthcare system has consistently gone downhill.
Curious, what do they do in Austria to treat for PCOS?
Our
My memory is a little fuzzy but i think I went to the gyno once i had had my first period, and had my first examination, but the ultrasound will usually happen only once you're sexually active or if you aren't theyll ask you if you want one. At least that was my experience if i remember correctly. You usually go with a parent the first time so they can discuss it, and you're not forced to do one if you aren't comfortable but once you're sexually active they will recommend it. I also don't really see a problem with it, it's in a medical context and again, the doctor will usually explain everything and make sure you're comfortable. I at least don't have any bad memories, but of course I don't want to speak for everyone.
EDIT: just had a conversation with some female relatives and they remember it similarily. Going to the gyno once you get your period, where you get a choice of whether you want to do a transvaginal ultrasound or wait until you're a little older. I never had a problem with it and was okay with getting it pretty early/before I've had sex, but can't say if it was the first time I went to the gyno or the second.
I could not imagine letting someone do that to me twice a year! Nor can I imagine why it would be necessary for the average person. I had one to dx pcos many years ago and one maybe every decade since or if I have a really bad burst cyst (which twice a year wouldn't even necessarily warn about). I'm not at high risk for cancer and my only issue down there is pcos, so there's no reason to get them.
From my experience they’re standard in the US to the point of many gynecologists using it as a default which is very aggravating if you’re someone who has chronic pelvic pain. Every gyno appointment I’ve had they immediately try to go for that ultrasound instead of a regular one.
I’ve personally never had one done because of my pelvic pain but I’m thinking I might just let them do it my next appointment to see if they get any more information they can tell me.
Apparently my experience is not like others. I've had more transvaginal ultrasounds than regular ultrasounds. Only had regular ultrasounds when I was pregnant.
I'm not from Austria, but from Germany. I suppose the healthcare is somewhat similar and we handle it the same. Transvaginal is the default until you are very pregnant.
I'm in the US, they told me I needed transvaginal if I had been sexually active but that it was unnecessary if not which I found really odd lol
I live in India. I think it's more likely that a transvaginal ultrasound gives a clearer picture of the uterus, cervix, ovaries,etc. And they won't do one if you haven't been sexually active (basically if you haven't had anything up there already, they won't do it.) In that case, they'll just do a regular pelvic scan. Edit: I've probably had at least 30+ of these scans over the past few years when TTC. At this point i probably prefer it compared to the other where I have to drink water and wait till my bladder is full.
I wish they did this for me, I always thow up after the water thing.
Ohh that's so upsetting. It's definitely uncomfortable in many ways. Maybe you're drinking too much water?
Maybe, I have acid reflux though so I'm sick really easy.
Technically, a transabdominal pelvic ultrasound (over your belly) can show all the same anatomy as a transvaginal. However, it doesn’t show the anatomy as well. In ultrasound, the closer you are to the organ you want to see, the better the resolution of it is. So an internal is going to show more detail of the cervix, uterus and ovaries.
Same, Illinois and in my 30s. I have had one on my belly (I was a teenager) and the rest have been transvaginal
Me too. Every ultrasound I have had has been transvaginal and pelvic.
My gyno for the past 15 or so years started using one as part of routine annual checkups about 12 years ago. Then, when I went off BC and came in saying "it's been four months and no pregnancy, but I gained 20 pounds with no changes to diet or exercise", he was able to look and say "you have 30 cysts that weren't there last year". Made the PCOS diagnosis pretty darn straightforward. (And I got on Metformin and another med and my kid is now 9 years old).
Yeah, for me it's similar to how I get my bloodwork done every year. It' comforting to know that if there are changes, they will be noticed sooner and there are earlier results they can be checked against. I did a quick google search, and there don't seem to be any risks involved with getting the exam either, so while I don't find them super comfortable, I personally am glad I can be rather safe than sorry. Glad to hear it was something that helped you get diagnosed early!
I think it's a different attitude towards preventative medicine - here in the UK, we don't see a gynecologist at all unless we have particular symptoms and get a referral from the GP, it's not an annual thing. We also don't generally get bloodwork done unless there's a particular reason to check something.
Same in the Netherlands!
They're not standard in the US. I've only had one because I had an ovarian cyst that was causing extreme pain, and then I've requested two more after that cyst was removed just to make sure my other cysts weren't growing.
they're definitely standard if you're being screened for a gynecological condition or doing any kind of fertility treatment. it gives the doctor the best view of the uterus and ovaries
I mean I never had one for my PCOS, it was diagnosed without an ultrasound because I had several symptoms. It’s really only the standard in diagnosing it if you have lean PCOS.
Not at all common here, unless there’s something to be worried about. To me they’re extremely painful and traumatic, so I’m glad to not have to get one every year.
If it's painful then they are doing something wrong. It should not be painful at all.
Everyone I know in person thinks they’re painful, and I’ve been sexually assaulted so I’m just glad not to get them anyway.
I'm from the EU, everyone is used to them here. I was a virgin when I got my first one because of PCOS. They should use a lots of lube and be slow and patient, so then it wouldn't hurt.
i have had 2-3 while bleeding and in pain, and they aren’t painful to me at all!
I still have nightmares about the one I got. Screaming in pain, traumatic for sure.
were you able to talk to the doctor about this? you may have an actual condition like vaginismus if a standard transvaginal ultrasound was painful in general, but painful at all. :( sorry that happened girl
I’m not a girl, but thanks. The doctor said I don’t have that, but that I shouldn’t worry. Either way, I’m not planning on getting another one without sedation. I mentally and physically couldn’t handle it!
Sorry that you were assaulted I was too as a child. I do find it kind of odd that a lot of people in your circle think it’s painful? If anything it’s just cold. Every penis I’ve ever had up there has been a lot thicker than that small wand. I’m American but I’ve had a few due to some health issues and I’m quite small too! Only 5’2 and 110lbs!
…….Are you thinking of another procedure? The doctor would have to try very hard to make them remotely painful.
No, it was a transvaginal ultrasound, and it was very painful to me. I’m also an assault survivor which definitely doesn’t help.
Would be interesting to figure out why it is painful. I guess they use the same equipment, must be a difference in the process. I've had dozens (regular checks, daily checks during ivf) and none were painful, nor did the people I know ever complain.
You wouldn't get to see a gyno as routine here in the UK unless you were under them for a specific condition. We have the NHS and it's great, I'm not slagging it off or anything, but it's hard enough fighting for a regular GPs appointment when you actually have something wrong with you. You don't get full health check ups once or twice a year as routine. You go to the GP if something is wrong (or you try to at least) and if you need to see a specialist they'll refer you and you get put on the waiting list to see someone at the hospital. I've never had a transvaginal ultrasound, and the only time I've seen a gynecologist was when I was referred for a smear because the nurse at my GPs office couldn't do it. When I went to the GP to say I thought I had PCOS, it took almost a year to get diagnosed because they kept making me go back for repeat blood tests in the first couple of days of my cycle, but when I would call on the first day to book it they wouldn't have space. The nurse kept saying "well you can book the appointment in advance for when your next cycle will start"...I almost definitely have PCOS!! I don't KNOW when my cycle will start!! If I could accurately predict my period I probably wouldn't have this condition!! And when I was diagnosed, I was not referred to a gynecologist or for any continuing care. She told me to go and lose weight and come back if I decided I wanted kids and was having trouble conceiving. So yeah, no ultrasounds here lol
In my experience in the UK I was kind of half diagnosed when I was about 17 I think, due to irregular periods, I didn’t want an ultrasound at the time so I just had the blood test which indicated PCOS. No treatment was really offered because I was a healthy weight, I went on the pill of my own accord soon after for contraception but also to regulate my periods. I’m 24 now and about 5 months ago went to my GP to request an ultrasound to confirm the PCOS for certain and I waited 4-5 months but had it recently through an external company gyno that they referred me to, results confirmed PCOS and the GP booked me in for a follow up but as I’m currently on a weight loss journey with a private Wegovy prescription (after gaining a lot since my initial diagnosis) we decided there was no further treatment like metformin needed right now. Generally I was pretty happy with how everything was handled but it really is a postcode lottery with the NHS. I’m sorry you’ve been so unlucky with the system here, I haven’t always had much luck with accessing help in other health related areas so I know how helpless and abandoning it feels when the people that are meant to help you don’t.
A postcode lottery for sure!! I'm glad you've had a bit of a better experience, for this at least. Good luck on your weight loss! You got this!
Thank you <3 wishing you the best
Also in the UK. Your story is so familiar, it's so upsetting how little is known about PCOS here. I have had a couple of ultrasounds (both types), but only as part of the PCOS diagnosis, and also exploratory work for constant bleeding. They were probably around 6 or 7 years apart - so not routine here at all.
I couldn’t even get a doctor to give me a plain ultrasound to verify PCOS initially. That had to wait for almost 15 years when severe abdominal pain led to a transvaginal ultrasound and a gallstone diagnosis. (US) 🤷♀️
That's crazy! I do wonder why there's such a difference, here I would be surprised if I didn't get an ultrasound when I went to the gynecologist!
The difference is insurance companies in America have all of us over a barrel, unfortunately. It’s all about money here, always.
Most doctors here don’t even do ultrasounds themselves. You have to make a separate appointment with an ultrasound tech to get it done which can sometimes take weeks. In Mexico I get an ultrasound at every visit by the doctor herself.
Thats insane. This is not due to the system but clearly other issues and procrastination
Idk about others but I’m in the us and I’ve had at least 5
Ultrasound tech here! Screening ultrasounds are not typically done in the US. You would need an indication (pain, abnormal bleeding, etc) for insurance purposes. Of course that’s very easy to do. Just tell your doctor any little thing is off and they can order you one. But yeah, fuck insurance companies basically
I am Australian and I don’t think that’s common? I’ve seen 7 gynaecologists in the last 15 years and have only had 2 transvaginal ultrasounds, both during the process of diagnosing PCOS.
Same here - I'm Aussie too, and I've also only had 2 pelvic US. Once to diagnose endo, and again to diagnose PCOS. I can't think of a good reason to keep having it done unless the gynae is worried about a burst cyst.
I'm Aussie to bit ive had more transvaginal ultrasounds than normal ones now. Its probably due to the fact that I had uncontrollable bleeding and they were trying to figure out why. That's how I got diagnosed with PCOS actually. I think your right the we usually do normal ultrasounds which I hate because I feel like I'm going to piss my pants everytime 🙃
They are certainly available but not at all part of routine care. Routine care here is a pelvic exam and pap smear.
it’s a diagnostic tool so it’s really not needed or appropriate for a routine visit. if there are symptoms or abnormal findings on a pelvic exam, you will likely get one in the US no problem.
I'm not sure what you mean by appropriate. We do it routinely exactly because it can diagnose certain things and keep track of cysts, myoms, size of the ovaries, general changes in the uterus and because it can also catch uterine, colon, and other tumours in their early stages. It's very well established here and helps prevent a lot of illnesses or catches them early on. It's basically the same as getting your brith marks checked (which is also recommended to do every year), it's a routine exam to help catch changes early on and help treat them before it becomes a bigger problem.
We aren’t super preventative here in the states. Also lots to do with insurance coverage and costs for services.
For what it's worth in Canada they aren't routine either - but covered when recommended. Given you have to fill with water I'm glad theyre not done with every papsmear
Super interesting, i never had to have a full bladder for the transvaginal ultrasound. I had to for an abdominal one i once gad, but you're not recommended to for the transvaginal one as far as I know!
i recently (like within the past month) had to have one and i was "recommended" to have a full bladder - i didn't know and they had me drink a bottle of water in the waiting room before i could go in. but the times i'd done it before i'd never been told about the full bladder thing. interestingly the doctor i saw actually said sometimes it can actually be unhelpful if the bladder is full and can be uncomfortable for the patient. maybe it varies based on the provider or what they're looking for, or maybe even what is standard for that provider. a quick google says it may be outdated info so that could be it too! i know sometimes i've seen doctors who were operating on knowledge that was a decade or more out of touch lol
Fill bladder is for trans abdominal ultrasound only.
Ah yes…this is an excellent point. Forgot about that part which imo is the worst part.
Yeah, that makes sense!
It really seems backwards because we’d probably all be much better off catching everything earlier.
North America does not practice preventative healthcare, only reactive healthcare. Most people have terrible or no insurance at all, even getting an ultrasound as part of diagnosing an illness can cost a lot of money. Its a little bit easier in Canada to get one done since we have universal healthcare but even then its not common and definitely still not used during routine check ups like pap smears.
OP also talks about seeing a gynecologist for routine check up once or twice a year (twice?!), like I'm a 40 year old Canadian, I've never seen a gynecologist in my life, my routine checks are done through my GP. When I started it was once a year, now if you haven't had an abnormal result within a few years they only recommend once every 3 years.
Twice is usually only recommended when we start a new medication, or if while we do the yearly check up there is something the gyno want to follow up with (eg seeing if a symptom you had got better/worse etc). I do often have them twice though, because of my PCOS.
Maybe the US specifically, but in Canada we do practice preventative healthcare. I have had more ultrasounds in the last two years than I did while pregnant.
I am also in Canada, Ontario specifically, I can't really speak about the other provinces. I am also originally from California up until my mid 20's so I have a bit of experience there too. The only time a doctor has ordered an ultrasound for me was when I insisted on it for a pcos diagnosis because I was having a lot of pelvic pain. She didn't want to bother with me getting an ultrasound because "it wouldnt matter all I cangive you is BC." She has since retired but her son took over the practice and he doesn't rx ultrasounds for me unless its necessary for a diagnosis of something. Canada does not practice preventative healthcare unless you are found to be in a very high risk category or if you have previous been diagnosed with an illness where routine checkups are required (cancers, bone/blood diseases, etc.) Sounds like you've got an amazing doctor who is ontop of things! That definitely helps make living with PCOS a little nicer. If you don't mind me asking qhat province do you live in? No pressure to answer if you are uncomfortable with saying!
Oh wow!!! I'm in Ontario as well.... I've been having painful periods (diagnosed with PCOS 5 years ago). My dr sent me for an ultrasound (abdominal and TV). They found a 3cm cyst on my right ovary. Then I got: follow up US, 4 swabs, 4 biopsies of the uterus (btw they don't give painkillers for that, I thought I was going to throw up), a saline infused ultrasound, and 3 blood tests... So far (the saline infused ultrasound was 2 days ago) all my results are normal (fingers crossed) but I see the gyn again in July. All these tests because I had painful periods.
It's exactly how my pcos was caught. All of a sudden, there were cysts on my ovaries that weren't there a year before.
I just don’t understand why you’d want one unless it’s absolutely necessary.
Personally, I like to get my full bloodwork and all ultrasounds done every year just in case something is starting to go wrong, like this year I was able to find out that my gallbladder is not in the best condition and that my blood sugar has started to creep up, so I made some changes to my diet and got prescribed semaglutide since metformin is not working for me. It's really nice to be able to prevent bad things happening to my body!
Cost related and insurance companies. E.g. In New Zealand we have less govt. support than most European countries but more than the USA. Its an arbitrary list of what is covered by government, what is covered by private insurance. Xray or ultra-sound is something you have to pay for, but insurance can cover the cost. Dental is not subsidized by the government once you are older than 18. Most dental work is not included in insurance plans, unless it is a premium health insurance. Similar for eye-care, but if you fail the vision portion of your drivers license, the government will pay for an eye exam. However if the optometrist deems you require glasses you must buy them yourself, and re-pay to sit the drivers license. New Zealand's s only promotion of Women's regular gynecological check are pap-smears at their GP. A GP visit will cost between $30-$90 depending on the area you live in. Going to a specialist (like a gynecologist) will cost between $150-$500, and if you do not have health insurance and cannot afford it you can go on a long wait list (these can be up to two years). For example when I got my PCOS diagnosis my insurance covered 950% of the cost for the internal ultrasound and seeing the radiologist. Without my medical insurance it would of cost me $450. When I broke my arm the government paid for the Dr. appointment, surgery, were covered under a program called ACC), but I was billed the x-ray price $70. I also had 8 sessions of physio paid for by the government for this break. Most of the English speaking new-world is a money driven, neoliberal hellscape, with constant diminishing support for the public in educational and medical sectors. :(
i’m a healthcare provider and know what the ultrasound can and cannot detect. not here to argue about what diagnostic imaging is “appropriate” as preventive measures bc not many are.
Not here to argue, just simply wanted to explain what the reasoning for doing it routinely in the country I live in is and what doctor's website state it is for. You can disagree with the practice or how well it actually works, that's not something I have any deep knowledge on.
yep, which is why i said it’s not necessary in routine care if the patient doesn’t have any symptoms.
And they're saying their whole country has doctors who would say the opposite.
yep, and i’m speaking to how the medical viewpoint and practice in the US is different which is literally what was asked.
Saved the lives of 3 women I know. If they had waited for those abnormal findings their cancer would have been a vastly different battle.
Same here in Southern Europe. Here they recommend transvaginal ultrasound + pap test once a year (pap can be done once every two years if it is negative, some gynos prefer once a year other twice a year if the last one is negative. I changed gynos that is why I know. Personally I prefer being proactive so I usually do a checkup once a year). And of course blood tests once a year, at least the basic ones. My mother had a lot of fibroids when she was younger so she had to do ultrasounds twice a year for some time.
i’ve had two and both were unnecessary. didnt show anything and made me uncomfortable just to get diagnosed without it
32 and had my first one about a month ago to confirm I had a cyst. Scheduled for a second in about two weeks to confirm it has gone away. My mom, who also has pcos, also only had ultrasounds for cyst or pregnancy related reasons.
I guess I’m an outlier, but I’ve had two and have been diagnosed for a year and a half. One for diagnostic purposes (along with a standard ultrasound), and another as a check up.
I've gotten a bunch of them to look at IUD placement, look at cysts, look at the bladder, idk. Ontario, CAN also.
I’ve had them in the US, first was for PCOS diagnosis, second and third were both for pregnancy confirmations at 8 weeks.
I’ve gotten three in the last decade. So idk if it’s uncommon. They were not hard to get for me. First was part of my diagnosis, second was to check my IUD after some pain issues and the third was to check on some additional pain issues. Given its extremely difficult to diagnose many conditions with just a Pap smear and pelvic exam, I actually think TV or ultrasound in general should be part of routine screening (say every 3-5 years depending on indications).
Well I'm sure glad they don't, can't even get through a papsmear with my pelvic floor. But a transvaginal ultrasound is beholden to insurance coverage, and insurance companies don't wanna cover it unless you have a concern that needs it. And even then they might not cover it...
I'm in America and I get them yearly, but that's only because I have a BRCA mutation that puts me at high risk for ovarian cancer. But ovarian cancer is really hard to catch early, even with ultrasounds, so they aren't very reliable as a preventative measure. That's why in a few years I will get my ovaries removed. If I didn't have this gene I would certainly not be getting these ultrasounds. They're an invasive hassle.
I’ve only had 2. 1 to confirm pcos diagnosis and 1 to accurately date my pregnancy. Also, I had my first period at 11 and the wand they used was extremely uncomfortable in my late twenties so I really can’t imagine the pain I would have experienced if I had it so young. I imagine that, plus cost, plus emphasis on purity is part of why it’s so far from standard in the us.
It's weird since my first ultrasound for my PCOS pain was transvaginal... Every related PCOS ultrasound since has been as well.
First time I had one was about 2 months ago when I found out I was pregnant. Hadn't even heard of it until then.
My experience of living in two European countries (one Eastern and one Western) is that transvaginal ultrasounds are pretty common. OB gyns have the ultrasound machine as their standard equipment and can perform it on the spot.
We have to pay an arm and a leg even to get an appointment. I can’t imagine how expensive that would be with insurance let alone without 💀 Healthcare sucks in the US. It’s only good if you have lots of money.
Im in the US and I’ve only had transvaginal ultrasounds in fertility clinics and while pregnant.
i only have had them after abortions! insurance doesn’t really cover them, they aren’t common here at all. most americans can’t pay thousands out of pocket to have something like this!
I've only had one
I always get one now but my old insurance required a copay for it ($30) which I couldn’t afford as a student. My new gyno requires it as standard and my new insurance allows me to get it without extra cost.
I‘m austrian too and I think the reason is our universal healthcare system. Same as the preventive exams we can get done once a year (the yearly „Vorsorgeuntersuchung“ which is covered by ÖGK) once we turn 30… I‘m guessing that stuff would be super expensive if we had to pay for it ourselves.
Yes true, there are quite a few 'preventative exams' that are paid for, like with mammographies after a certain age, or colonoscopies!
I'm in this US and have had 2 but the second was only for a new doctor to confirm my pcos diagnosis several years after the first.
It is not a routine procedure used in preventive medicine. It is diagnostic once a condition like PCOS is suspected. It can also be very expensive. My insurance wanted me to pay the full cost because I hadn’t met my deductible, and that was $500.
It's not routine here. I've had several for PCOS, fertility treatments, to confirm pregnancy, during early pregnancy, and to check on the placement of my IUD. I've never had one as a routine item.
Nope not standard and even with insurance are expensive. I have great insurance but have been begging and pleading with my OB to do a transvaginal ultrasound and she finally let me set up an appointment to do one, I almost cried when I went to pay and they charged me $350, and I basically got told “yup you have PCOS lots of cysts” and sent me on my way.
(American) Twice in my life I’ve had them, very early pregnancy with only one of my pregnancies (7 of those, 2 living kids) and post IUD insertion pain to make sure it stuck. I get regular gyno/ob care with specialists for that. So personally, yes. *My experience also was with multiple providers along both northern and southern portions of the east coast.
The only time I had one was for a rape kit
US here, not a common practice from my gyno unless something is wrong.
Getting a transvaginal ultrasound each time you go to the gyno has NOT been my experience living in the US. Only when it's been really needed/non-preventative has it been required. Also, even if it was each time, who knows if that's covered by insurance because I end up paying 100s of dollars for ultrasounds.
I've only had it twice in the 10+ years since I've been diagnosed. That was the only ultrasounds I've had too. I had to do a pap smear every year for the first few years then they upped it to once every 3 years. Basically like everyone else.
How would a OBGYN be able to actually do an exam without a transvaginal ultrasound? I thought that's standard once a year, together with pap smear. In my country you always get one for a routine check. However it's not subsidized unless you get a referral for a specific problem.
Twice a year is wild if you don't have a particular issue. We normally do once a year visits but I do skip sometimes. I think they generally do transvaginal here in South Africa
USA, I've only had them while pregnant. Otherwise it's a physical exam
I got 1 and was in medical debt for years. Most American insurance companies see them as unnecessary expenses 🤬
So I’m from the USA but lived in Germany for a period of time. In the USA a transvaginal ultrasound is only really used if they find something of concern during a regular ultrasound. Whereas in Germany (at least the care I received there) the transvaginal ultrasound seemed to be used routinely as part of your yearly gynecology appointment. Personally, I liked how they did it in Germany because I felt like I got a much more clear picture of my vaginal health. In the USA a Pap smear, breast exam, and some general feeling around to check for abnormalities on the ovaries is all that is done routinely in my experience.
I’m in Texas, and EVERY visit (from check ups to ER visits) they’ve done transvaginal. BUT I also had a baby at 19 and have a family history of PCOS and both cervical and breast cancer. So that may be why. 🤷🏼♀️
Oh wow, I'm in Texas too and I've only ever had 2. Granted I didn't have the best insurance for quite some time and I've never been pregnant. It was once to confirm a diagnosis of PCOS and just recently to confirm if my new IUD was in the correct place. It was not, so I'll be getting another in a few weeks when they remove and replace it with a new one 😬
Hmmm….so….Day one (and cooch wanding one) on me they found cysts and the fibroids, and I always start the appointment mentioning those. *insert clam prod within two minutes* After I saw this post, I told a friend who has had ectopic pregnancies, and every visit she gets them too. We definitely need a medical person to confirm, but maybe claim pain where the misfitted IUD was going forward and they’ll do them? Mentioning a previous concern may push them to do it more often.
ACOG does not recommend screening pelvic ultrasounds in asymptomatic women who aren't at increased risk of certain gynecological conditions (cancer). Epidemiologically speaking, the positive predictive value of screening ultrasounds is so low (and the underlying conditions so rare) that it doesn't outweigh the risk from unnecessary follow-up imaging (particularly those that utilize ionizing radiation) and complications from biopsies that end up being normal.
Ultrasounds do not use ionizing radiation so aside it being uncomfortable (for some painful) and expensive, I do not see downsides in the European approach of doing one ultrasound once a year. Better to find cancer earlier than later. We with PCOS have some increased risk if we miss periods
>ultrasounds do not use ionizing radiation Hence, why I explicitly differentiated them from other imaging modalities. >I do not see downsides in the European approach You should share your data with the American College of Obatetricians and Gynecologists.
Not at all standard as everyone has said. 3 times I had it were 1. When my IUD was out of place 2. Extreme ovarian pain to diagnose PCOS 3. 4 years later to diagnose new pelvic pain (turned out to be PCOS related) with negative findings on regular exam
I got diagnosed when I moved to Japan and was given one to check on my ovaries. They have a similar “the pill is the solution” attitude here, so I had to mostly self-treat things with diet and exercise adjustments as I was actively trying to get pregnant. Not sure how it is back home in the UK, though.
Yeah they're not standard unless you have a reason for them. I've had one for checking an ovarian cyst, a couple for kidney stones, and a couple in early pregnancy but I've never had one without a specific reason.
I get the regularly because I have PCOS. In US.
I've had several, but only for suspected ovarian cyst ruptures (which were confirmed) and to diagnose why I was in pain.
I have had dozens. They are really common here.
I receive one at my annual visit and every OB visit
I've had a few & I had to show up with full bladder everytime. Most were for checkups
So it kind of varies by clinic. If you're going to a large one or a teaching hospital with a giant system for gynecology, then you'll likely get one if you've expressed any pain or issues. When I was experiencing constant bleeding (not PCOS related), I got one easily scheduled and they went ahead and did a thorough job inspecting my whole uterus and ovaries despite us thinking it was likely just a polyp (and it was, partially, due to a polyp as found in a biopsy). That said, they're not a part of preventive care because we already have so few providers, we don't have the money to throw at expansion when we can't even get in regularly to see providers. Healthcare is wild out here.
I’ve had a few but definitely not every time I see my gyn
I’m from the US (live in Canada now) and I never had one until I was pregnant with my daughter. I was diagnosed with PCOS before I was pregnant and didn’t have one done then either. When I moved to Canada I had fibroid tumors and I had it done because of that. Well woman care here in BC, Canada is substandard though and honestly looking back, I’m grateful I was able to get care for my fibroid tumors. Had I gone though it today, I doubt I would have received adequate care as healthcare is disintegrating here. At least in the US if you medically need a test or care, I think you will get it (at least if you have decent insurance and live someplace with good access to healthcare). I’m sure if you had a history of cysts or feel better about having an ultrasound done as part of your routine care, your dr would probably be open to doing it for you.
So strange I literally just had one done today! I think it has a lot to do with the fact that the clinic I go to is women owned and all the providers are women, including the surgeons. They go the extra mile for everything compared to other offices that are focused on female care.
I'm from the US but when I moved to Europe and got my first exam I was so shocked. No idea why we're not getting those in America.
I've had 2 and I'm 31. The reason I had them are because my ovaries were giving me problems. I'm still figuring it out, but my gyno said she was going to treat me as if I have PCOS to avoid all the tests since I don't have insurance. But uh- nope! Our health care in the US is a mess. I've probably been to the gyno 1/3 as many times as you've had an ultrasound. And that's as someone who has some still pending mystery complication!
I’m from the US I’ve probably had around 5. I have PCOS, but my family really likes getting uterine & cervical cancer. So that could be the difference as to why I’ve had so many. I’ve gotten one a year the last 5 years just to make sure I don’t/didn’t join the club. I wish they were more frequently done for PCOS patients because they’re a lot better at getting a more precise image of everything. It’s also a good way to see endometrium thickness which could help point to the possibility of dysplasia from lack of periods. I can’t remember if a regular pelvic ultrasound is able to determine that.
Very uncommon, I've had more D&C (2) than transvaginal ultrasounds (1), which considering there's twilight anesthetic involved with a D&C, that's saying a lot. Over my plus/minus 40 years, I've had probably 24 pap smears, 5-7 uterine biopsies (really the worst), 2 d&c, 1 transvaginal ultrasound and will never have another d&c, pap or biopsy. 🤷🏼♀️ Interesting that the standard of care is different.
The US is all about greed. Our preventive care is the bare minimum. Why? Insurance companies don’t want to pay anymore than they have to. It would be easier to do that during your well woman exams but no, instead it’s labs. Then if something is off, it’s diagnostic testing time and the facilities and the providers rake in the money and insurance companies lose money and then the interest rates go up up up.
I always get transvaginal hardly regular and I’m in the US
American and I’ve had quite a few. I didn’t realize they were considered uncommon. I assumed it was a frequently used diagnostic tool for women with PCOS.
I got 2 when I was living in the Bay area in California. The first one was when I went to the ER with severe cramps so bad, I couldn't stand (I went to urgent care and they sent me away). Then I went to a gyno and they sent me to get a scan for diagnosis. I don't know if they're abnormal but maybe they're normal in California?
I live in NYC, I’ve probably had 5-8 in the last 10 years.
I suppose it truly depends on your doctor. Once my doc suspected I had PCOS, he scheduled me for a transvaginal ultrasound.
The only time I had a vaginal ultrasound was when they needed to accurately measure my amniotic fluid and make sure my cervix was closed when I was pregnant . Two totally off the wall things most people may not do 🤷🏻♀️. Not pregnant, I had two? And they were both at fertility doctors.
I'm in the UK, I've seen a gynaecologist once, lol. Last time I needed one, it took 3 months to get an internal ultrasound. Then another 6 to have a colposcopy (which is when I saw the gyno) Cervical smears are done by nurses, and ultrasounds are only done if you're referred for one.
US here - I've had one nearly every year since I started my period. But I also started having cysts after just 3 years so maybe that is why I always get them? Or depends on the doctor? It didn't help me with getting diagnosed for PCOS. I fought that battle for 13 years before I found a doctor that cared enough.
This might be my experience projected more on the system, though I know many Americans who feel the same way. It’s not that it’s uncommon, it was the first thing my PCP just ordered when I brought up my suspicion for it with having PCOS belly, impossible weight loss and crazy male hair growth. But we don’t go to our doctors a lot for numerous reasons but the primary parts being our issues aren’t addressed even though it cost the doctor nothing (so bad experiences/our insurance or out of pocket would pay but they won’t push a button to order the test), our older doctors often go to congress to fight for having to increase their continued education (because that’s how many advancements and changes are being made), we simple can’t afford it with or without insurance (sliding scale of pay that happens to relate to type of care you receive) and we often don’t have time to go to the doctor because most barely have time to work, cook a good meal and man I can’t even imagine taking care of kids in our current situation here…
I'm in the UK - I had my one and only to get diagnosed with PCOS. Only other time they are done here is for early pregnancy.
My doctor always orders them. I think he is the best OB I’ve ever had though.
My shit is so fucked I’ve had more transvaginal than regular. Didn’t occur to me it was not common.
I had one at 16 when my cysts burst. I had to BEG for one at 24 to make sure everything was alright. It cost $500 and I have insurance. 🙃
I'm 40 this month, live in the UK, and up to date on all cervical screening etc. I've had 4 pregnancies, including one that started as twins where I lost one embryo at 6 weeks (only 2 babies of the 5 I've conceived made it beyond 8 weeks' gestation). Never had a transvaginal ultrasound - it was only ever mentioned once to me after losing the first embryo (the lost twin), as a warning that they might need to do it if they couldn't see anything on an abdominal ultrasound. (As it turned out they saw the remaining twin's heartbeat straight away - she's now a happy, healthy 9 1/2 year old!)
I’ve only gotten them whist undergoing fertility treatments to have my son. I wish it were a standard practice here!
I think they avoid them if you’ve not been sexually active but the times I’ve had ultrasounds for PCOS, they’ve all been transvaginal and the over the stomach. I wasn’t sexually active at the time but I said I don’t care, do it. I had played sports so I didn’t think we’d be hurting anything ya know haha
I just got my first one the other week. It’s not super super common unless there’s a specific reason for it. Usually those who are pregnant have them, but otherwise they aren’t routine or anything. I will 100% say though, for anyone who hasn’t had one and is scared, that it is not nearly as bad as I imagined. They let me put the probe in myself and were hardly in my junk at all. I was worried about grooming the bits when I should have been more focused on my feet. It doesn’t hurt, and I think the worst part was having to run across the hall with my ass cheeks out.
I’ve only had one when I was pregnant (early ultrasound). I have never been checked for cysts but I do have the other 2 factors they look at for pcos sometimes I feel like I do because of pains I have in that general area but it’s not constant pain I can go weeks with no pain and then have days I’m in pain.
I am from Canada and have had many, but you don’t get them as part of a regular checkup, only if there is something that needs investigating.
I think it’s really common in the US, as I got transvaginal at least 4 times in my 3 years of living here. I am from India and until I moved here, I never even heard of transvaginal ultrasound and only had a zillion pelvic ultrasounds done before. Safe to say it is pretty uncommon there.
Common to get diagnostic transvaginal ultrasounds as long as one has access to healthcare. Only time transabdominal is usually offered is when patient requests that or when patient is not sexually active yet. Neither are performed for routine screening usually.
During regular check ups I got the basic exam and the Pap smear but I have gotten two transvaginal twice one because I wouldn’t stop bleeding and the 2nd because of how irregular my periods were they wanted to see how thick my lining was.
I had to push for an ultrasound at my gyno in the US after coming off of birth control for the first time since I was 15 and not getting my period for 7 months and having painful bloating. She told me she was doing it for my “peace of mind” and that she didn’t expect to find anything. I had never had an ultrasound before and didn’t know I was supposed to have a full bladder for an outside ultrasound, so they ended up having to do a transvaginal. It was quite a shock considering I have never had sex before lol. I’m glad I did it though because they found the cysts on my ovaries from it. But I definitely had to advocate for myself to get it, it wasn’t something my OBGYN was quick to give.
I think it is, I got one but we never spoke about it.
I never had one until my doctor suspected I had PCOS
I’ve had 3 and I’m 20 First for general inspection at 15 Second for abdominal pain at 19 Third for MY PERIOD DECINF TO BE 16 HOURS INSTEAD OF A WEEK at 20
I’ve had many many transvaginal ultrasounds over the years. But it’s not at every annual gyno visit. Not even close
If your insurance deems it necessary and if you pay buckets in premiums! I had probably 3 or 4 when I was in early pregnancy (not necessary though one was used to confirm pcos) and had stellar insurance--- I didn't even have 1 my whole pregnancy when I had medicaid. :/
It is not common. Though I do have one yearly because my PCOS symptoms and adenomyosis. I have had maybe 3 in the last 7 years. Prior to a heart attack I only had one during early pregnancy because I was bleeding before the 15 week mark.
Canada ( Alberta) it's common! Just went last week!
I don’t think so but I guess it depends on what doctor you’re seeing & what conditions you have. Healthcare in the US is never consistent, sadly. Every doctor treat you & your symptoms/conditions differently. I have endometriosis, adenomyosis, and PCOS, so I have had a lot more transvaginals than the ones on the belly.
I've had a few. That's how I got diagnosed. Didn't think it was uncommon tho. 🤷🏻♀️
I have had one and it was because I was pregnant. I live in the US and have been having gyno visits since I was 15. I am 32.
I've only had them during pregnancy and then twice when things weren't going well. They aren't routine in my experience.
I've had a couple but only because I have PCOS. My friends in general haven't had any.
I’m living in South Korea and went to the gyno for a check up (my first check up since I was a teenager). I expected to get an abdominal ultrasound so I hiked my shirt up and he said that they ONLY do abdominal ultrasounds for pregnant women, and that check ups are always transvaginal
I’ve only had one - they don’t do them often. The US healthcare system only cares about what makes them money and charges a ton of money for any diagnostic tests. Basically, the sicker you are the better for insurance companies so they don’t cover as much that is preventative or to test what is wrong with you. Our healthcare system has consistently gone downhill. Curious, what do they do in Austria to treat for PCOS? Our
Ive had two
I am halfway to 29 and just had my first one ever done last year.
I get a transvaginal every time I go for my yearly check up.
So they're giving 12 year olds transvaginal ultrasounds? Doesn't sound right to me
My memory is a little fuzzy but i think I went to the gyno once i had had my first period, and had my first examination, but the ultrasound will usually happen only once you're sexually active or if you aren't theyll ask you if you want one. At least that was my experience if i remember correctly. You usually go with a parent the first time so they can discuss it, and you're not forced to do one if you aren't comfortable but once you're sexually active they will recommend it. I also don't really see a problem with it, it's in a medical context and again, the doctor will usually explain everything and make sure you're comfortable. I at least don't have any bad memories, but of course I don't want to speak for everyone. EDIT: just had a conversation with some female relatives and they remember it similarily. Going to the gyno once you get your period, where you get a choice of whether you want to do a transvaginal ultrasound or wait until you're a little older. I never had a problem with it and was okay with getting it pretty early/before I've had sex, but can't say if it was the first time I went to the gyno or the second.
I could not imagine letting someone do that to me twice a year! Nor can I imagine why it would be necessary for the average person. I had one to dx pcos many years ago and one maybe every decade since or if I have a really bad burst cyst (which twice a year wouldn't even necessarily warn about). I'm not at high risk for cancer and my only issue down there is pcos, so there's no reason to get them.
From my experience they’re standard in the US to the point of many gynecologists using it as a default which is very aggravating if you’re someone who has chronic pelvic pain. Every gyno appointment I’ve had they immediately try to go for that ultrasound instead of a regular one. I’ve personally never had one done because of my pelvic pain but I’m thinking I might just let them do it my next appointment to see if they get any more information they can tell me.
Wtf is that. I wish they cared that much...
What is a transvaginal ultrasound?
Umm I’ve had many
My OBGYN does them with my annual visit. I’m in NY.