Pelvic Ultrasound for Heavy or Irregular Periods: What to Expect

When periods change in your 40s, getting heavier, longer or less predictable, your clinician will often order a pelvic ultrasound. It’s one of the most common tests for abnormal bleeding.¹ Here is what happens.

Why it’s ordered

A pelvic ultrasound looks at the uterus, cervix and ovaries. It can help find causes of abnormal bleeding and other menstrual problems, such as fibroids and ovarian cysts, and can also help detect cancers of the uterus or ovaries.¹ The vaginal scan is used to view the uterine lining (endometrium) and the muscle wall of the uterus.¹ Our guide to uterine fibroids explains one of the most common findings.

Ultrasound uses sound waves, not radiation, and is described as safe and painless.¹

Two ways to scan

Through the belly (transabdominal). You may be asked to drink water beforehand to fill your bladder, which helps the images. Gel and a handheld probe are moved over your lower belly.¹

Through the vagina (transvaginal). You’ll empty your bladder first. You lie on your back, sometimes with your feet in stirrups, much like a pelvic exam. The probe is covered, lubricated and inserted about 2 to 3 inches. Its tip is smaller than a standard speculum.¹ RadiologyInfo says a vaginal scan is usually more comfortable than a manual pelvic exam.¹

Many appointments include both. A Doppler setting may be used to check blood flow, and you may hear a pulsing sound.¹

How to prepare

• Ask whether you need a full or empty bladder.¹
• Wear loose, comfortable clothing and leave jewelry at home. You may change into a gown.¹
• Bring your bleeding record. Our heavy period visit checklist lists what to note.

Afterward

Most scans take about 30 minutes, and you can go back to normal activities right away. A radiologist reads the images and sends a report to the clinician who ordered the test.¹

What it can’t show

Gas in the bowel can block the view, and imaging can be harder through more body tissue.¹ If the lining or the inside of the uterus needs a closer look, you may be offered a saline ultrasound (sonohysterography) or a biopsy.¹ Our article on saline ultrasound vs. endometrial biopsy compares them.

Questions to ask

1. Will it be a belly scan, a vaginal scan or both?
2. Should my bladder be full or empty?
3. When and how will I get the results?
4. What happens next if something is found?

Try: “My periods have gotten much heavier this year. Will the ultrasound check my uterine lining as well as for fibroids, and what’s the next step if it’s unclear?”

Period, Handled includes a Period Scorecard and a visit script. Use them to track bleeding before your scan and bring questions to your results visit. See the book.