Internal Ultrasound worries

[Startingoverinmy30s]

Hi all,

I’m just looking for some advice/reassurance about having an internal ultrasound. Sorry in advance for the long post…

Ive had irregular periods for several years (when I finally get a period it’s either very light and lasts a day or two or very heavy lastiny two plus weeks and painful) I had blood tests to check my hormones and all fine and I had an abdominal ultrasound. The ultrasound picked up that I had a fibroid on my right ovary. I was told by my GP that it was small and to get in touch if it ever started causing me pain. Since last November I’ve had pain mid cycle on my right side and general pelvic pain at times although my periods are now much more regular. My GP referred me for another ultrasound and I just received my appointment letter and it’s for an internal ultrasound.

I know I am probably being ridiculous but I am absolutely terrified. My first ever smear test and internal exam when I was early 20s was extremely painful and I ended up with vaginismus following this which took years to overcome. I can now just about cope with a smear as long as the nurse uses the smallest speculum (I’ve been lucky as the nurses have always been very gentle and patient with me) but the thought of having a probe inside me for up to 15 minutes and them pressing and moving it makes me want to be physically sick. Is it as bad and painful as I’m imagining it to be? Why can’t they do another abdominal scan and is this something I could reasonably request?

Usually abdominal ultrasounds don't show as much as an internal. That is probably why they are suggesting it, to further investigate.

After having lots of investigations myself into severe period pain, and then going on to have IVF, I've had a fair few internal ultrasounds. I would honestly say it is no where near as uncomfortable as a smear test. It's also not usually 15 minutes, that sounds like worst case scenario. The nurses are calm and patient and you can ask them to stop at any point for a break. For me it felt like a pressure, it was not painful at all.

Smear test is way worse than an internal ultrasound, honestly.

I’ve had several internal ultra sounds, I’d much rather have those than a smear, they are way easier to cope with. The worst bit of it was the cold gel on the probe, it wasn’t painful at all.
good luck with it, just try and breathe through it.

I agree with pp. The internal ultrasound was way less painful than any smear.

Agree with the others. Also, from your post “pressing and moving” - the internal one isn’t like the external one in this way so don’t worry.
take deep breaths to relax, take music if you need to and let them know you are feeling worried about it. It’s definitely ok to ask if it could be done differently but there’s likely a reason they’ve suggested it.
Good luck

I’ve had several internal ultrasounds and they’ve ranged from mildly uncomfortable to not noticeable at all and I have had terrible trouble with painful smears. They longest one was 5 minutes max.

I know it’s a worry when you’ve had awful experiences in other gynae areas but I would have an internal ultrasound every day if it meant I never had to have a smear again!

Why can’t they do another abdominal scan and is this something I could reasonably request?

You don't HAVE to consent. You can say no. I've had similar but the circumstances were slightly different. They said they could do an abdominal scan but it doesn't also pick up everything.

In your case you've already had an abdominal scan, and they clearly want to do further investigations. That makes it harder. There's clearly an issue they want to find out more about and there may be limitations on how they can achieve that goal.

This is why you should discuss this and why you are concerned at your appointment. They can't make you have an internal scan. But equally you also need to make an informed decision about why they think it's necessary and go from there.

I think once you have all the information you will feel better and understand and be able to make a decision you feel comfortable with.

Don't let anyone else on this thread tell you different or emotionally blackmail you into something you don't want to do. Make a decision on your terms and that you think is the best for you.

I've had similar issues and was hesitant when I needed an internal ultrasound but it was only uncomfortable and not painful in the end. I wouldn't be embarrassed about telling the sonographer at your appointment about your concerns - I found the staff at my appointment very understanding.

Internal ultrasounds show things much more clearly but you don't have to agree to it.

However, after having many myself I can honestly say it's not traumatic.

If you are able to insert a tampon or have sexual intercourse without pain then you should be fine with the ultrasound probe.

I need a lot of drugs to cope with a smear.
I've just had a cycle of IVF which involved 5+ internal scans. Some of them had a moment of yuck and then it settled and I was fine even when they moved it.
Internal scans are no where near as bad as smears. The probe is smaller than the closed speculum and then they don't need to open it.

(They did my smear during IVF while sedated as I was overdue).

I can just about tolerate them. I refused smears, internal fingers etc for years and needed to have GA for colonoscopy after I smacked the doctors hand who tried a rectal exam 🫢 I ask them to go in slowly bit by bit. Getting it in feels fine. The moving around is slightly uncomfortable and I do fuss at that point, but it’s not constant wriggling the bloomin thing just a few times up down side to side. I’d try it and see but let them know beforehand you might not tolerate it and you were told if not mri would be next step. Then if returned to GP say they recommended an MRI instead. Because you need to know what’s happening in there

Thank you all so much for your kind and reassuring posts!! I actually can’t make the date they have offered me as I will be out of town but when I phone to reschedule I will let them know about my concerns and history and see what they say. I ideally would like to get done whatever they think best to check the fibroid and that there isn’t anything else going on but my past experiences just make me very nervous and automatically expect the worst.

@Rainbow1612 I’m not able to use tampons (I’ve tried all types) as they are just too uncomfortable and I do find sex a bit painful at times but not impossible anymore. It does worry me that I’m going to tense up and make it worse and set myself back again 😔

I agree. They really don't last 15 mins either in my experience. Maybe both an internal and external would, but not on its own. I find it much less invasive as they insert the probe without really looking at the area iyswim whereas a smear all is exposed. I was worried my last one would hurt as I had some soreness after taking hrt after having Zoladex injections in preparation for a procedure but the radiologist was fantastic.

Hi @Startingoverinmy30s
I'm a sonographer, and perform probably 20 internal scans a week. They are incredibly well tolerated by most women, nowhere near as unpleasant as a smear.

The probe (camera) is about as thick as a tampon, and is only inserted a couple of inches into the vagina. There will be plenty of lubricating gel, and the sonographer should tell you that you are in control and can stop the scan at any time.

That being said, you DO NOT have to consent to an internal scan if you are not absolutely happy to do so.

In my department, even if booked for an internal scan, we would look abdominally to start with, then offer you an internal if we felt it would improve the accuracy of the scan.

Sonographers are very used to women having worries about these scans, and yours should be happy to talk you through any concerns. I'm happy to answer any questions you might have.

Is it as bad and painful as I’m imagining it to be?

No, honestly not, from someone who has never been sexually active (not through want of trying) or had children etc. The most embarrassing part is actually telling these professionals now I have never been sexually active.

I had an tummy ultrasound turn into an internal to diagnose a fibroid, it had to be done. I may have wished the sonographer at the time went to Specsavers but that's by the by.

Thank you for taking the time to reply and explain things for me! I’ve called the hospital this morning to reschedule and I mentioned my anxiety and they were lovely! Told me to come with a full bladder so they can do an abdominal ultrasound first and to explain everything to the sonographer and to take it from there. I apologised for being awkward and they said not to worry at all and they will do what I am comfortable with on the day.

Glad to hear that @Startingoverinmy30s. You really won't be the first or last patient to be worried, and I'm sure the sonographer will look after you. Hope all goes well for you

Hi OP, I've had loads of them. The worst issue for me is that the lubrication always gives me thrush. You don't really notice the probe it's so slim.

You can have a look at your ovaries and uterus too which I find fascinating. My sonographer points out what she is looking at and gives me the measurement of the endometrium and tells me the size of my ovarian cysts (which come and to).

It's actually really interesting once you get past the initial embarrassment and they are so kind and gentle I'm sure you'll be OK.