How important is pelvic examination for women?

Pelvic Examination is a method of examining the reproductive organs both externally and internally, using visual inspection and palpation to detect abnormalities in the pelvic cavity, uterus, ovaries, and is performed by a gynecologist.

The symptoms that a woman might not expect are unusual, such as more menstrual cramps, a change in menstrual colour, a change in menstrual volume, fatigue, frequent urination, or and constipation or difficulty passing stools. These symptoms are warning signs that require an examination by a gynecologist to conduct a screening for Myoma Uteri and Ovarian Cysts, which are common diseases in women. A routine pelvic examination may not be enough, so these conditions should be tested for with a Transvaginal Ultrasound Examination.

Transvaginal Ultrasound (TVS)

TVS uses high-frequency sound waves transmitted through the vaginal canal to visualize the pelvic organs mainly all parts of the female reproductive organs both externally and internally. TVS generally provides much clearer details compared to abdominal ultrasound. Thus it is more advantageous  for early problem detection such as abnormal mass, uterine fibroids, ovarian cysts, etc; even the tiny ones. It also helps evaluating the uterine and ovarian conditions for assisted reproductive measures as well.

Why do you need to screen for abnormalities in the uterus and ovaries?

The ultrasound examination of the uterus and ovaries is not just about detecting abnormalities, but also about preventing diseases before they develop, such as:

  • Detection of uterine fibroids
  • Ovarian cysts or cysts, such as chocolate cysts.
  • Abnormalities in the uterine cavity, such as polyps.
  • Abnormalities in the cervix and vagina.
  • Cervical cancer.

Does the ultrasound examination of the uterus and ovaries have any side effects?

The ultrasound examination checks for abnormalities of the uterus and ovaries through the vagina, using a transvaginal ultrasound machine specifically designed for gynecological examinations. It utilizes high-frequency sound waves and does not involve radiation, making it safe for patients. The examination is quick, and after it is completed, patients can resume their daily activities as usual.

Diseases commonly found in women sometimes might not be detectable through routine examinations alone. This could mean detecting just benign fibroids or potentially cancerous cells. The transvaginal ultrasound not only enhances diagnostic accuracy but also aids doctors in promptly identifying and treating serious conditions. Common women’s health issues include:

Myoma Uteri

This is caused by abnormal changes in the muscle cells of the uterus. It may occur in the uterine lining, the uterine cavity, or grow into a lump protruding from the uterus, and the patient may be able to feel it. It is more common in women who enter puberty during their 30s and less common in women who enter menopause due to hormonal depletion.


  • Irregular vaginal bleeding: Irregular or unusually long periods are common. The symptoms worsen with the increasing size and number of uterine fibroids.
  • Abdominal Pain: Abdominal pain during menstruation or unrelated to menstruation.
  • Frequent urination or difficult excretion: This can be caused by a large tumour pressing on the bladder and rectum, causing frequent urination or difficult excretion.
  • Infertility: This can be caused by a growing tumour pressing against the uterine cavity, thus obstructing the implantation of the embryo.


This is caused by endometrial growth outside the uterus, forming a Chocolate Cyst or Endometriosis Cyst, or forming inside the Adenomyosis, causing inflammation in that area and resulting in fibrosis.


  • No symptoms.
  • Longer lasting and more severe menstrual cramps than usual.
  • More painful when defecating than usual during menstruation.
  • Abdominal pain during or after intercourse.
  • Infertility: Since the disease causes pelvic fibrosis, it makes the pelvic floor unsuitable for the fertilization of egg and sperm, thus leading to infertility.

Ovarian Cysts

Ovarian Cysts: These are partly caused by abnormal cell division in the ovaries, which can develop into a cyst. It is more common in women of childbearing age, between 18 and 45 years of age.


  • No symptoms.
  • Abdominal pain.
  • Abnormally enlarged abdomen, palpable lump in the abdomen, bloating, and abdominal distension.
  • Frequent, painful urination, which is caused by the growing cyst pressing on the bladder.
  • Irregular menstrual problems, Irregular or heavy menstrual periods, severe menstrual cramps, or persistent pain in the abdomen, even without menstruation.
  • Painful intercourse.
  • Some people gain weight or have acne, while others lose their appetite or lose weight.

This package is suitable for the following individuals:

  • Women who are 25 years old or older.
  • Women who experience the following symptoms:
  • abdominal pain or abnormal menstruation
  • palpated a lump in the lower abdomen
  • Individuals with a family history of reproductive health conditions should undergo regular annual examinations.

Preparing for pelvic examination and a transvaginal ultrasound examination

  • Try not to schedule a cervical screening during a menstrual period.
  • You should not douche or use any intra-vaginal medications for at least 2 days before your scheduled examination.
  • Avoid sexual intercourse for at least 1 day before your scheduled examination.
  • If you have your period or experience severe menstrual cramps, you can consult with a physician without waiting for your period to end.
  • Wear comfortable clothing that is not too tight and empty your bladder before your scheduled examination.

BNH Hospital encourages all women to have regular pelvic exams.

BNH Women’s Health Centre has a long experience in women’s health care for Thai and foreign women. We provide personalized care and comprehensive services including counselling, prevention, screening, diagnosis and innovative treatments from our experts in Obstetrics, gynaecology, Oncology, Urogynecology and Fertility, in order to ensure excellent and impressive health care experience.

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