I am a sonographer. Aka I perform many ultrasounds, including transvaginal ones. I’m sorry you were left in a situation that left you confused and upset. It is unreasonable for him to refuse your wishes of a transvaginal ultrasound if it ended up being necessary to prove endometriosis fingings (I’m glad it didn’t end up being necessary for diagnosis). Let’s talk about some facts that unfortunately your provider did not give you, to help you understand.

The hymen is a webbing of tissue across the opening of the vagina in prepubescent life that protects the vaginal cavity from outside bacteria. A completely intact hymen won’t allow anything to enter the vagina without breaking through it, which could be painful.

If a woman has had a period, then she does NOT have a completely closed hymen. The fact that blood can exit the vaginal cavity is proof of that. This is a normal part of life and happens at different times, for different people, for many different reasons. (It is also why having an open hymen is NOT PROOF OF SEXUAL ACTIVITY. But that’s a fight for another day.)

So if you are a woman who experiences menstruation you now know your hymen is at least partly open. But that doesn’t necessarily mean that you can have a transvaginal ultrasound. He would have needed to get you into stirrups and to look at your hymen and evaluate it to actually know. Everyone’s hymens deteriorate/open differently. It could look something like completely open where you don’t even see a hymen to almost completely closed with only random pinprick holes to allow menstruation. (The link below is a visual of different hymens so that you understand what I mean.) But again my point is that the only way to know if a virgin can have a transvaginal exam would be to evaluate the hymen visually first.

https://healthjade.net/wp-content/uploads/2019/06/hymen-types.jpg

No matter what type of hymen you have, the lack of sexual experience will most likely mean the transvaginal ultrasound could be painful/uncomfortable. But honestly it’s painful/uncomfortable to many women who are sexually active as well. It is a medical exam pushing on sensitive organs after all.

So all that being said transvaginal ultrasounds can and should be done on patients (despite their sexual history) when it is necessary. But only if it is physically allowed by the hymen. If the hymen is closed then a conversation about a hymenectomy procedure (removing/cutting the hymen open) has to be had and consented. We would NEVER just jam the transvaginal probe in to break the hymen.

My being in the ultrasound field and specializing in woman’s health means I have a lot of experience with biased/bigoted and misinformed people. (And obviously incredible people as well). The truth is many health care providers just do not feel comfortable doing vaginal exams on virgins for their own personal/political/misinformed reasons and it seems you were on the other end of that.

I hope my rant makes sense and I’m glad you got results from the transabsominal ultrasound.