While Transvaginal, Testicular, and Transrectal ultrasounds are amazingly effective diagnostic tools. As is pertinent here, the use use of Transvaginal ultrasound is becoming more and more common in routine GYN exams and procedures, particularly for peri-menopausal woman, and adolescents. Both ends of the scale you may say. In the case of younger women or girls, it creates a permanent record or archive of (one of) the initial visits and makes studying changes much easier apart from its diagnostic value at the time. However, they are not, nor should they be used in place of visualization, and manual examination. They should augment it. I have yet to have a patient complain that it was painful, or even uncomfortable. I have had many, at first, look at the probe, and got a chuckle as their eyes widened and jaw dropped, with the look only we women can have that says, ¨You think you´re gonna get all that in me¨!