Changes in ultrasound morphology of the uterus and ovaries during the menopausal transition and early postmenopause: a 4‐year longitudinal study

Abstract Objectives To describe changes in uterine and ovarian size and morphology as determined by ultrasonography from 2 years before to 2 years after menopause. Methods Twenty 50‐year‐old women with fairly regular vaginal bleeding at the start of the study underwent transvaginal ultrasound examination every 3 months until 12 months postmenopause, then every 6 months until 24 months postmenopause. The results are presented from 2 years before to 2 years after the menopause. Results In the 2 years preceding menopause all the women were in menopausal transition. From 2 years before to 2 years after menopause uterine anteroposterior diameter decreased by 22% (mean) and left and right ovarian volumes by 45 and 20% (median), respectively. At 2 years before the menopause the total number of intraovarian follicle‐like cystic structures varied from 0 to 5, at the menopause from 0 to 7, and at 1 and 2 years after the menopause from 0 to 4 and from 0 to 2, respectively. Premenopause, the most common finding was that of ovaries containing either no follicles or a few follicles with at least one measuring ≥ 11 mm and simultaneously a hyperechogenic endometrium of varying thickness and not manifesting any midline echo or triple‐layer appearance. Images compatible with the late follicular phase were found in 6% (9/150) of examinations (‘cycle day’ 8–196) and images compatible with the luteal phase in 7% (10/150) (‘cycle day’ 11–56). Intraovarian cystic structures (3–25 mm) were seen in 14 women after the menopause. Conclusion We have described sonographic changes in the uterus and ovaries occurring during the transition from premenopause to postmenopause. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.