Objective: To evaluate the relationship between ovarian volume and age, hormonal levels, obesity, and phase of menstrual cycle in pre- and perimenopausal women.
Design: A study was carried out with 98 women from the general population who were not receiving drugs known to interfere with hormonal levels. Right and left ovary volume was measured by ultrasound. Blood samples were drawn for estradiol, follicle-stimulating hormone, and luteinizing hormone determinations.
Results: Fourteen women were excluded because of the presence of ovarian cysts. Mean ovarian volume for pre- and perimenopausal women was 7.1 ± 3.1 cm3. There was no statistical difference in ovarian volume related to the phases of the menstrual cycle. Ovarian volume was significantly smaller in all age groups over 40 years compared with the 35-to-39 age group (P < 0.05). No association was observed between ovarian volume and body mass index. In turn, age (P = 0.013) and follicle-stimulating hormone levels (P = 0.002) showed a significant negative correlation, and luteinizing hormone showed a significant positive correlation with ovarian volume (P = 0.005).
Conclusions: Ovarian volume was smaller in pre- and perimenopausal women aged 40 years and older in relation with younger women. The current standard measurements of ovarian volume by transvaginal ultrasound should be reevaluated for pre- and perimenopausal women between 40 and 55 years of age.
An accurate measurement of normal ovarian variables is essential to determine parameters of abnormality. For example, malignant ovarian neoplasia may be detected by changes in ovarian morphology or volume. 1,2 Zalel et al 3 have observed a significant variation (more than two standard deviations) in ovarian volume in the presence of neoplasms for every menopausal age. This difference was even more marked in the group presenting malignant tumors. Those authors conclude that ovarian volume could serve as the primary method to diagnose ovarian cancer.
Several studies have been carried out to establish the relationship between normal ovarian volume and contraception methods, 4 phase of menstrual cycle, 5 menopausal status, 6 and decade of life. 7 The study of Tepper et al 6 showed a progressive decrease in ovarian volume in postmenopausal women. Another study observed ovarian volumes in the highest percentile until the age of 39, followed by a progressive decline until the seventh decade of life in pre- and postmenopausal women. 7
However, little attention has been paid to the influence of menopausal transition on ovarian volume. 4,5 During pre- and perimenopausal years, important changes occur in gonadotropin and estradiol levels. 8,9 These hormonal events could be associated with ovarian morphology, at least during this transition period. Therefore, our aim was to carry out a sonographic investigation to assess the relationship between ovarian volume and age, hormonal levels, and obesity in pre- and perimenopausal women.
From the 1Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Brazil, 2Division of Obstetrics and Gynecology, Medical School, Universidade de Passo Fundo, Brazil, and the 3Department of Social Medicine and 4Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Received May 8, 2002; revised and accepted September 18, 2002.
This study was supported by grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), FAPERGS (Fundação de Amparo à Pesquisa do Rio Grande do Sul), and PRONEX 26/98 (Programa de Apoio aos Núcleos de Excelência em Pesquisa).
Address reprint requests to Karen Oppermann, MD, PhD, Division of Obstetrics and Gynecology, Medical School - Universidade de Passo Fundo, Rua Teixeira Soares, 885/704, 99010–081 Passo Fundo, RS - Brazil. E-mail: firstname.lastname@example.org.
*This study was presented in part at FIGO 2000, the World Congress of Gynecology and Obstetrics, Washington, D.C., September 4, 2000. (Oppermann-Lisboa K, Fuchs SC, Spritzer PM. Ovarian volume decreases with aging in pre- and perimenopausal women. Int Gynecol Obstet 2000;70(Suppl):FC1.29.03.)