Menopause ultrasonography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Rahmah Al-Edresi, M.D.[2]

## Overview

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On pelvic ultrasound, menopause is characterized by small uterus and an endometrial thickness between 5-8 mm. Small ovaries with either a few follicles or no, and normal or non-visible adnexa. Transvaginal ultrasound is helpful for intitial evaluation of postmenopausal bleeding women, if endometrial thickness is 4mm or less, women more prone able for endometrial cancer. Endometrial biopsy is indicated in recurrent postmenopausal bleeding women.

## Ultrasound Findings in Menopause

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#### Pelvic ultrasound findings in menopausal women include:

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* Anteroposterior diameter of uterus decreased by 22%.
* Hyperechogenic endometrium of varying thickness between 5-8 mm and without any midline or triple layer appearance.
* Ovarian volumes decreased by 20 - 45%.
* Ovaries do not contain follicles or a few follicles that are measure less than 11 ml.
* Normal or non-visible adnexa.
* Some women had small adnexal cysts[1][2][3][4]

#### Transvaginal ultrasound findings in postmenopausal bleeding women include:

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* Transvaginal ultrasound is recommended in postmenopausal bleeding women for intitial evaluation for case.
* The endometrial thickness is measured on a long-axis view of the uterus. If the endometrial thickness is thin about 4mm or less, these cases more prone able for endometrial carcinoma.
* Recurrent of postmenopausal bleeding is indicated for endometrial biopsy.[5][6]

## References

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1. ↑ Sokalska A, Valentin L (2008). "Changes in ultrasound morphology of the uterus and ovaries during the menopausal transition and early postmenopause: a 4-year longitudinal study". Ultrasound Obstet Gynecol. 31 (2): 210–7. doi:10.1002/uog.5241. PMID 18197593.
2. ↑ Merz E, Miric-Tesanic D, Bahlmann F, Weber G, Wellek S (1996). "Sonographic size of uterus and ovaries in pre- and postmenopausal women". Ultrasound Obstet Gynecol. 7 (1): 38–42. doi:10.1046/j.1469-0705.1996.07010038.x. PMID 8932630.CS1 maint: Multiple names: authors list (link)
3. ↑ Varner RE, Sparks JM, Cameron CD, Roberts LL, Soong SJ (1991). "Transvaginal sonography of the endometrium in postmenopausal women". Obstet Gynecol. 78 (2): 195–9. PMID 2067762.CS1 maint: Multiple names: authors list (link)
4. ↑ Sladkevicius P, Valentin L, Marsàl K (1995). "Transvaginal gray-scale and Doppler ultrasound examinations of the uterus and ovaries in healthy postmenopausal women". Ultrasound Obstet Gynecol. 6 (2): 81–90. doi:10.1046/j.1469-0705.1995.06020081.x. PMID 8535922.CS1 maint: Multiple names: authors list (link)
5. ↑ "ACOG Committee Opinion No. 734: The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding". Obstet Gynecol. 131 (5): e124–e129. 2018. doi:10.1097/AOG.0000000000002631. PMID 29683909.
6. ↑ Briley M, Lindsell DR (1998). "The role of transvaginal ultrasound in the investigation of women with post-menopausal bleeding". Clin Radiol. 53 (7): 502–5. doi:10.1016/s0009-9260(98)80169-4. PMID 9714389.

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