Ovarian status in healthy postmenopausal women.
OBJECTIVE
There are currently no programs to assess ovarian health in postmenopausal women. The aim of this study was to describe the ovaries in healthy women at least 5 years after menopause by questionnaire, transvaginal ultrasonography, and blood ovarian cancer markers.


METHODS
A total of 515 women who were asymptomatic and at the Stages of Reproductive Aging Workshop +2 stage of menopause (>5 y postmenopause) were recruited by advertisement. Clinical history was obtained by questionnaire, and biophysical assessment by a transvaginal ultrasound investigation and biochemical assessment by serum CA-125 and inhibin were performed. Abnormal findings were confirmed and then reviewed.


RESULTS
Both ovaries were identified by transvaginal ultrasonography in 71% of women. The right ovary was visualized in 86.3% of these volunteers, and the left ovary was visualized in 78%. The presence of small unilocular cysts and echogenic foci facilitated identification of the ovary in some women. Ovarian/paraovarian lesions were present in 12.6% of women. Abnormalities of the endometrium and uterus were also common, prompting surgery in 7.2% of the women. Total serum inhibin concentrations were normal for postmenopausal women, whereas serum CA-125 was elevated in two women.


CONCLUSIONS
We find that the description and detection of postmenopausal ovaries by transvaginal ultrasonography allows the identification of both ovaries in most postmenopausal women. Ultrasonography-detected abnormalities of the ovary and/or the uterus/endometrium are common in women at this stage of life. The potential need for surgical intervention after the detection of such abnormalities needs to be carefully evaluated when considering transvaginal ultrasonography as a screening tool for ovarian cancer.
Monash University Department of Obstetrics and Gynaecology, Clayton, Victoria, Australia. david.healy@med.monash.edu.au
David L
DL
Healy
Robin
R
Bell
David M
DM
Robertson
Tom
T
Jobling
Martin K
MK
Oehler
Andrew
A
Edwards
Paul
P
Shekleton
Jacqueline
J
Oldham
Sofie
S
Piessens
Mark
M
Teoh
Pamela
P
Mamers
Nancy
N
Taylor
Frances
F
Walker
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood; D008403:Mass Screening; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000517:prevention & control; D010053:Ovary / Q000000981:diagnostic imaging* / Q000473:pathology; D017698:Postmenopause; D014463:Ultrasonography
D018394:CA-125 Antigen; D007265:Inhibins