Normal ovarian size in women over 40. Normal ultrasound picture. How is ultrasound performed?

Ultrasound examination of the reproductive system in women is one of the most accessible and accurate methods used both in emergency cases and for routine diagnosis of most gynecological diseases, detection of the fertilized egg, study of fetal development, assessment of the effectiveness of treatment, and identification of tumor formations. Features of ultrasound of the pelvic organs in women are the variability of the echographic picture depending on age, phase of the menstrual cycle, and obstetric history.

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Ultrasound of the reproductive organs in women

Ultrasound examination is the creation of images (echograms) by reflecting high-frequency sound waves from organs, which are recorded by a sensor. An acoustic signal, passing through dense media, is almost completely reflected, forming white areas on the echogram. Loose fabrics partially reflect the waves, creating different shades of gray on the screen. Liquids and cavities absorb sound and are colored black in the image.

Indications and benefits

Ultrasound examination of the reproductive organs is used for:

diagnostics of pathologies both during routine examination and in urgent cases;
monitoring the effectiveness of treatment;
tracking the dynamics of changes;
screening examination, including at different stages of pregnancy;
carrying out various internal manipulations (biopsy).

The advantages of the method allowing its use in obstetrics and gynecology:

high information content;
non-invasive;
safety for both the woman and the fetus;
accessibility and low cost;
possibility of repeated execution;
no contraindications.

A pelvic ultrasound in women typically examines the uterus, cervix, ovaries, pouch of Douglas, and bladder. Additionally, the vessels and lymph nodes located close to the reproductive organs are examined. According to indications, clarifying visualization techniques (Dopplerography, contrast-enhanced echography) are used to assess not only the anatomical norm, but also the functional state of organs.

Kinds

An echographic examination of the reproductive organs can be carried out in several ways:

1. Transabdominal (through the abdominal wall).
2. Transvaginally (by inserting a special sensor into the vagina).
3. Transrectally (through the rectum).

1-2 days before performing any type of echographic examination, you need to exclude foods that cause gas formation (legumes, cabbage, white bread, grapes, pears, dairy products, etc.). Before the procedure itself, it is advisable to empty your bowels and not eat. It is recommended to take a towel or napkins to cleanse the skin of the special gel after the examination.

Types and features of echographic examination of the reproductive organs:

Kinds	Indications and features	Preparation and execution	Precautionary measures
Transabdominal (TA)	Routine examination of the pelvic organs to identify pathologies. Performed for all categories of patients (including children). Provides a wide view of the pelvic cavity. During pregnancy, it is carried out to examine the fetus. Sometimes ultrasound results can be influenced by obesity, abdominal adhesions and flatulence	An hour before the ultrasound, drink 1 liter of still water, do not empty your bladder before the procedure (a full bladder conducts sound waves better). During an obstetric examination, drink 1-2 glasses of water an hour before the procedure.	The procedure is safe
Transvaginal (TV)	Targeted examination of the uterus and appendages. Conducted for women who are sexually active. Not for use in children. The advantage is a higher quality and clearer image. The disadvantage is the limited view of other areas of the pelvis. The results of the study are not affected by obesity and adhesions, and gases in the intestines are less affected. There is a risk of infection transmission if the sensor is processed and the procedure is performed incorrectly	Does not require special training from the woman. The study is carried out with an empty bladder. Before use, the sensor is disinfected and a condom is placed on its surface.	Tell your doctor if you are allergic to latex.
Transrectal (TR)	In special cases according to indications: in girls and women who are not sexually active to diagnose pathology of the uterus and appendages; with space-occupying formations of the utero-rectal space, etc.	Carry out after a cleansing enema. Use a special sensor with a condom on	Warn the diagnostician if you have an allergy to latex

In special cases (with congenital fusion of the vaginal opening in girls or during menopause according to indications), a transperineal examination can be performed (through the perineal area).

There are clarifying methods for visualizing the reproductive organs that are used during ultrasound:

1. Dopplerography is an ultrasound mode in which the reflection of sound waves from moving objects (including blood through vessels) is recorded. Allows you to determine the number of vascularization zones, the mosaic nature of blood flow, as well as indicators of blood flow speed. Used to study neoplasms when assessing the mother-placenta-fetus system.
2. Hysterography is a method of examining the uterus by introducing echo-negative contrast into its cavity. Prescribed for suspected malignant gynecological diseases, to determine the cause of infertility, etc.

Dates

An ultrasound can be performed immediately after menstruation or 1–3 days before it begins, depending on the purpose. In emergency cases, ultrasound can also be performed during menstruation. It is worth noting that there are differences in the sensitivity of echography for various diseases. For greater reliability, it is necessary to conduct the examination on certain days of the cycle:

Interpretation of echograms is carried out on the basis of:

position of the organ and surrounding tissues;
its size;
contour assessments: evenness, clarity;
echogenicity: hypoechogenicity, hyperechogenicity, anechoicity;
sound conductivity: strengthening or weakening of the signal;
analysis of the internal structure of the formation: cystic, solid-cystic, solid.

Due to the functional characteristics of the female reproductive organs, only a specialist can give an opinion based on the ultrasound results - taking into account age, gynecological history, cycle phase and the use of certain hormonal drugs.

Uterus

Experts pay attention to the shape of the uterus, its contours and position in the pelvis. The location of the uterus is determined by the angle between its body and the cervix. Normally, it is tilted forward, this position is called anteflexio. Deviation back (retroflexio) is not considered a pathology, but a woman may have problems conceiving and bearing a fetus.

The size of the uterus according to ultrasound can undergo significant changes depending on age, obstetric history and reproductive function at the moment. The choice of type of ultrasound scan can also affect the measurement results and produce slightly different readings in the same patient. On a TV scan, the uterus is more rounded because it is not under pressure from a full bladder.

Measuring the length and thickness of the uterus, endometrial thickness

The uterine myometrium should be homogeneous. When studying the echostructure of the endometrium, it is necessary to take into account the phase of the cycle. For convenience, the double layer of the endometrium is measured using the concept of M-echo.

The table shows the normal indicators:

Index	Norm
Form	Pear-shaped
Position	anteflexio - the uterus is tilted anteriorly; retroflexio - the uterus is tilted posteriorly
Contours of the uterus	Clear and smooth
Echostructure of the myometrium	Has a homogeneous structure. There may be fine mesh. 3 layers can be traced:
Echostructure of the myometrium	Internal (subendometrial) - is a thin hypoechoic strip around the endometrium	Medium - the thickest, has medium echogenicity	External - has the form of anechoic and hypoechoic inclusions, separated from the middle layer by a zone of vascular plexus
Echostructure of the endometrium	Homogeneous structure, changes in the thickness and echogenicity of the endometrium in different phases of the cycle: Phase I - anechoic structure; Phase II - hyperechoic structure. The thickness of the M-echo in the postmenopausal period should not be more than 5 mm
	Cycle days	Endometrial thickness, mm
	1 - 2	1 - 4
	3 – 4	1 - 4
	5 – 6	3 - 6
	8 – 10	6 - 10
	11 – 14	8 - 15
	15 – 18	10 - 16
	19 – 23	10 - 20
	24 – 28	10 - 17
Uterus dimensions:	Length, mm	Width, mm	Thickness, mm
Women who have not given birth	38 - 50	27 - 37	39 - 49
Pregnancy without childbirth	43 -55	32 - 42	41 - 51
After the first birth	45 - 57	34 - 44	45 - 55
After 2 or more births	49 - 65	39 - 49	50 - 60
Menopause before 5 years ago	32 - 44	26 - 36	30 - 42
Menopause more than 5 years ago	28- 38	20 - 30	26 - 36
Structure of the cervix	Homogeneous
Size of the cervix (in postmenopause, the cervix decreases insignificantly)	Length, mm	Width, mm	Thickness, mm
	28 - 37	29 - 53	26 - 33
Cervical canal	from 2 to 6 mm
Douglas space	Lack of fluid (the presence of a small amount of transudate is permissible only during the period of ovulation)

Size of the uterus in girls

In children and adolescents, the size of the uterus is checked against age standards:

Ultrasound to determine pregnancy and after childbirth

Ultrasound is a method for determining pregnancy in the early stages, as well as the ectopic location of the ovum. In a normal pregnancy, an ultrasound procedure must be performed in each trimester:

I trimester - up to 12 weeks - examination of the fetus to identify gross malformations;
II trimester - 16-20 weeks - assessment of fetal development;
II trimester - 32-34 weeks - fetal examination, preparation for childbirth.

After an uncomplicated birth, an ultrasound is performed transabdominally on the 2nd day. Normally, a small number of blood clots are detected, and the involution of the size of the uterus is subsequently traced.

The echogenicity is average with echo-negative inclusions (from 5 to 7-8 foci) - follicles. Features of follicles on different days of the cycle:

1. 8-9 days - identification of a dominant follicle up to 15 mm in size. The remaining follicles undergo involution.
2. 10-14 days - ovulation - increase in the dominant follicle to 25 mm.
3. After 14 days - the formation of a corpus luteum at the site of the burst follicle.

Postmenopause - follicles are not detected

The size of the ovaries in postmenopausal women decreases in the same way as the uterus:

The fallopian tubes

Normally, it is very difficult to detect the fallopian tubes with transabdominal ultrasound. Unchanged tubes are clearly visualized by transvaginal ultrasound. If there is an inflammatory process or tubal pregnancy, the fallopian tubes become detectable for transabdominal imaging.

What does a normal ultrasound picture look like in healthy women?

Normal uterus

Rice. 1. Normal uterus.
Second phase of the cycle. The myometrium is homogeneous.
The thickness of the M-ECHO corresponds to the day of the cycle.

When assessing the condition of the uterus with ultrasound, you can determine:

Position of the uterus.
Normally, the uterus is either deviated towards the bladder, that is, anteriorly (this position of the uterus is called anteflexio), or deviated towards the rectum, that is, posteriorly, (retroflexio).
Dimensions of the uterus (longitudinal, anteroposterior and transverse). The average dimensions of a normal uterus are from 4.0 to 6.0 cm in length, anterior-posterior from 2.7 to 4.9 mm. The dimensions of the uterine body vary depending on the woman’s age, constitution and obstetric-gynecological history.
Endometrial condition(its thickness varies depending on the day of the menstrual cycle).
Immediately after the end of menstruation, the endometrium is visualized in the form of a strip 1-2 mm thick. In the second phase of the cycle, the thickness of the endometrium (M-ECHO) can range from 10 to 14 mm on average.
Condition of the myometrium.
Normally, the myometrium should be homogeneous and not have pathological formations in its structure (fibroids, adenomyosis, etc.)

Normal ovaries

Rice. 2. Normal ovary with follicular apparatus.
There is no dominant follicle, since the study was carried out on the 3rd day of the menstrual cycle.

When assessing the condition of the ovaries using ultrasound, it is determined:

Position of the ovaries.
Normally located on the sides of the uterus, most often asymmetrically, at a short distance from the corners of the uterus. The shape of the ovaries is usually oval, while the right and left ovaries are not at all identical to each other.
Ovarian sizes(longitudinal, anteroposterior and transverse).
The average size of normal ovaries in length is from 2.4 to 4.0 cm, anterior-posterior from 1.5 to 2.5 mm.
Structure of the ovaries.
Normally, the ovaries consist of a capsule and follicles of varying degrees of maturity (in the first phase of the cycle). In the second phase of the cycle, as a rule, the corpus luteum is visualized - a sign of ovulation. The number of follicles may be different on the left and right. The maturing follicle is detected already in the first phase of the cycle and reaches its maximum size by ovulation, on average about 20 mm.
The contents of the dominant follicle are homogeneous because it contains follicular fluid and the capsule is thin. After ovulation, a corpus luteum is formed at the site of the dominant follicle, which, as a rule, has a mesh echostructure (it contains adipose tissue) and also a thin capsule - 1-2 mm. Most often, the shape of this formation is oval or irregularly shaped.
In postmenopause, the ovaries are normally either not visualized or are located in the form of fibrous cords.

Normal fallopian tubes

Normally, the fallopian tubes are not visible during ultrasound examination.

Short term intrauterine pregnancy

Rice. 3. Uterine pregnancy 7-8 weeks.
The size of the fertilized egg and embryo corresponds to the period of delayed menstruation.

During pregnancy, only the fertilized egg is visualized in the uterine cavity in the early stages; later, an embryo appears. The size of the fertilized egg and embryo must correspond to the period of pregnancy according to menstruation.

It is also mandatory to evaluate the fetal heartbeat, which, as a rule, appears after 10-14 days of delayed menstruation.

During pregnancy, the corpus luteum of pregnancy should be visualized in one of the ovaries, which controls the development of this pregnancy and ensures the vital activity of the fetus in the early stages (before the formation of the placenta).

Ultrasound of the ovaries is rarely performed as an independent procedure - it is usually done as part of an ultrasound of the pelvic organs in women. But in some cases, the doctor prescribes an ovarian scan to monitor their functional activity. This occurs when there is a suspicion of organ diseases, hormonal disorders, when diagnosing infertility and other problems.

Why do you need an ultrasound scan of the ovaries?

The ovaries are sex glands that perform many different functions in the female body. They are responsible for puberty, sexual activity, and reproductive health. They also maintain a regular menstrual cycle and affect the general condition of women’s bodies.

Ultrasound examination is the best way to determine the condition of these organs and determine their performance. Using ultrasound you can determine:

size and shape of the female reproductive glands;
clarity and evenness of their contours;
state of the follicular apparatus (number of ripening follicles).

The state of the female ovaries constantly changes during the monthly cycle - follicles mature, one becomes dominant, ovulation occurs (egg release), and the corpus luteum develops. All these processes can be clearly seen using ultrasound. This allows you to assess the condition of the reproductive system and timely recognize any pathologies of the gonads.

Indications for ultrasound scanning of the ovaries

An ovarian scan is mandatory if a woman is scheduled for a gynecological ultrasound. In this case, an ultrasound of the pelvic organs is performed - the uterus, cervix, uterine appendages (the ovaries themselves and fallopian tubes), and the bladder. Such a study is done once; it needs to be repeated only if the results turn out to be inaccurate.

A special ultrasound of the ovaries is performed several times during one menstrual cycle. This is necessary to track the condition of the gonads at each phase of the female cycle.

An ovarian scan (either a single scan or monitoring of their functional activity) is required when there are the following indications:

irregular menstrual cycle (delayed periods or complete absence);
regular nagging or sharp pain in the lower abdomen, right or left;
too scanty, heavy or very painful menstruation;
suspicion of a tumor;
obvious symptoms of inflammation of the uterine appendages;
preparation for IVF;
signs of a cyst;
diagnosis and treatment of infertility;
preventive examination.

How is the ultrasound procedure performed?

Ultrasound of the ovaries, like regular ultrasound of OMT in women, is done in 3 ways. The main methods are external (transabdominal) and abdominal (transvaginal). In exceptional cases, transrectal scanning is used.

Transabdominal ultrasound.

This scan is done through the lower abdomen using an external ultrasound probe. Of all types of ultrasound examination of the pelvic organs, this is the least informative. Therefore, external ultrasound is usually used during clinical examination, general examination, and also for women who are not sexually active.

In addition, external ultrasound examination requires very careful preparation, and this is not always convenient for the patient.

Transvaginal ultrasound.

This type of ultrasound scan is considered optimal for examining the ovaries, primarily for studying their functional activity. This procedure uses an internal sensor onto which a special ultrasound condom is placed. The scanning process takes 15-30 minutes and is absolutely painless for women.

Internal ultrasound is the most informative when examining the pelvic organs. In this case, the sensor is located as close as possible to the female genital organs, and the picture on the screen comes out very clear.

There are only a few contraindications for transvaginal examination. It is prohibited for virgins and for uterine bleeding.

Transrectal ultrasound.

This ultrasound is performed with an internal sensor, which is inserted into the anus. Transrectal scanning is done in exceptional cases. When external ultrasound is not informative enough, and transvaginal ultrasound is impossible for objective reasons.

Preparing for an ultrasound scan of the ovaries

In order for the results of an ovarian ultrasound to be as accurate as possible, careful preparation for the procedure is necessary. This primarily concerns external, transabdominal ultrasound.

Preparation for external ultrasound examination of the ovaries in women includes the following procedures:

Special diet. Before external ultrasound, it is important to ensure that there are no gases in the intestines, so you will have to adjust the menu. 3-4 days before the ultrasound you need to give up sweets, brown bread, legumes, cabbage, fresh fruits, and carbonated drinks.
Taking pharmaceutical drugs. To enhance the effect of the diet, 1-2 days before the analysis you can drink a small course of activated charcoal or Espumisan.
Laxative or cleansing enema. An empty bowel is required for the scan to be successful. Therefore, if you are prone to constipation, you can take a laxative or do an enema the day before. But only with the agreement of your doctor!

The bladder must be full before transabdominal scanning. To do this, you need to drink a liter of any liquid without gas an hour and a half before the procedure and not go to the toilet. In some cases, 2 ultrasounds may be required at once - external and abdominal. In this case, after an external ultrasound, the patient goes to the toilet, and then the doctor carries out the procedure using an internal sensor.

No special preparation is required for transvaginal ultrasound. The main thing is that the intestines and bladder are empty. It is necessary to prepare for transrectal ultrasound in women in the same way as for transabdominal ultrasound.

Another important requirement for any type of ovarian ultrasound is to choose the right day. The gynecologist will definitely tell the patient when it is best to come for an ultrasound. If the procedure is single, the best time is the beginning of the cycle, days 5-7. When monitoring the condition of the ovaries, at least 3 procedures are required - in each phase of the cycle.

Norms and interpretation of ultrasound scanning of the ovaries

On the ultrasound monitor, each ovary is visualized as a small oval formation. The surface of each gland is slightly bumpy because it is covered with ripening follicles. The more days have passed since the beginning of the cycle, the larger these tubercles are.

Quite soon, among the total number of follicles, one dominant one stands out, and it is clearly visible on ultrasound. It is he who will release a mature egg at the moment of ovulation.

The interpretation of ultrasound results always indicates the size of the organs and follicles themselves. The size of the gonads may vary slightly depending on the phase of the cycle, the number of pregnancies, the age of the women, etc. The norms for each ovary for ultrasound are as follows:

in length – 20-37 mm;
width – 18-30 mm;
volume – 4-10 cubic meters. cm;
organ thickness – 14-22 mm.

Norms for follicles vary depending on the day of the menstrual cycle:

Days 5-7 – 5-10 formations, size – 2-6 mm;
Days 8-10 – 5-9 follicles, size up to 10 mm, dominant – 12-15 mm;
days 11-14 - the dominant follicle grows to 16-20 mm, ovulation usually occurs at 18 mm;
15-18 days - a corpus luteum measuring 15-20 mm appears at the site of the burst follicle;
days 19-23 – the corpus luteum increases to 25-27 mm;
Days 24-27 – the corpus luteum reaches 10-15 mm.

Then comes menstruation.

What pathologies can be recognized using ultrasound scanning of the ovaries?

Normally, on an ultrasound monitor, the ovaries should not be enlarged; there are no cystic or tumor-like formations on them. They usually match in size; the difference between the left and right organs in women is minimal.

Using an ultrasound machine, you can see the following pathologies of the female reproductive glands:

functional or physiological cysts (follicular and luteal cysts of the corpus luteum);
pathological cysts (dermoid, endometrioid, cystadenoma);
polycystic (the ovaries are greatly enlarged, and numerous cysts measuring 2-9 mm are visible in them);
malignant tumors.

In rare cases, women's ovaries are not visible during ultrasound. If one (or both) organs are not visible, the main reason is their absence. It may be congenital or due to removal of the ovary during surgery. Other causes are premature ovarian failure, severe adhesions in the pelvis or bloating.

Usually, ultrasound of the ovaries in women is performed in conjunction with other studies, but in some cases it can be prescribed by a doctor as an independent procedure.

What does every woman need to know when preparing for such an examination?

The ovaries are a paired organ that provides the hormonal background necessary to maintain reproductive function and the formation of an active egg capable of fertilization. It is the activity of the ovaries that determines the female menstrual cycle and affects the general condition of the body.

Often, gynecological ultrasound of the ovaries and ovaries is prescribed to monitor their functional activity. The fact is that the structure of these organs undergoes cyclical changes every month: follicles appear, from which the dominant one develops, forming the egg, hormones are synthesized, ovulation and the development of the corpus luteum occur.

All these processes are perfectly visualized during the examination and allow the doctor to find out how fully the patient’s ovaries “work.”

A gynecologist gives a referral for an ultrasound scan of the ovaries at the slightest suspicion that any pathological processes or hormonal disorders are occurring in a woman’s body.

irregular menstrual cycle, missed periods;
painful menstruation;
excessively heavy or scanty bleeding, discharge of blood outside of menstruation;
diseases of the mammary glands (mastopathy, neoplasms);
suspicion of inflammatory processes in the appendages;
complaints of pain in the lower abdomen;
suspicions of the presence of neoplasms;
monitoring in preparation for IVF;
dynamic observation of ovarian functions;
absence of planned pregnancy;
screening observation of women's health (prevention of disease development).

The risk of developing diseases of the reproductive system can be significantly reduced if you are regularly examined by a gynecologist. Doctors recommend that every healthy woman undergo an annual ultrasound examination in order to notice abnormalities in time and prevent the occurrence of pathologies.

How to do an ultrasound of the ovaries: methods of conducting

There are three ultrasound methods for checking the ovaries in women: transabdominal, transvaginal and transrectal. Let's consider each method in detail.

Transabdominal - ultrasound is performed through the abdominal wall using an external sensor. This method is now used less and less, because... involves significant preparation of the patient for the procedure. If the preparation is poor, the reliability of the results is distorted.

Transvaginally - since the accuracy of this type of ultrasound data is much higher, and there is no need for preparation on the part of the patient, this method is a priority in modern clinics. A narrow probe is inserted through the vagina upward towards the cervix, providing maximum possible access to the pelvic organs.

There is also a transrectal method, but it is used extremely rarely, in exceptional cases (for example, in virgins).

How to prepare for an ovarian ultrasound

Preparation for an ovarian ultrasound in women is of great importance. Although there are no special restrictions on diet, medications or health conditions, a woman should take into account the following rules.

Ultrasound of the ovaries should be performed on certain days of the monthly cycle.

In order to assess their morphological condition and check for the presence of pathologies, it is necessary to do an ultrasound immediately after the end of menstruation, on days 5–7 of the cycle.
In order to determine their functional activity, the study should be carried out on the days recommended by the attending physician. The fact is that during the course of a month, reproductive processes occur in a woman’s body, which have 4 phases of development. To determine the causes of infertility or hormonal imbalance, it is often necessary to observe the condition of the organ in each of these phases.

With transabdominal access, the bladder should be filled as much as possible.

An hour and a half before the test, you should drink 1–1.5 liters of still water or tea. The bladder, filled with water, conducts ultrasound well to the ovaries, which are located behind it.

If the bladder is not full enough, the doctor may not “examine” the organs of interest properly. It is not recommended to have a bowel movement before the end of the procedure - this may affect the reliability of the results.

No special preparation is required for transvaginal ultrasound.

The most important thing a woman should take care of is personal hygiene products. For individual protection against infections, a special condom is placed on the sensor.

Typically, diagnostic rooms are fully equipped with such disposable products, but sometimes, in their absence, the patient is asked to purchase the product herself. The product is called “Condom for Ultrasound” and is sold in all pharmacies.

Note: If a woman has a severe allergy to latex, you should notify your doctor in advance.

Before transrectal ultrasound, it is necessary to clear the rectum of feces.

To do this, on the eve of the appointment, the girl must do a small enema (300–350 ml of water). You should also ensure that there are no gases in the intestines - do not eat foods that stimulate their formation the day before (fruits, vegetables, sweets, brown bread, legumes, carbonated drinks).

How is the ovarian ultrasound procedure performed?

Ultrasound examination of the ovaries using transabdominal access - the patient lies on the couch with her back down, freeing the groin area and abdomen from clothing. The doctor generously lubricates the surface of the skin with gel in order to ensure better contact of the external sensor with the body. The device is moved over the skin with slight pressure.
For transvaginal access, it is necessary to take the position necessary for optimal insertion of the sensor - lie on your back with your knees bent. The device is quite narrow and does not cause any discomfort - the procedure is completely painless.

In order to fully examine both ovaries, an ultrasound diagnostic specialist will need 10–15 minutes.

Standards for ovarian examination results

During the examination, the doctor determines the position, size and structure of the ovaries.

The normal position of the ovaries is on the sides of the uterus and somewhat posteriorly. It is because of their adherence to the uterus that they received the informal name of appendages. During pregnancy, these organs move upward.

The size of the ovaries can vary depending on the day of the menstrual cycle, the woman’s age, the number of full-term and terminated pregnancies, the use of oral contraceptives and the individual characteristics of the body. The following parameters are considered normal for a woman of reproductive age:

volume – from 4 to 10 cm3;
length – from 20 to 37 mm;
width – from 18 to 30 mm;
thickness – from 16 to 22 mm.

In most women, the right and left ovaries differ in size. However, a significant difference in volume may indicate the presence of pathology or a congenital anomaly. An increase in size may indicate polycystic syndrome or oophoritis.

The structure of the ovaries depends on the day of the menstrual cycle - the doctor determines the size and number of follicles, the presence of a dominant follicle, the corpus luteum, and examines for cysts and tumors.

A discrepancy between the structure and the norm may indicate polycystic disease (many undeveloped follicles), late ovulation, functional disorders and pathologies.

The normal size of the ovaries according to ultrasound depends on the day of the study:

Days 5–7: 5–10 follicles in the cortex, ranging in size from 2 to 6 mm;
8–10 days: 5–9 follicles no more than 10 mm and 1 dominant, 12–15 mm;
11–14 days: dominant follicle 16–20 mm, ovulation – when it reaches 18 mm;
Days 15–18: (15–20 mm) at the site of the ovulated follicle;
19–23 days: the corpus luteum gradually reaches a size of 25–27 mm;
24–27 days: the corpus luteum regresses to 10–15 mm;
menstruation: the corpus luteum disappears.

The contours of healthy appendages should be uneven, but clear. Blurred boundaries may indicate inflammation.

In acute cases, ultrasound is also performed during menstruation - the procedure is absolutely safe and cannot lead to any complications.

The ovaries play a very important role in the female reproductive system. Without their normal work, a lady will not be able to have children. During menopause, the ovaries stop working and decrease in size.

However, they are susceptible to various dangerous diseases, including the formation of cancerous tumors. In this publication we will look at how the size of the ovaries should normally change during menopause, what possible pathologies of this organ are possible, as well as methods for diagnosing its condition.

The ovaries are oval-shaped organs of the female reproductive system. They are located on either side of the uterus. In the tissues of the ovaries there are special vesicles - follicles, intended for the development of eggs. They are clearly visible on ultrasound, and also produce female sex hormones: progesterone and estrogens.

From the first day of the menstrual cycle, the process of growth and maturation of follicles begins under the influence. One follicle grows faster than the others. The egg matures in it, and it is called dominant. The growth of other follicles is slowed down. During ovulation, the follicle ruptures and the egg is released. The ruptured follicle transforms into the corpus luteum, which produces progesterone.

Under the influence of sex hormones, the reproductive function of a woman is ensured, and this is only possible with normal functioning of the ovaries. When the egg is fertilized, pregnancy occurs. If the egg is not fertilized, the menstrual cycle will end with menstruation.

A certain number of follicles are formed in the eggs of girls during intrauterine development. Over the entire reproductive period, hundreds of eggs mature, most of which remain unfertilized. When the supply of follicles in the ovaries is depleted, it occurs. Normally, menopause occurs at the age of 50.

In these dimensions, menopause can be compared to pathologies.

How organ size changes during menopause

In women of reproductive age, the normal size of the ovaries has the following parameters:

organ length – 20-35 mm;
its width is 15-20 mm;
thickness – 20-25 mm.

Both organs differ in size. This difference is considered normal. In a forty-year-old woman, the normal weight of one organ is 9.5 g.

During premenopause

The menopausal period has three stages, during which the ovaries change their size. The first stage is called perimenopause. It starts with the first symptoms of menopause - increased sweating, surges in blood pressure, excessive irritability and others. They are provoked by hormonal imbalance, which occurs due to the fact that the ovaries begin to produce fewer sex hormones.

How female genital organs change with age.

The menstrual cycle is disrupted. It becomes shorter or longer, and the number of critical days and the abundance of menstrual flow also changes. Delays are more common in women. First for a few days, and then weeks and months. The amount of menstrual flow decreases and lasts fewer days.

The first changes in the ovaries occur in premenopause against the background. The number of remaining follicles decreases with each menstruation. The cortex, which previously contained follicles, is replaced by connective tissue.

The ovaries begin to decrease in size to the following parameters:

length does not exceed 25 mm;
width no more than 15 mm;
thickness within 9-12 mm.

The ovaries are constantly decreasing in size. After a few months, both organs become the same size.

During menopause and postmenopause

During menopause, the last independent menstruation occurs. They can only be established retrospectively. Therefore, the diagnosis of menopause is made 12 months after menstruation, if there has been no menstrual flow. Throughout this year, the ovaries continue to decrease in size.

The following sizes of ovaries at menopause are considered the accepted norm:

length is in the range of 20-25 mm;
width – 12-15 mm;
thickness – 9-12 mm.

The volume of the organ decreases to a value of 1.5-4 cm 3. In some women, the follicles in the ovaries during menopause still remain in small quantities, but they can no longer develop. Accordingly, ovulation does not occur. If a lady takes a urine test, it will reveal what is produced by the adrenal cortex.

The final stage of the menopause. In postmenopause, menstrual function is completely absent. Many people are interested in what happens to the ovaries, the work of which is completely completed in the female body.

They continue to decrease in size. So, 5 years after the start of this stage, the volume of the ovaries will be approximately 2.5 cm3, and after 10 years - 1.5 cm3. The weight of the organ in a 60-year-old lady normally does not exceed 4 g.

Pathologies during menopause

After menopause, the risk of developing ovarian pathologies increases. Therefore, women should undergo a routine examination by a gynecologist every year, which includes an ultrasound of the pelvic organs.

Normally, the ovaries should shrink. When an enlargement of organs is detected during ultrasound diagnostics, it is necessary to undergo a more thorough examination in order to diagnose the emerging pathology.

It could be:

Cyst.
In menopausal women, only 30% have both organs affected. In the vast majority of cases, pathological changes occur in only one ovary - a follicular cyst is formed. These are round anechoic formations with a thin-walled capsule. They occur due to hormonal disorders and can resolve on their own over 2-3 menstrual cycles. When this does not happen, treatment is carried out. If an endometrioid cyst develops, it has a harder capsule and is capable of degenerating into a malignant neoplasm. Therefore, it is removed through surgery.
Polycystic disease.
With this disease, several cysts can form in the ovary at the same time. Such formation during menopause occurs more often than single cysts. This is due to the fact that the level of female sex hormones has decreased significantly, and the amount of male hormones, on the contrary, has increased. This result is caused by long-term use of oral contraceptives, which were not prescribed by a gynecologist and were not suitable for a particular body. Polycystic disease can be a side effect of taking hormone replacement therapy during menopause.

Hormonal medications treat menopausal symptoms, but they promote the development of tumors. Therefore, you should absolutely not take such medications on your own.

Expert opinion

Alexandra Yurievna

General practitioner, associate professor, teacher of obstetrics, work experience 11 years.

Malignant neoplasms

According to medical statistics, ovarian cancer ranks second among cancer diseases leading to death in women after menopause.

Structure of the female ovary.

Therefore, all ladies should know the symptoms of ovarian cancer:

Pain appears in the pelvic area, which causes discomfort to the woman.
There is bloating or bloating in the abdomen, as if you overeat.
Persistent indigestion, which should be a reason to visit a doctor and undergo a medical examination.
The frequency of urination increases. Moreover, every time there may be a urge to immediately urinate.
Appetite worsens.
A woman’s weight changes very quickly, either increasing or decreasing.
The waist size increases.
Sexual intercourse causes pain.
The lower back or lower abdomen may hurt.

With the development of ovarian cancer, these signs may be constantly present, and they will also get worse. The most basic symptom of the development of a cancerous tumor is the presence of blood in the urine, feces and sputum. Moreover, this symptom manifests itself both with a small size of the malignant neoplasm and with a large tumor.

What you need to know about ovarian cancer

The main causes of ovarian cancer include lack of childbirth and abortions. Hormonal medications taken may provoke the development of malignant neoplasms.

All women need to know what to do if they notice these symptoms and suspect the development of cancer. You should immediately undergo examination by a gynecologist and oncologist. So, the lady will save her health and life.

Cancer has 4 stages, which differ in the distribution of the disease in the female body:

Stage I – the tumor has formed on only one ovary.
Stage II – the neoplasm develops on one or two organs, but it has simultaneously spread to the pelvic area.
Stage III – the tumor affects one or two ovaries, and metastases are located outside the pelvis and can penetrate the retroperitoneal lymph nodes.
Stage IV – a malignant tumor is present on one or both ovaries, and metastases already have a separate pattern of spread and manifestation.

In the early stages, the disease is easier and faster to cure. The main treatment for cancer is surgery. Chemotherapy is used in combination with it. Radiation therapy for the development of ovarian cancer is ineffective.

What diagnostics are needed after menopause?

In order not to miss the pathological processes occurring in the organs of the reproductive system, a woman should undergo a routine medical examination by a gynecologist at least once a year. Doctors advise doing it more often – once every six months. The doctor will conduct a gynecological examination and refer the lady for an ultrasound of the pelvic organs.

This study allows you to assess the condition of the ovaries and uterus. The specialist will determine the size and structure of the organs, and also assess compliance with normal parameters for a particular age. If a neoplasm appears on the organs, then with the help of this study it is possible to accurately determine its location and size.

You should know that in some cases, even in a completely healthy woman, it is almost impossible to determine the condition of the ovaries after the onset of menopause by ultrasound. Due to the lack of follicles, they are not visible even with a full bladder. The lady will be offered to undergo a transvaginal ultrasound procedure, which is a more accurate study.

A woman can always find time to visit a gynecologist if she wishes. Regular ultrasound during menopause will detect the occurrence of pathology at the earliest stages, despite the natural reduction of organs. When the ovary is abnormally enlarged, the woman will be referred for consultation to an oncologist.

If the tumor is detected at the initial stage of development, it will be easier to treat it. Most oncologists are of the opinion that once a woman is diagnosed with menopause, any cyst or tumor on the ovary should be removed. The size of the tumor is not significant. This position is associated with a high risk of degeneration of a benign neoplasm into a malignant one against the background of prolonged low estrogen levels.

Bottom line

Ladies who have experienced menopause should understand that the cessation of menstrual function does not lead to the absence of problems in the reproductive system, but rather, on the contrary, requires increased attention to it. The work of the ovaries ceases with the onset of menopause, but they are susceptible to the development of pathologies and cancerous tumors.

Carrying out regular medical examinations will help to detect a tumor that has just appeared and prevent its growth until the last stage of the disease, when treatment does not always give a positive result. We wish you good health!

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