Ovarian volume, age, and menopausal status Marcelo Giacobbe, MD, 1,2 Aarão Mendes Pinto-Neto, MD, 2 Lucia Helena Simões Costa-Paiva, MD, 2 and Edson Zangiacomi Martinez MD 2 ABSTRACT Objective: The purposes of this study were to verify whether ovarian volume differs according to chronological age and menopausal status in healthy women and to evaluate the sensitivity and specificity of ovarian volume alone and ovarian volume associated with age in predicting meno- pausal status. Design: The participants in this study were premenopausal (n = 121) and postmenopausal (n = 71) women between 40 and 55 years of age who were interviewed about social, demographic, and medical conditions. These women underwent transvaginal ultrasound to determine ovarian vol- ume. Analysis of variance (ANOVA) was applied to evaluate the correlation between ovarian volume, age, and menopausal status. Receiver operating characteristic (ROC) curves were elabo- rated to evaluate the sensitivity and specificity of ovarian volume and age related to menopausal status. Results: The difference in ovarian volume was significant and uniform as age increased in both groups (P = 0.03). Premenopausal women presented larger ovaries than did postmenopausal women. Menopausal status and age were correlated with ovarian volume. Menopausal status seemed more important than age in determining ovarian volume decrease (R 2 = 0.36) because age contributed little when added to a model already containing menopausal status. ROC curves indi- cated that ovarian volume and age were effective in determining menopausal status. The best cutoff points in terms of sensitivity and specificity were ovarian volume less than 4cm 3 and age 48 years or older. The areas under the ROC curves of ovarian volume and ovarian volume plus age were similar. Conclusion: Ovarian volume differs according to age in premenopausal and postmenopausal women. Menopausal status is more important than age in determining ovarian volume. The data suggest that ovarian volume and age are quite accurate in predicting menopausal status. Key Words: Ultrasound – Ovarian volume – Menopause – Age – Transvaginal – ROC curves. M enopause is an important event in a wom- an’s reproductive life. Several organic modifications take place that lead to a higher incidence of cardiovascular dis- eases, osteoporosis, genital prolapse, and cognition dis- orders. 1 Menstrual cessation is expected to occur be- tween ages 42 and 58. 2,3 It marks the end of a senescence process, which began about eight years ear- lier. Despite that, alterations in hormonal secretion are not always present in this earlier period, and perimeno- pause endocrinology is often variable. 4 As a result, the decline in ovarian function is clinically silent, except for a woman’s decreased fertility. The ovary is the most important source of estrogen. The ovarian follicles are a number of nonrenewable, primordial structures that have endocrine and repro- ductive functions throughout a woman’s life. Some re- searchers have studied ovarian biopsies and identified alterations in follicular density, finding a strong corre- lation between histologic results, the number of pri- mordial follicles, and clinical conditions presenting Received January 30, 2003; revised and accepted May 28, 2003. From the 1 Leonor Mendes de Barros Maternity Hospital, São Paulo, Bra- zil; and the 2 Tocoginecology Department of the Medical School of the State University of Campinas-UNICAMP, Campinas, SP, Brazil. Address correspondence to: Marcelo Giacobbe, Rua Vilela, 722 ap. 13 – Tatuapé, CEP 03014-000, São Paulo-SP, Brazil. E-mail: giacobbe@ uol.com.br. Menopause: The Journal of The North American Menopause Society Vol. 11, No. 2, pp. 180-185 DOI: 10.1097/01.GME.0000082296.62794.F2 © 2004 The North American Menopause Society   Text printed on acid-free paper. Menopause, Vol. 11, No. 2, 2004 180