OBJECTIVE: This is a prospective case control study which aimed to determine the correlation of ovarian volume measurements with endometrial tissue diagnosis such as benign, premalignant and malignant conditions in women with postmenopausal bleeding.

METHODS: Thirty four postmenopausal women with bleeding underwent transvaginal ultrasound for ovarian volume measurements prior to dilatation and curettage. The presence of benign (Group I), premalignant and malignant endometrial. conditions (Group II) were correlated with ovarian volume.

RESULTS: Mean endometrial stripe thickness for group I (N= 19; 1.16ml+/- SD 0.88ml) was not significantly different from group II (N = 15; 1.58ml +/- SD 0.53ml). Mean ovarian volume among patients with premalignant and malignant histology (5.70ml +/- SD 1.91ml) was significantly higher than those with benign histology (2.04ml +/- SD?1.10ml) (P = 0.023). Linear regression analysis showed an association between ovarian volume and premalignant and malignant endometrial conditions (P=0.000). Using the mean ovarian volume cut-off of 5.8ml for postmenopausal women with bleeding, the sensitivity, specificity, positive predictive value and negative predictive value for premalignant and malignant endometrial conditions were 100%, 67.87%,40% and 100%,respectively.

CONCLUSION: Large ovaries among postmenopausal women may represent a marker of risk for endometrial cancer and may be used as an adjunct to endometrial thickness in ruling endometrial malignancy.