Amenorrhea ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

There are no echocardiography findings associated with amenorrhea. However, an echocardiography may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as Turner syndrome. Findings on an echocardiography suggestive of Turner syndrome include bicuspid aortic valve, elongation of transverse aortic arch, coarctation of aorta, and partial anomalous pulmonary venous return (PAPVR). There are no ultrasound findings associated with amenorrhea. However, an ultrasound may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as polycystic ovary syndrome (PCOS), premature ovarian insufficiency, androgen insensitivity syndrome, 17-alpha hydroxylase deficiency, and also anatomic genital defects.

• There are no echocardiography findings associated with amenorrhea. However, an echocardiography may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as Turner syndrome.
• Findings on an echocardiography suggestive of Turner syndrome include:^[2]
  • Bicuspid aortic valve (39.2%)
  • Elongation of transverse aortic arch (31.4%)
  • Coarctation of aorta (15.7%)
  • Partial anomalous pulmonary venous return (PAPVR) (15.7%)

• There are no ultrasound findings associated with amenorrhea. However, an ultrasound may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as polycystic ovary syndrome (PCOS), premature ovarian insufficiency, androgen insensitivity syndrome, 17-alpha hydroxylase deficiency, and also anatomic genital defects.

• Rotterdam criteria is diagnostic of polycystic ovary syndrome (PCOS). Rotterdam criteria uses ultrasound findings which include:^[5]
  • Detecting 25 or more follicles^[6]
  • Detecting increased ovarian volume > 10 cm³
• Other findings on an ultrasound suggestive of polycystic ovary syndrome (PCOS) include:^[5]
  • Increased stromal echogenicity
  • Increased stromal volume
  • Peripheral location of follicles, which can give a “string of pearl” appearance

• Findings on an ultrasound suggestive of premature ovarian insufficiency include:^[7]
  • Streak ovaries: Fibrous tissue substituted in ovaries.
  • Uterus hypoplasia: Lack or shrinkage of the uterus.

• Findings on an ultrasound suggestive of androgen insensitivity syndrome include:^[10]
  • Bilateral cryptorchidism 
  • Juxta or rudimentary uterus
  • Shortened vagina

• Findings on an ultrasound suggestive of 17-alpha hydroxylase deficiency include:^[11]
  • Lack of gonads
  • Atrophied uterus

• Findings on an ultrasound suggestive of imperforate hymen include:^[14][15]
  • Hypoechoic mass in the vagina (hematocolpos) and enlarged uterus (haematometra)
  • Normal ovaries
• Findings on an ultrasound suggestive of Asherman’s syndrome include:^[16]
  • Hypoechoic bands through the endometrial cavity.
• Findings on a combined abdominal–perineal ultrasound suggestive of transverse vaginal septum include:^[17]
  • Abdominal ultrasound: Large hourglass-shape hypoechoic abdominopelvic mass with bilateral symmetric tubular projections
  • Perineal ultrasound: Short depth vagina with a hyperechoic shelf (septum) beneath a large hypoechoic mass (hematocolpos)

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