How to check for ovarian problems

Checking for ovarian problems is mainly achieved through medical examinations such as gynecological ultrasound, six hormone tests, anti Mullerian hormone testing, and tumor markers. These examinations can evaluate the morphology, reserve function, and presence of lesions in the ovaries.

1. Gynecological ultrasound:

Gynecological ultrasound is the most direct examination for observing ovarian morphology, which is divided into abdominal ultrasound and vaginal ultrasound. It can clearly display the size, shape, and position of the ovary, as well as whether there are structural abnormalities such as cysts, tumors, and polycystic changes. For example, ultrasound can observe whether the ovaries have the typical "necklace sign" of polycystic ovary syndrome, where multiple small follicles are arranged along the ovarian capsule. For suspected ovarian cysts or tumors, ultrasound can preliminarily determine whether their nature is cystic or solid, and whether the boundary is clear. This examination is non-invasive and convenient, making it the first choice for basic ovarian screening.

2. Six items of sex hormones:

The six items of sex hormones are mainly evaluated for ovarian endocrine function through blood tests. The examination items include follicle stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, and prolactin. For example, when follicle stimulating hormone levels continue to rise above 40 international units per liter and estradiol levels decrease, it usually indicates a decline in ovarian reserve function or entry into perimenopause. The ratio of luteinizing hormone to follicle stimulating hormone is greater than 2-3, combined with hyperandrogenism, which is a typical manifestation of polycystic ovary syndrome. This examination should be conducted on the 2nd to 4th day of the menstrual cycle and can objectively reflect the basal hormone levels of the ovaries.

3. Anti Mullerian Hormone:

Anti Mullerian hormone is currently the most sensitive indicator for evaluating ovarian reserve function, which is not affected by the menstrual cycle and can be tested by blood sampling at any time. It is secreted by small antral follicles in the ovary, and its level directly reflects the number of remaining follicles in the ovary. For example, an anti Mullerian hormone level below 1.1 nanograms per milliliter usually indicates decreased ovarian reserve function, which may affect fertility; And above 4.0 nanograms per milliliter, it may be related to polycystic ovary syndrome. This examination has important value for family planning, assessing the risk of premature ovarian failure, and predicting ovarian responsiveness before assisted reproductive technology.

4. Tumor markers:

When ultrasound detects suspicious space occupying lesions in the ovaries, doctors will recommend testing for tumor markers such as cancer antigen 125, human epididymal protein 4, etc. Cancer antigen 125 is often significantly elevated in ovarian epithelial cancer, but it may also be mildly elevated in benign diseases such as endometriosis and pelvic inflammatory disease, so its specificity is limited. Human epididymal protein 4 has higher specificity for the diagnosis of ovarian cancer, especially when combined with cancer antigen 125, which can improve the accuracy of diagnosis. For example, for postmenopausal women, if the cancer antigen 125 exceeds 35 units/mL and the human epididymal protein 4 exceeds 140 picomoles/L, they need to be highly vigilant about the possibility of ovarian malignancy.

5. Other imaging examinations:

When ultrasound cannot provide a clear diagnosis or there is suspicion of deep invasive lesions, doctors may recommend pelvic magnetic resonance imaging or computed tomography. Magnetic resonance imaging has higher resolution for soft tissue and can more clearly display the relationship between the ovary and surrounding tissues, helping to distinguish the nature of complex ovarian cysts or tumors, such as distinguishing chocolate cysts from teratomas. Computed tomography is more commonly used to evaluate the extent of intra-abdominal metastasis and lymph node status of ovarian malignant tumors. These examinations are usually used as a supplement to ultrasound for preoperative evaluation or differential diagnosis of difficult cases.

It is recommended that women with ovarian related symptoms such as menstrual disorders, infertility, abdominal pain, and bloating, or high-risk individuals with a family history of ovarian cancer, undergo the above examinations regularly. Daily attention to regular sleep patterns, balanced diet, avoiding excessive weight loss, and maintaining a healthy weight can help maintain normal ovarian function. If the examination results are abnormal, please consult a gynecologist or reproductive endocrinologist in a timely manner to develop an individualized diagnosis and treatment plan.