Objective  To investigate the changes of serum sex hormone levels and ovary size in ovarian aging in women living in a Beijing community.

  Methods  A total of 418 healthy women aged 30 to 68 years who could be staged by STRAW+10 staging system were recruited from a Beijing community and prospectively followed-up for 5 years. Menstrual diary was recorded by every woman during the research. Serum estradiol(E₂) and follicle stimulating hormone (FSH) levels were tested at baseline and 5 years later. Pelvic ultrasonography was performed for measurement of ovary size.

  Results  According to STRAW+10 stage, E₂ began to decrease in early postmenopausal stage, which further decreased in late postmenopausal stage. FSH increased significantly from the beginning of late menopausal transition stage, remaining at a high level after menopause. The length, width, and area of the ovary all reduced after menopause. Hormone levels and ovary size changed with some rules in the 5-year follow-up even when the STRAW+10 stage did not change. In women with staging progressed after 5 years of follow-up, E₂ and FSH levels, and length, width, and area of the ovary were significantly different (all P < 0.01) when progressing from early or late menopausal transition stage to early postmenopausal stage. Ovarian no-echo cyst (diameter ≥ 1.4 cm and < 2.5 cm) was the most common in late menopausal transition stage both at baseline and after 5 years, with an incidence of 6.5% and 12.1%, respectively.

  Conclusions  When the STRAW+10 stage changes from menopausal transition to early postmenopausal stage, E₂ decreases and FSH increases significantly with obvious ovarian atrophy. Reproductive aging has more influence on hormone levels and ovary size than aging does. STRAW+10 staging system could be applied for women in Beijing.