The following is a summary of the “Uterine contractile activity in healthy women throughout the menstrual cycle measured using a novel quantitative two-dimensional transvaginal ultrasound speckle tracking method,” published in the January 2023 issue of Reproductive Biomedicine Online by Rees, et al.

The purpose of this study is to utilize a novel quantitative ultrasound approach to investigate regular menstrual cycle uterine contractile function. About 3 European locations hosted this prospective multi-center observational study between 2014 and 2022. The coordination, amplitude, direction, and velocity of uterine contractions and their frequency (contractions per minute) were studied. Using speckle tracking, features were gleaned from transvaginal ultrasound (TVUS) recordings. Women at least 18 years old and with regular, unmedicated periods were considered. 

Those criteria included a regular cycle, the absence of dysmenorrhea, and the absence of menometrorrhagia. TVUS was performed for four minutes at the start of menstruation, in the middle of the follicular phase, at the end of the follicular phase, at the beginning of the luteal phase, and the end of the luteal phase. There were 96 recordings collected from 64 different women, but only 70 were usable for the study. The late follicular phase was characterized by the highest contraction frequency (for the posterior wall) and velocity (for the anterior uterine wall in the F2C direction) and the lowest in the menstrual and late luteal phases (1.61 vs. 1.31 and 1.35 contractions/min, P< 0.001 and 0.81 vs. 0.67 and 0.62 mm/s, respectively). 

The amplitude of contractions was not found to be significantly different. However, when comparing contraction coordination across all phases of the follicular cycle, mid-follicular phase contractions were the least coordinated (P = 0.002). This investigation represents the first objective TVUS measurement of uterine contraction features in normally menstruating women. Similarly, it highlights contraction coordination as an individual aspect of uterine peristalsis. Consistent with previous research, uterine contractility increases towards the end of the menstrual cycle follicular phase and decreases towards the end of the luteal phase.