Menopause Likely: At 48 years old with no periods since July 2016, it is likely you have reached menopause, defined as 12 consecutive months without menstruation.

Ovarian Size: The size of your ovaries (3.4 x 2 cm) is typical for postmenopausal women, as ovaries tend to shrink after menopause.

Confirmation: Consider other menopause symptoms like hot flashes or mood changes. Hormone tests (FSH, estradiol) can confirm menopause.

Cycle Return: It is unlikely your menstrual cycle will return naturally after several years without periods.

Consultation: Consult your healthcare provider if you experience unusual bleeding or new symptoms.