Ovaries – structure, functions, ailments and diseases

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The ovaries are the reproductive organs of women that play an extremely important role in the production of female sex hormones and eggs. How are the ovaries built and what is their role in the female body? What does ovarian pain mean? What ovarian diseases are most often diagnosed by specialists and how to recognize their first symptoms?

Ovaries – general characteristics

The ovary is the gonad, or sex gland, that occurs in women. The ovaries are a paired organ, which means they are located on the right and left sides of the woman’s reproductive system. They are located in the lower abdomen, inside the peritoneal cavity, at the side walls of the pelvis. The left ovary is located more in front, while the left ovary is located more in the back.

The ovaries are regarded as the developmental equivalent of the testicles. They secrete important hormones such as estrogen, progesterone, relaxin, and androgens. Inside the ovaries, a Graaf follicle grows, containing an egg cell.

If you want to learn more about the anatomy of the Graaf’s follicle and its role in the female body, read on: Graff’s bubble – structure, what role does it play? What to do when it does not break?

Ovaries – structure

The ovaries are small organs that resemble almonds in shape. They are located at the side walls of the pelvis and are fixed with three ligaments – the ligament of the ovary proper, the suspensory ligament and the mesentery. The fourth structure that keeps the ovaries in place is the ovarian hypha. Mesenterias are organs made of a connective tissue membrane that supports and stabilizes the internal organs of the abdominal cavity. The mesentery contains vessels and nerves that supply the ovaries.

On the outside, the ovaries are covered with a single-layer sex epithelium, while underneath it is the ovarian whitish membrane. Looking at the cross-section of the ovary, it is possible to see a two-layer structure of this organ. Each ovary is made of two parts – medullary and cortical. It is located on the surface ovarian cortex or the parenchymal layer in which the egg cells contained in the ovarian follicles are formed. Under the whitish membrane there are primary, deeper and more mature ovarian follicles, and finally the corpus luteum. Under the cortex layer of the ovary is located the core of the ovaryin which numerous blood vessels are located. Their task is to nourish the flesh layer.

The ovaries are small organs and their size changes as a woman matures. During puberty, the ovaries are slightly smaller and have a smooth surface. Women reach their largest size in their reproductive age. In adult females, they are approx. 2-4 cm long, 1,5-3 cm wide and 1 cm thick. However, they weigh about 5-8 g. In the following years, folds appear on the ovaries, and their size significantly decreases. When a woman enters the menopause, ovarian function completely ceases. The size of the ovaries it also changes slightly at different stages of the ovulatory cycle.

The ovaries are very vascularized organs. The blood that reaches the ovaries comes from the ovarian artery and the uterine artery. Additional vascularization of the ovary is the ovarian vein, which enters the inferior vena cava on the right, and into the renal vein on the left. In addition, there are also lymphatic vessels in which the vessels run in the ovarian suspensory ligament to the lumbar lymph nodes.

Examination of the reproductive organs of a woman. What is worth knowing about them? Check: How are the reproductive organs examined?

Ovaries – functions in the female body

A woman’s ovaries fulfill two important functions. First, the ovaries secrete hormones important for a woman’s health, and second, they produce eggs.

The hormones that are secreted by the ovaries are:

1. estrogens – is a steroid hormone that affects the development and shaping of secondary and tertiary sexual characteristics in the female body, i.e. somatic, hormonal and metabolic sex. Secondary sex characteristics constitute a set of somatic differences that distinguish between a man and a woman. They concern differences in the proportions of the body structure, muscle development, thickness and location of adipose tissue, structure of the skeleton, voice color or hair pattern. Tertiary sexual characteristics, on the other hand, are formed in adolescence. Thanks to estrogen, women have breasts growing and hips rounded. Additionally, they prepare the lining of the uterus to receive a fertilized egg. Estrogens are also known for their influence on the well-being and beauty of women. Their action makes the skin smooth and the hair shiny;
2. progesterone – it is a steroid hormone like estrogen. It is responsible for the implantation of the embryo in the uterus and for the proper development of pregnancy. During the second phase of the menstrual cycle, its level rises, which indicates ovulation. Proper progesterone levels are especially important for women who are planning to become pregnant;
3. androgeny – these are hormones that are produced by the ovaries and the adrenal cortex. Androgens are considered typically male hormones because they are primarily responsible for shaping male sexual organs, male muscles, hair and low voice. They also take part in spermatogenesis, i.e. sperm production. Androgens are present in the female body, but their concentration should not be too high. If a woman’s androgen levels are too high, it is usually accompanied by disorders such as hirsutism, acne and irregular periods;
4. relaxing – is a hormone that is extremely important during pregnancy. It is responsible for maintaining the function of the yellow body, which in turn affects the production of progesterone. Relaxin is also important after childbirth because it is responsible for lactation. 

The second important role played by the ovaries is the production of eggs. When a woman reaches puberty, a Graaf follicle matures in the ovary, which contains an egg in it. The maturation of the follicle is possible due to the action of follicle-stimulating hormone. When the Graaf’s follicle reaches a size of 1-1,5 cm, it ruptures and releases an egg that goes to the fallopian tube. What remains after the rupture of the follicle forms the red body, which, among other things, is made of a progesterone-containing yellow body. As previously mentioned, progesterone enables the egg to be fertilized and implanted in the uterus. Graaf’s follicle matures on average every 28 days, and this process continues until the menopause.

Ovarian pain – what could it mean?

Ovarian pain may not always indicate a disease. The most common cause of ovarian pain is your approaching period or ovulation. The pain that occurs in this case is prickly or distressing and occurs in the lower abdomen. Pain on the right or left is associated with the rupture of the Graaf vesicle. If your ovarian pain is not accompanied by other symptoms and your pain is relieved after menstruation or ovulation, there is usually no need to worry.

Unfortunately, in some cases, pain in the ovaries may indicate dysfunction of the glands and other parts of the reproductive system. It is also worth mentioning that ovarian pain can also be caused by long-term stress. Ovarian pain is also a symptom that, in some cases, occurs in the first weeks of pregnancy. If ovarian pain is accompanied by other symptoms, such as nausea or vaginal discharge, it may indicate a female illness, such as polycystic ovary syndrome, ovarian cyst, adnexitis or endometriosis.

If you want to know how much you will pay for a fertility test, read on: How much do women’s fertility tests cost and where to do them?

Inflammation of the ovaries – symptoms and treatment

Inflammation of the ovaries is also known as adnexitis. This condition affects young and sexually active women. Most cases of ovarian inflammation are diagnosed in women in their thirties and forties.

The cause of ovarian inflammation is a bacterial infection caused by Chlamydia trachomatis and Neisseria gonorrhoeae, less often Mycoplasma genitalium, Escherichia coli, Streptococcus pyogenes or Gardnerella vaginalis. These bacteria enter the ovaries through the vagina, the cervix and then the uterine cavity. However, less frequently bacteria reach the ovaries through the blood, such cases are usually diagnosed as a result of postoperative infections.

The risk of a bacterial infection that causes inflammation of the ovaries increases if a woman has sex during her period. In addition, infection is favored by such procedures as curettage of the uterine cavity or its endoscopy.

Inflammation of the ovaries is most often manifested by severe pain in the lower abdomen. This pain increases with menstruation, but also with sex. Pain radiates to the thighs and groin and is often accompanied by fever, vomiting, nausea and diarrhea.

Treatment of ovarian inflammation it is based on taking antibiotics and anti-inflammatory drugs. If the disease is acute, the doctor may decide to hospitalize the patient and administer drugs intravenously.

If you want to learn more about adnexitis, check out: Inflammation of the appendages – symptoms, treatment

Polycystic Ovary Syndrome – Symptoms and Treatment

Polycystic ovary syndrome is one of the most common hormonal disorders diagnosed in women of childbearing age. This disease is accompanied by many metabolic and hormonal disorders, especially androgen excess, obesity, insulin resistance, carbohydrate disorders and hyperinsulinism. The long-term polycystic ovary syndrome can lead to diabetes, cardiovascular disease and hypertension.

The causes of polycystic ovary syndrome are not fully understood. However, it is indicated that the development of this disease may be influenced by lifestyle or socioeconomic status. Specialists also say that polycystic ovary syndrome may be genetic.

Primary symptom of polycystic ovary syndrome there are menstrual disorders, such as the lack of cycles or a reduced frequency of their occurrence, i.e. less frequently than every 35 days. If laboratory tests are performed, the concentration of male hormones is too high. This indicator is also visible in the external appearance of the woman. There is excessive hair on the face and body, there are problems with acne, and alopecia is also observed. Among other symptoms, hypertension and excessive weight gain are also indicated, disproportionate to the diet or physical activity of the patient.

Treatment of polycystic ovary syndrome it depends on the age, lifestyle, and weight of the patient. In the treatment of polycystic ovary syndrome, it is important to change the lifestyle, especially in overweight or obese women. This involves changing your diet and introducing daily physical activity. The second course of treatment is the stimulation of ovulation with the use of a drug with clomiphene citrate. Laparoscopic ovarian scarification, a technique where organs is viewed and operated using an endoscope, is also possible.

For more information about PCOS, see this article: Polycystic ovary syndrome

Ovarian failure – symptoms and treatment

There are two types of ovarian failure: secondary and primary.

1. Primary ovarian failure – is a disorder that is accompanied by low blood levels of oestrogens and high levels of pituitary gonadotrophins. The cause of primary ovarian failure is premature ovarian failure or gonadal dysgenesis. In dysgenesis, sex determination and differentiation are disturbed. It comes in several forms. It is caused by disorders of the sex chromosomes. A person with this disorder has normal body shape and female reproductive organs, but their sexual development is delayed or absent. Treatment of this condition is based on the administration of hormones. Gonadal dysgenesis can also occur as Swyrea’s syndrome. In this case, there is a female phenotype with a male karyotype. This means that there are female genitalia with no secondary sexual characteristics. Treatment for Swyer syndrome is based on the administration of hormones and removal of the gonads.
2. Secondary ovarian failure – diseases of the hypothalamic-pituitary system are considered the cause of secondary ovarian failure. These diseases lead to amenorrhea, incomplete development of puberty or their complete absence. Secondary ovarian failure may be due to Kallmann’s syndrome, a genetic condition in which hypogonadotrophic hypogonadism is present. Secondary ovarian failure can also be caused by prolonged starvation and anorexia. It also occurs in women who play sports intensively. Long-term stress, which may change the frequency of luteinizing hormone secretion, may also be responsible for ovarian failure. Sheehan’s syndrome also affects secondary ovarian failure. This is postpartum pituitary necrosis. Symptoms of this disease are lack of lactation and postpartum amenorrhea. Sheehan’s syndrome can lead to an underactive adrenal cortex and an underactive thyroid gland. 

What are the causes of menstrual disorders? Check: Menstrual disorders

Ovarian cysts – symptoms and treatment

A cyst on the ovary is also called a cyst. A cyst is a closed cavity that is filled inside with a fluid or jelly-like substance. Ovarian cysts can occur in any woman, regardless of age. They are most often diagnosed functional cystsincluding follicular and corpus luteum cysts. Functional cysts are considered benign changes and do not pose a threat to the patient’s health.

They are definitely more dangerous inactive cysts, including endometrial and dermoid cysts. Endometrial cysts are formed in the course of endometriosis and turn brown because they are filled with dark blood. Dermoid cysts, on the other hand, consist of adipose tissue, epidermal cells, and often bone tissue and teeth.

Ovarian cysts are caused by a hormonal imbalance. Lowering the level of sex hormones may prevent the Graaf’s follicle from rupturing during ovulation. Cystic changes are also caused by endometriosis, in which the lining of the uterus extends beyond the uterine cavity. A wandering endometrium can penetrate the ovaries. The endometrium accumulated in the ovaries flakes and begins to bleed, and the blood accumulating in the ovaries forms cysts.

Ovarian cysts do not show any characteristic symptoms. Very often patients confuse them with other ailments. In the case of ovarian cysts, there are disturbances in the menstrual cycle and bleeding between periods. You may also feel pain in the right or left ovary. Additional symptoms include headaches, nausea, vomiting, feeling worse and nervousness.

Treatment of functional cysts usually it only requires regular gynecological checkups and ultrasound. It happens that small cysts disappear spontaneously without pharmacological or surgical intervention. If the cysts are larger, your doctor may recommend hormone therapy. If administration of hormones does not help and the cysts are large, they should be removed. In the case of polycystic disease, it may be necessary to remove the entire ovary, which does not affect the woman’s fertility. Endometrial and dermoid cysts can be treated with hormones, but due to the risk of serious complications, they are usually removed surgically.

Learn more about ovarian cysts in this article: Ovarian cysts

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