Need To Know

Ovary 101: What You Need to Know About Your Ovaries

By Tracee Cornforth
December 14, 2009


The ovaries are magnificent glands which are part of the female reproductive system. The ovaries are about the size and shape of an almond and sit just above the fallopian tubes -- one ovary on each side of the uterus. Every month during ovulation, either the right or left ovary produces a single mature egg for fertilization.


Did you know that when a baby girl is born, she already has about 1,000,000 ovarian follicles? Each ovarian follicle contains a hollow ball of cells with an immature egg in the center. During childhood, approximately half of ovarian follicles are absorbed by the body. By the time a girl reaches puberty and her menstrual cycle begins, only about 400,000 ovarian follicles are left to develop into mature eggs.


Although only one egg usually fully matures during ovulation, somewhere between ten and 20 follicles begin the process of maturation monthly. The excess ovarian follicles are reabsorbed before ovulation occurs.


The process of ovulation is started and controlled by a drop in the hormone estrogen (mostly etradiol) to a low level. When the drop in estrogen levels occurs the hypothalamus (a part of the brain) is signaled to increase its secretion of gonadotropin-releasing hormone (GnRH) thus sending a message to the pituitary gland to increase its secretion of follicle-stimulating hormone (FSH). The increase in FSH causes the growth of ten to 20 of the ovarian follicles.


Estrogen is secreted by some of the cells in the follicle. Just before ovulation occurs, the follicle that contains the maturing egg eases toward the surface of the ovary. Once the matured egg reaches the ovarian surface, ovulation occurs when the follicle and the ovarian surface open allowing the egg to drift out of the ovary.


Additionally, progesterone is also produced by the cells in the ovarian follicles shortly before ovulation occurs. After ovulation, if pregnancy has not occurred, the empty follicle is called the corpus luteum and it is reabsorbed into the body. If pregnancy does occur the corpus luteum produces hormones that help to maintain the pregnancy.


After the egg is released from the ovary it travels to the oviducts (the funnel-shaped ends of the fallopian tubes) where it begins its long journey of several days into the uterus. The mature egg is moved along on its journey through the fallopian tubes by wavelike muscle contractions in the fallopian tube. The inner lining of each fallopian tube contains cilia which are constantly beating microscopic hairs; these cilia are what helps move the sperm towards the egg if a woman has had unprotected sexual intercourse. Conception (the fertilization of an egg with sperm) most often occurs in the part of the tubes that is nearest the ovary. Five to six days are required for the fertilized egg to reach the uterus.


Midcycle Pain or Discomfort
Some women experience a twinge, a cramp, or some discomfort in the lower back or abdomen when ovulation occurs. Women sometimes notice a small amount of vaginal discharge, sometimes containing a small amount of blood, during ovulation. For some women these symptoms are severe enough to be mistaken for an ectopic pregnancy or appendicitis. Other women experience headaches, gastric pain, or a general malaise; while others women experience feeling much better during ovulation. When women experience these symptoms during ovulation it is called Mittelschmerz or midcyle pain.


Ovarian Cysts
Ovarian cysts are fluid-filled sacs, similar to blisters. Ovarian cysts are common among women during their reproductive years and are growths that form on either of the two almond-sized glands on each side of the uterus. Most types of ovarian cysts are harmless and go away without any treatment.


Polycystic Ovary Syndrome
Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects an estimated seven percent of all women. It is the most common hormonal disorder among women. According to experts, the actual number of women affected by PCOS may be as high as one out of ten simply because so many cases remain undiagnosed. Why are so many cases of PCOS undiagnosed? Since the symptoms can vary from woman to woman it is often difficult to accurately diagnose polycystic ovarian syndrome. Because polycystic ovary syndrome can cause significant long-term health consequences, a quick and accurate diagnosis, followed by proper treatment is urgent.


Ovarian Cancer
Ovarian cancer is often called the "silent" killer because many times there are no symptoms until the disease has progressed to an advanced stage. One-third of American women will get some form of cancer in their lifetime and approximately 1.4 percent of those cases will be cancer involving one or both ovaries.

Fallopian tubes that have been damaged by diseases, infections, or other conditions may be scarred, damaged, or destroyed which sometimes can cause an ectopic (tubal) pregnancy to occur. Some of the causes of fallopian tube damage include pelvic inflammatory disease (PID), endometriosis, or IUDs, as well as some sexually transmitted diseases (STDs) or other pelvic infections.

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