The ovaries are the female reproductive organs that house the ovum.

The ovaries are located on both sides of the womb and is attached to the pelvic sidewall. During pregnancy, the position changes considerably due to the movement of the womb. After the baby is delivered, the ovaries generally do not return to their original position.

It is oval in shape and grayish in colour. The size is about 3-5 cm in length during childbearing age. It can be divided into medial and lateral surfaces, upper and lower poles, and anterior and posterior borders .

The medial surface of the ovary faces the pelvis, which is in close proximity to the ileum (a part of the small intestine). The lateral surface is in contact with the pelvic wall. There is a tiny gap between the upper pole of the ovary and the end of the fallopian tube where the egg released by the ovary during ovulation can be swept by the finger-like ends of the fallopian tube, called fimbria, into the tube. On the other hand, the lower pole of the ovary faces the womb.

  • Functions of the ovaries

The ovaries mainly have two functions: reproductive and endocrine functions

Reproductive function

The ovaries undergo periodic changes once a month and releases an egg cell (ovum) during ovulation in the 14th -16th day of the menstrual cycle. The egg cells are secreted by the follicles in the ovary, and only one egg matures and released every month. After ovulation, if the egg enters the fallopian tube and encounters a sperm, it is fertilised to become a fertilised egg.

Endocrine function

The body produces more than 20 kinds of hormones and growth factors that controls the growth and functions of bones, immunity, reproduction, nerves and other nine systems to maintain the youth and vitality of human organs . The ovaries can produce and release sex hormones such as estrogen, progesterone, androgen, etc.

In general, progesterone acts together with estrogen, making it easier for the fertilised egg to be safely implanted in the uterus, and also promotes the further development of the mammary gland, preparing for the breastfeeding after delivery.

Effects of declining ovarian function

At birth, a female has 1-2 million eggs but only 300 will become mature and released for fertilisation. After the age of 30 the function of the ovaries started to decline, and if the ovarian function declines, it can lead to the following:

Irregular menstruation, vaginal atrophy, low ovulation rate, sexual life disorder, sexual apathy and infertility

Hot flushes, irritability, depression, insomnia

Weight gain, swollen belly, hips falling

Dry skin, loss of elasticity, hair loss

Susceptible to colds, infections, or chronic diseases

Atherosclerosis, such as: myocardial ischemia, myocardial infarction (heart attack)

Atrophy of the urethra, polyuria, frequent urination, urinary incontinence

Cervical spondylosis, rheumatism, arthritis, osteoporosis

Stomach discomfort, loss of appetite, constipation

Ovarian diseases

Most ovarian problems are caused by cysts. There are many types of ovarian cyst but the most common is functional type of cyst. This cyst develop as part of menstrual cycle which are usually harmless and short lived as they will disappear by itself. They are usually detected accidentally during ultrasound scanning of the abdomen and did not affect the fertility and allows normal conception.

Ovarian torsion is a cyst that grow to the point that it twist and turn over itself and blocked the blood supply. Therefore, a woman will experience sudden severe abdominal pain on either right or left lower abdomen. This is an emergency and immediate hospitalisation is required.

Meanwhile, polycystic ovarian syndrome (PCOS) is another condition where the women have multiple cyst in the ovary and this condition will affect fertility.

What is PCOS?

PCOS is a condition where the ovary contains multiple cyst due to lack of hormone that allows the egg to be released. This condition affect 1 out of 10 women in childbearing age. About 50% of women have not being diagnosed properly.

Features of this condition include, menstrual irregularities (no period or heavy period), anovulation (no ovulation) and signs of hyper androgen (acne, hair loss, facial hair). Women with PCOS also has higher chance of developing diabetes mellitus and obesity.

The exact cause of this is unclear but there is evidence of abnormal hormonal function, particularly higher amount of male hormones. On ultrasound, polycystic ovaries contain multiple follicles (more than 8 follicles) that can measure up to 8mm in diameter. These follicles are underdeveloped which means ovulation does not take place and interrupts the normal menstrual cycle which makes woman with PCOS harder to conceive. In order to get pregnant, losing weight and fertility treatment with doctor might improve the chance.

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