The ovaries are inconspicuous, tiny organs that have a huge impact on the woman's body. Their efficiency determines not only the hormonal balance, but also the work of the heart and the quality of sex life. How are the ovaries built and what are their functions in the female body? What are the most common diseases of the ovaries and how are they treated?
Ovaries(Latinovarium ) are classified as even organs. They are located on both sides of the pelvis in the so-called ovarian wells inside the peritoneal cavity. The ovaries are the reproductive organ and the counterpart of the male testicles. They produce hormones and eggs.
Ovaries: structure
The ovaries are slightly almond-shaped. In an adult, he althy woman, they are about 2-4 cm long, about 1 cm thick and about 2-3 cm wide. One ovary weighs approx. 6-8 g.
The ovary is fixed in the pelvis by two ligaments - the ligament of the ovary proper, which connects the lower edge of the ovary with the body of the uterus, and the suspensory ligament of the ovary connecting the upper edge with the peritoneum. The latter also includes the vessels and nerves that supply the ovary.
The arterial blood flows to the ovaries through the ovarian arteries that depart from the abdominal aorta. After supplying the fallopian tubes, the ovarian arteries mesh with the uterine arteries.
The blood from the ovaries flows into the network of tiny vessels of the flagellar plexus located in the broad ligament of the uterus and on to the right and left ovarian veins. The right ovarian vein enters the inferior vena cava, and the left ovarian vein enters the renal vein.
As a woman grows and matures, the ovaries change. During puberty, the ovaries are smaller than previously reported and their surface is smooth.
In older women, they become more wrinkled and have an irregular surface. When the menopause arrives, the functions of the ovaries slowly diminish and their dimensions diminish.
The ovaries also change at different stages of the ovulatory cycle. It is similar with their activity.
The ovaries are most active during ovulation. Then they also increase significantly. The ovaries also enlarge during the first trimester of pregnancy to accommodate the significantly increased need for hormones.
Ovaries: functions
The ovaries play a double role in the body - they secrete the necessary hormones and produce cellsegg.
During puberty, which occurs in girls aged 11-13, the menstrual cycle is regulated by the hormones of the pituitary gland.
The period lasts about 28 days and repeats monthly for 35-40 years, which is until the menopause.
Under the influence of pituitary hormones, one Graaf follicle matures into an egg every month.
The ovaries produce hormones - estrogens, progesterone, relaxin and androgens, i.e. steroidal hormones. In women, they are androstenedione and dihydrotestosterone.
Diseases of the ovaries
An ovarian failure may not produce any symptoms. Their bad work can be signaled by:
- severe pains in the lower abdomen
- unnatural vaginal discharge
- ovulation cycle disorders
Some diseases are accompanied by:
- fever
- nausea
- vomiting
- diarrhea
- constipation
- pain during intercourse
Each ailment or irregularity should make a woman visit a gynecologist. Treatment of an infection on your own may end badly, e.g. with reduced fertility, the development of cancer or dangerous vaginal bleeding.
- Acute adnexitis
The disease affects both the ovaries and fallopian tubes. Acute adnexitis may be caused by infection with aerobic bacteria (non-hemolytic streptococci) and anaerobic bacteria ( Bacteroidesspecies ). It can also cause disease. gonorrhea ( Neisseriagonorrhoeae ) or Chlamydia trachomatis .
Symptoms of adnexitis are severe, increasing pain in the lower abdomen, high temperature (38-40 degrees C) and increased heart rate.
If the infection spreads to the peritoneal cavity, Blumberg's symptom may appear, i.e. pain felt when a hand is torn off the abdominal wall. But keep in mind that appendicitis can also present peritoneal symptoms. Therefore, any pain that resembles peritoneal pain should be consulted quickly with a doctor.
The results of laboratory tests are also important in the diagnosis of inflammation, e.g. high ESR or an increased number of white blood cells (leukocytosis).
It is possible to perform a bacteriological examination of the cervical canal or peritoneal fluid swab to identify specific strains of bacteria responsible for the infection.
Treatment is based on the administration of broad-spectrum antibiotics, i.e. those that destroy many strains of bacteria.
Sometimes, in the absence of a clear diagnosis, laparoscopy is performed to make sure thatthe cause of the symptoms is not appendicitis. Neglecting the acute inflammation of the appendages may lead to a situation in which they will need to be removed.
- Premature loss of ovarian function
Premature ovarian decline occurs in 1% of women under 40. For most women, this does not happen until the menopause, which is on average around 50-55 years of age in Europe.
Frequent infections, chemotherapy, radiotherapy, family burdens and autoimmune diseases lead to premature ovarian decline.
Symptoms that signal the decline of ovarian activity include
- hot flashes
- sweating
- missed or irregular periods
Blood tests show decreased estrogen levels and increased follicle stimulating hormone (FSH) levels.
Treatment consists of hormone replacement therapy.
- Ovarian failure
The ovaries are part of the endocrine system, but are also influenced by the superior endocrine glands of the hypothalamus and pituitary gland. They secrete hormones that stimulate or inhibit the activity of the ovaries.
If the hypothalamus or pituitary gland fails, the ovaries will not get the signal of how to work. In such a situation, when the ovaries are properly built, we deal with a secondary failure.
When the pituitary gland and hypothalamus function properly and the ovaries do not fulfill their functions, it is called primary failure.
Symptoms of ovarian failure vary widely - you may experience:
- primary amenorrhea, i.e. no bleeding until around 16 years of age. Primary ovarian failure may be genetically determined and adversely affect the functioning of the entire body
- secondary amenorrhea is when there is no bleeding for more than 6 consecutive months, and the situation applies to a woman of childbearing age. Treatment is based on hormone replacement. Sometimes surgery is needed.
- Ovarian cysts
When mature Graafian follicles inside the ovary do not burst during ovulation, they can expand in order to release an egg capable of fertilization. Fluid collects in them and a cyst is formed.
Cysts can be the size of a grain of porridge, but also the size of an orange. When an ovarian cyst grows, the following may appear:
- constipation
- flatulence
- stomach pains
- frequent urination (due to pressure on the bladder)
- disordersmenstruation
- dysmenorrhea
- pain during intercourse
Most cysts show no symptoms. They are usually detected during a transvaginal ultrasound scan.
Very often, cysts do not require treatment and disappear on their own. Sometimes hormone treatment is necessary. In extreme situations, when the cyst twists (pedunculated cysts, "on the leg") or ruptures, urgent medical attention is required.
In the case of endometrial cysts, surgical treatment is considered the most effective.
As a reminder, endometriosis is a disease in which the lining of the uterus is found in different parts of the body. When a piece of the endometrium enters the ovary, a chocolate cyst may form, which is filled with brown mass.
Such a cyst is usually removed because rupture of the cyst may expel its contents into the peritoneal cavity, which can eventually lead to peritonitis, a life-threatening condition.
- Polycystic Ovary Syndrome (PCOS)
This is a condition called polycystic ovary syndrome or Stein-Leventhal syndrome. About 4-6% of women of childbearing age have PCOS. Polycystic ovary syndrome is a genetic disease, therefore it often runs in families.
Normally, the ovaries contain Graaf's follicles, which mature in a he althy woman and then release an egg, which is called ovulation. The released egg is capable of fertilization.
In women suffering from PCOS, ovarian (Graff) follicle development is stopped before the egg is released. The bubbles disappear and in their place cysts form, which are visible on ultrasound.
Symptoms of the disease include menstrual disorders (rare, irregular or secondary periods), acne, hirsutism (hirsutism), obesity, impaired glucose tolerance or diabetes, and ovarian cysts.
Laboratory tests show abnormal hormone levels and elevated fasting or oral blood glucose levels.
Treatment for PCOS depends on the symptoms present. Patients are given drugs that restore the correct concentration of androgenizing hormones by inhibiting their production or reducing their action.
Symptoms of the disease are alleviated by taking combined contraceptive pills. Women who want to have a baby are recommended drugs that stimulate ovulation. Z
Failure to treat may lead toinfertility, as well as diseases that coexist with overweight, i.e. hypertension, atherosclerosis and ischemic heart disease. Endometrial hyperplasia can also cause neoplastic changes.
- Ovarian tumors
They usually develop after the age of 55. It is now believed that the primary outbreaks of ovarian cancer originate in the fallopian tubes. So far, the factor responsible for this neoplasm has not been identified.
It is known that, like other cancers, it is favored by contact with carcinogenic substances (cigarette smoke, chemicals, industrial waste) and exposure to ionizing radiation.
The risk of falling ill is also genetically determined - the more women in a close and extended family were ill, the more at risk the woman is.
Cancer is also favored by childlessness, old age, high socioeconomic status and a diet rich in animal fats.
It is also believed that hormonal contraception used for more than 10 years doubles the risk of developing the disease.
In the initial stage of development, cancer shows no symptoms. A little later, you may experience abdominal pain, a feeling of fullness or a feeling of pressure in the pelvis. Sometimes there are also problems with the digestive system.
Later, abdominal pain and pelvic pressure increase. A woman may feel pressure on the bowel and bladder.
In addition, there is a lack of appetite, nausea and ascites due to the accumulation of exudative fluid in the abdominal cavity.
Menstrual periods often become irregular, and there is also bleeding in between them, which, however, is more often a symptom that suggests other neoplastic diseases of the reproductive organ, e.g. cervical cancer.
Most cases of ovarian cancer are diagnosed in stage III and IV.
Earlier detection of a tumor, optimally in the 1st stage of development, is possible when the solid focus, often located inside a cyst of a few centimeters long, has a few to several millimeters and a correspondingly small mass. Such a tumor can be detected by the doctor when examining the patient or more frequently by performing an ultrasound examination.
According to the data of the Cancer Center in Warsaw, ovarian cancer is more common in women living in cities than in the countryside. The increased risk of the disease concerns mainly women from the Białystok and Łódzkie voivodships. The worst epidemiological situation is in Greater Poland.
About 75 percent ovarian cancer cases are diagnosed at high stage (III and IV). In the preclinical phase, cancer is most often detected by chance. Canceran ovary may develop in one or both of the ovaries. It often metastasizes, even quite distant, e.g. to the lungs.
The basic treatment method is surgery, during which the doctor tries to remove all the neoplasm. In the first stage of development, the disease is rarely detected. When the cancer is advanced, chemotherapy is often used before surgery to reduce the mass of the tumor. After this stage of treatment is completed, an operation is performed, and then individually selected chemotherapy regimens are applied.
Worth knowingHow do I protect myself against ovarian cancer?
Regular gynecological examinations are the basis. In addition, women should avoid smoking, excessive X-ray radiation and carcinogenic substances.
The prophylactic role is also played by hormonal contraception containing estrogens and progestogens. The administration of drugs reduces the secretion of estrogen by the ovaries, which may protect against cancer.
The risk of falling ill is also reduced by pregnancies and deliveries (each subsequent pregnancy lowers the risk of falling ill by about 10%). Also, childbirth after the age of 35 reduces them.
The high-risk group includes women with a family history of this cancer. They should perform transvaginal ultrasound twice a year and mark the CA-125 marker once a year.
Some hereditary women with a documented mutation in the BRCA gene after 35-45. years of age, it is proposed to remove the appendages (ovaries and fallopian tubes).