The Human Ovary: Anatomy, Physiology, Disorders & Treatment Guide

1. Introduction

• The ovaries are essential reproductive organs in females, responsible for producing eggs (ova) and secreting hormones (oestrogen and progesterone).
• They regulate the menstrual cycle, fertility, and hormonal balance.
• Common ovarian disorders include polycystic ovary syndrome (PCOS), ovarian cysts, ovarian cancer, and premature ovarian failure.

2. Anatomy of the Ovary

• Location: On either side of the uterus, attached to the fallopian tubes.
• Structure:
  • Cortex: Contains follicles with developing eggs.
  • Medulla: Supports ovarian blood supply and nerves.
  • Follicles: Fluid-filled sacs housing immature eggs.
• Blood Supply:
  • Ovarian Artery: Supplies oxygen-rich blood.
  • Ovarian Vein: Drains deoxygenated blood.

3. Physiology of the Ovary

• Egg Production (Oogenesis):
  • Each ovary contains thousands of primordial follicles at birth.
  • During puberty, one follicle matures each month and releases an egg.
• Menstrual Cycle Regulation:
  • Follicular Phase (Days 1–14): Follicle develops, oestrogen rises.
  • Ovulation (Day 14): Egg is released.
  • Luteal Phase (Days 15–28): Progesterone maintains uterine lining.
• Hormone Secretion:
  • Oestrogen: Regulates the menstrual cycle and secondary sexual traits.
  • Progesterone: Supports pregnancy.
  • Testosterone (Small Amounts): Influences libido and ovarian function.

4. Common Disorders & Pathophysiology

A. Polycystic Ovary Syndrome (PCOS)

• Cause: Hormonal imbalance leading to irregular ovulation.
• Symptoms: Irregular periods, acne, weight gain, infertility.

B. Ovarian Cysts

• Cause: Fluid-filled sacs forming on the ovaries.
• Types:
  • Functional Cysts: Follicular or corpus luteum cysts, resolve on their own.
  • Pathological Cysts: Endometriomas, dermoid cysts, may need treatment.

C. Ovarian Cancer

• Cause: Uncontrolled growth of ovarian cells.
• Risk Factors: Family history, BRCA gene mutation, prolonged estrogen exposure.

D. Premature Ovarian Failure (POF)

• Cause: Ovaries stop functioning before age 40.
• Risk Factors: Autoimmune diseases, chemotherapy, genetic conditions.

E. Endometriosis of the Ovary

• Cause: Uterine tissue grows outside the uterus, affecting the ovaries.
• Symptoms: Chronic pelvic pain, heavy periods, infertility.

5. Signs & Symptoms of Ovarian Disorders

• Early Symptoms:
  • Irregular menstrual cycles.
  • Abdominal bloating or discomfort.
  • Unexplained weight gain or hair growth (PCOS).
• Advanced Symptoms:
  • Severe pelvic pain.
  • Infertility or difficulty conceiving.
  • Abnormal vaginal bleeding.
• Red Flags:
  • Sudden sharp pelvic pain (possible ruptured cyst).
  • Unexplained rapid weight loss or gain.
  • Persistent bloating with early satiety (potential ovarian cancer).

6. When to See a Doctor

• Missing periods for 3+ months without pregnancy.
• Chronic pelvic pain or severe menstrual cramps.
• Difficulty conceiving after 6–12 months of trying.

7. Emergency Signs Requiring Immediate Care

• Sudden, intense pelvic pain with nausea (possible ovarian torsion).
• Heavy, prolonged vaginal bleeding.
• Severe bloating with shortness of breath (ovarian cancer concern).

8. Diagnostic Process

• Clinical Examination:
  • Pelvic exam to assess ovarian size and tenderness.
• Laboratory Tests:
  • Hormone Panel: Measures estrogen, progesterone, LH, FSH, testosterone.
  • CA-125 Test: Marker for ovarian cancer.
  • AMH Test (Anti-Müllerian Hormone): Evaluates ovarian reserve.
• Imaging Tests:
  • Pelvic Ultrasound: Detects cysts, tumors, or ovarian abnormalities.
  • MRI/CT Scan: More detailed ovarian imaging if needed.
• Specialist Procedures:
  • Laparoscopy: Minimally invasive surgery to diagnose endometriosis or remove cysts.
  • Biopsy: Confirms ovarian cancer.

9. Likely Diagnoses

• PCOS (Polycystic Ovary Syndrome).
• Ovarian Cysts (Functional or Pathological).
• Ovarian Cancer.
• Endometriosis.
• Premature Ovarian Failure (POF).

10. Treatment Options

A. Medications

• For PCOS:
  • Oral Contraceptives (Birth Control Pills): Regulates periods.
  • Metformin: Improves insulin resistance.
  • Spironolactone: Reduces acne and excess hair growth.
• For Ovarian Cysts:
  • Painkillers (Ibuprofen, Naproxen).
  • Hormonal Therapy: Birth control pills to prevent new cysts.
• For Endometriosis:
  • GnRH Agonists (Leuprolide): Reduces estrogen to shrink lesions.
  • Pain Relievers (NSAIDs).
• For Ovarian Cancer:
  • Chemotherapy (Cisplatin, Paclitaxel).
  • Targeted Therapy (Bevacizumab).
• For Hormonal Deficiency:
  • Hormone Replacement Therapy (HRT) for POF.
• Approximate Medication Costs (USD):
  • Oral Contraceptives: $20–$100/month.
  • Metformin: $10–$50/month.
  • GnRH Agonists: $500–$1,500 per injection.
  • Cancer Treatment: $5,000–$15,000 per cycle.

B. Surgical/Procedural Interventions

• Ovarian Cyst Removal (Laparoscopic Cystectomy) ($5,000–$10,000).
• Hysterectomy (For Severe Endometriosis) ($10,000–$30,000).
• Ovarian Cancer Surgery (Oophorectomy) ($20,000–$50,000).

C. Lifestyle Modifications & Home Remedies

• For PCOS:
  • Weight management through low-carb diet, exercise.
• For Ovarian Cysts:
  • Heat therapy for pain relief.
• For Hormonal Balance:
  • Reduce sugar intake, avoid processed foods.

11. Precautions & Prevention

• Maintain a Healthy Weight: Reduces risk of PCOS and hormonal imbalances.
• Avoid Excess Alcohol & Smoking: Lowers ovarian cancer risk.
• Get Regular Pelvic Exams & Ultrasounds.
• Vaccinate Against HPV: Reduces risk of some ovarian cancers.

12. Prognosis & Recovery

• PCOS: Chronic but manageable with lifestyle changes.
• Ovarian Cysts: Most resolve without treatment; some require surgery.
• Ovarian Cancer: Prognosis depends on early detection.
• Endometriosis: Chronic, but treatable with medication or surgery.

13. Cost of Treatment

• Ultrasound: $200–$1,000.
• Hormone Tests: $100–$500.
• Ovarian Surgery: $5,000–$50,000.
• Cancer Chemotherapy: $5,000–$15,000 per cycle.

14. Frequently Asked Questions (FAQs)

1. Can ovarian cysts turn into cancer? – Rarely, but some complex cysts may require monitoring.
2. What are the early signs of ovarian cancer? – Persistent bloating, pelvic pain, loss of appetite.
3. Is PCOS curable? – No, but symptoms can be managed.
4. Can stress affect ovary function? – Yes, stress can disrupt hormone balance and ovulation.
5. Can you get pregnant with one ovary? – Yes, if the remaining ovary functions normally.