I remember a young woman, let’s call her Maya, sitting across from me in the clinic. She had that slightly worried look I see sometimes. “Doctor,” she began, “I keep hearing about my cycle, hormones, and trying for a baby… but I’m not really sure… what exactly do my ovaries do?” It’s a fantastic question, and honestly, one I get more often than you’d think. These small but incredibly important parts of you, your ovaries, are at the heart of so much when it comes to a woman’s health. So, let’s chat about them.
What Exactly Are Your Ovaries?
Think of your ovaries as two small, oval-shaped powerhouses. You’ve got one on each side of your uterus, tucked away in your lower abdomen. Their main jobs? Well, they produce and store your eggs – you might hear them called ovum. And, crucially, they make the hormones that orchestrate your menstrual cycle and play a huge role in pregnancy.
Here’s something that often surprises people: you’re born with all the eggs you’ll ever have. Millions of them, though only a fraction will ever mature. Each month, during ovulation, one of your ovaries usually releases an egg. If that egg meets a sperm and gets fertilized, a pregnancy can begin. This process continues, month by month, until you reach menopause. Sometimes, an ovary might release more than one egg – and that’s how non-identical multiple pregnancies can happen!
The Big Jobs: What Your Ovaries Do Day-to-Day
Your ovaries are key players in both your monthly cycle (menstruation) and in making a baby (conception).
Let’s break down that monthly cycle a bit. Inside each ovary are thousands of tiny sacs called ovarian follicles. Each one holds an immature egg. Early in your cycle, a hormone called follicle-stimulating hormone (FSH) nudges some of these follicles in one ovary to start maturing. Then, around the middle of your cycle – say, day 14 if you have a 28-day cycle – there’s a surge of another hormone, luteinizing hormone (LH). This LH surge is the signal for the ovary to release a mature egg. That’s ovulation.
Once released, the egg starts its journey down a narrow tube called the fallopian tube, heading towards the uterus. As it travels, your body ramps up production of another hormone, progesterone, which helps get the lining of your uterus ready and welcoming, just in case that egg is fertilized.
And if it’s not fertilized? The egg simply disintegrates and is reabsorbed by your body. Then, your hormone levels shift, and your period begins. And the whole cycle starts over.
The Hormonal Orchestra Conducted by Your Ovaries
We’ve mentioned estrogen and progesterone. These are the star hormones produced by your ovaries.
- Estrogen levels are usually highest in the first half of your cycle, before ovulation. It helps with egg development and has lots of other effects on your body too.
- Progesterone takes center stage in the second half of your cycle, after ovulation. Its main gig is to prepare your uterus for a potential pregnancy.
A Closer Look: Anatomy of the Ovaries
It’s good to have a picture in your mind of these important organs.
Where are they hiding?
Your ovaries are situated on the right and left sides of your uterus, down in your pelvis. They’re held gently in place by various muscles and ligaments. There’s a specific one, the ovarian ligament, that connects each ovary to the uterus, but they don’t actually touch the uterus directly.
What do they look like?
They’re generally oval-shaped and feel quite firm, with a slightly textured surface. Color-wise, they can range from a light gray to white.
How big are my ovaries?
This changes quite a bit with age. Before menopause, an ovary can be about the size of a kiwi – around 6 centimeters. But as you get older, especially after menopause, they shrink and can be as small as a kidney bean, maybe 2 centimeters. On average, we’d say an ovary is about 4 centimeters. It’s pretty standard for them to gradually get smaller each decade once you hit your 30s.
What are ovaries made of?
Each ovary has three main layers.
- The outer layer is a bit like a capsule.
- The middle layer, called the ovarian cortex, is made of connective tissue and is packed with those ovarian follicles we talked about – the ones holding the eggs.
- The innermost layer, the medulla, is where the blood vessels and lymphatic channels are found.
Can you feel your ovaries?
Generally, no, you can’t feel your ovaries from the outside. During a pelvic exam, your doctor or nurse practitioner might be able to feel them. You might, however, feel pain in the area of your ovaries if they’re enlarged or swollen due to a problem.
When Ovaries Cause Concern
Sometimes, things can go a bit off-kilter with your ovaries.
What does ovarian pain feel like?
Some women get a bit of a twinge or mild cramp around ovulation – we sometimes call this mittelschmerz, which is German for “middle pain.” It might be a dull ache on one side. You might also notice a little light bleeding or a change in discharge. But many women don’t feel ovulation at all. That’s all pretty normal.
However, if you’re having persistent or severe pain in your lower abdomen or pelvic area, that’s something we need to check out. It could be a sign of something more serious.
Symptoms that might signal ovary problems
If there’s an issue with your ovaries, your body might give you some clues. These can vary a lot, but keep an eye out for:
- Pelvic pain or a feeling of bloating that doesn’t go away.
- Abdominal pressure or tenderness.
- Nausea or diarrhea that seems unusual for you.
- Irregular vaginal bleeding (between periods, or heavier/longer periods).
- Unusual vaginal discharge.
- Painful periods (this is called dysmenorrhea).
- Very irregular menstrual cycles, or periods stopping altogether.
- Anovulation (when your ovaries don’t release an egg regularly).
Common conditions affecting the ovaries
There are several conditions that can involve the ovaries. Some of the ones we see more often include:
- Ovarian cysts: These are fluid-filled sacs that can form on or in an ovary. Most are harmless and go away on their own, but some can cause problems.
- Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder that can cause irregular periods, cysts on the ovaries, and other symptoms.
- Ovarian cancer: This is a serious condition, but thankfully less common.
- Primary Ovarian Insufficiency (POI): This is when the ovaries stop working normally before age 40.
- Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs, which can affect the ovaries.
- Ovarian tumors: These can be benign (non-cancerous) or malignant (cancerous).
- Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, sometimes on the ovaries.
How We Figure Things Out and Help
If you come to us with concerns about your ovaries, we have ways to investigate. It’s all about finding out what’s going on so we can get you the right support.
Tests we might use:
- A pelvic exam: This allows us to feel for any abnormalities.
- Ultrasound: This uses sound waves to create images of your ovaries and can show things like cysts.
- Magnetic Resonance Imaging (MRI) or CT scan: These are more detailed imaging tests we might use if we need a closer look.
- Blood tests: These can check hormone levels or look for markers that might indicate certain conditions.
- Urine tests: Sometimes useful, especially if an infection is suspected.
Common treatments for ovarian conditions:
Treatment really depends on what the specific issue is. It could involve:
- Simple pain relievers like acetaminophen or ibuprofen for discomfort.
- Hormonal birth control pills or other hormone therapy to regulate cycles or manage conditions like PCOS.
- Antibiotics if there’s an infection like PID.
- Surgery, which might be a minimally invasive laparoscopy to remove a cyst, or in some cases, an oophorectomy (removal of one or both ovaries).
- For ovarian cancer, treatments like radiation or chemotherapy are often part of the plan.
Whatever we find, please know we’ll talk through all the options with you, making sure you understand and are comfortable with the path forward.
More Things You Might Wonder About Your Ovaries
I get asked lots of other interesting questions about ovaries too!
What if an Ovary Has a Serious Problem, Like Twisting?
There’s a condition called adnexal torsion or ovarian torsion. It’s when an ovary twists around the ligaments that support it, cutting off its blood supply. Ouch! This is usually very painful and is a medical emergency. If it’s not treated quickly, the ovary can be permanently damaged or “die.” If that happens, surgery is needed to remove the affected ovary (an oophorectomy) because it can cause inflammation and other problems.
Ovaries and Menopause: What Changes?
As you approach and go through menopause (the average age is around 51), your ovaries gradually slow down. They stop making as much estrogen and, eventually, they stop releasing eggs. This means you lose the ability to become pregnant naturally. The ovaries themselves also tend to shrink or atrophy.
Pregnancy Outside the Uterus – Can it Happen in an Ovary?
Yes, it’s possible, though rare. An ectopic pregnancy is any pregnancy that implants outside the uterus. Most happen in the fallopian tube, but occasionally, one can occur in or on an ovary. Weird, right? But it happens.
Just to be Sure: How Many Ovaries Are We Talking About?
Typically, women have two ovaries – one on the left side and one on the right.
Can You Tell Which Ovary Released an Egg?
Often, you can’t! But some women experience that mittelschmerz (ovulation pain) on one side or the other. If you feel a distinct twinge on your left side one month, that might be your left ovary doing the work. But it’s not a foolproof way to know. The ovaries don’t strictly take turns; sometimes one is more active than the other for a while.
Key Takeaways About Your Ovaries
It’s a lot to take in, I know! But here are the main things I’d love for you to remember about your ovaries:
- They are vital for reproduction, producing eggs and key hormones like estrogen and progesterone.
- Your ovaries play a central role in your menstrual cycle, with ovulation (egg release) being a key event.
- You’re born with all your eggs; the number and quality decline with age.
- Problems like cysts, PCOS, or pain can occur, so listen to your body and see your doctor if you have concerns.
- During menopause, your ovaries naturally slow down and stop releasing eggs.
- Understanding your ovaries is empowering for your overall health.
You’re doing great just by learning more about your body. These little organs do so much for us, often without us even realizing it.
You’re not alone in figuring all this out. If you ever have questions or worries, that’s what we’re here for.
