Common Ovarian Conditions: Symptoms, Types, and Diagnosis

What are the ovaries?

The ovaries are part of the female reproductive system. Women have two ovaries, one on each side of the uterus. Each ovary is about the size and shape of an almond.

The ovaries produce and store a woman’s eggs. During ovulation, an ovary releases an egg. If that egg is fertilized by a sperm, a pregnancy can occur. Ovaries also make the female hormones estrogen and progesterone. When a woman goes through menopause, her ovaries stop making those hormones and releasing eggs.

Each ovary is the same sort of shape and size as an almond, and the organs mature during puberty. The uterus is the hollow, pear-shaped organ where a fetus can grow. The ovaries are held in place by ligaments joined to the uterine wall, and connected to the uterus via fallopian tubes, which the egg passes down on its monthly release ready to be fertilized.

Hormone production

The ovaries produce female reproductive hormones: progesterone, estrogen, relaxin, and inhibin. These hormones have effects on:

• The way breasts and body hair grow
• Body shape
• The menstrual cycle
• Pregnancy

Estrogen helps the breasts to develop and the hips to become larger, both important aspects of female reproduction. Progesterone causes the uterine lining to build up and keeps it in the event of fertilization. Relaxin is utilized during labor when it allows the pelvic ligaments to loosen and stretch.

Some conditions of the ovaries

There is some conditions of ovaries with their descriptions;

Ovarian infection

PID is an infection caused by bacteria. When bacteria from the vagina or cervix travel to your womb, fallopian tubes, or ovaries, they can cause an infection. Most of the time, PID is caused by bacteria from chlamydia and gonorrhea. These are sexually transmitted infections (STIs). Having unprotected sex with someone who has an STI can cause PID.

In certain cases of infection, in fact, pus might build up in the ovaries. This will be removed by surgery.

Symptoms

Some symptoms of ovarian infection are:

• Pain — ranging from mild to severe — in your lower abdomen and pelvis.
• Abnormal or heavy vaginal discharge that may have an unpleasant odor.
• Abnormal uterine bleeding, especially during or after intercourse, or between menstrual cycles.
• Pain during intercourse.
• Fever, sometimes with chills.

Ovarian cysts

Ovarian cysts are another type of condition of the ovaries. They are fluid-filled sacs or pockets in an ovary or on its surface. Women have two ovaries — each about the size and shape of an almond — on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released in monthly cycles during the childbearing years.

Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless. The majority disappear without treatment within a few months.

However, ovarian cysts — especially those that have ruptured — can cause serious symptoms. To protect your health, get regular pelvic exams and know the symptoms that can signal a potentially serious problem.

Symptoms

Most cysts don’t cause symptoms and go away on their own. However, a large ovarian cyst can cause:

• Firstly, Pelvic pain — a dull or sharp ache in the lower abdomen on the side of the cyst
• Secondly, Fullness or heaviness in your abdomen
• And finally, Bloating

When to see a doctor

Seek immediate medical attention if you have:

• Sudden, severe abdominal or pelvic pain
• Pain with fever or vomiting, for instance
• If you have these signs and symptoms or those of shock — cold, clammy skin; rapid breathing; and lightheadedness or weakness — see a doctor right away.

Types of cysts

Most ovarian cysts develop as a result of your menstrual cycle (functional cysts). Other types of cysts are much less common.

Functional cysts

This is a condition where your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate. If a normal monthly follicle keeps growing, it’s known as a functional cyst.

There are two types of functional cysts:

1. The first is the Follicular cyst. Around the midpoint of your menstrual cycle, an egg bursts out of its follicle and travels down the fallopian tube. A follicular cyst begins when the follicle doesn’t rupture or release its egg but continues to grow.
2. The second is the Corpus luteum cyst. When a follicle releases its egg, it begins producing estrogen and progesterone for conception. This follicle is now called the corpus luteum. Sometimes, fluid accumulates inside the follicle, causing the corpus luteum to grow into a cyst.

Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.

Other cysts

This a condition of the ovaries where it is not related to the normal function of your menstrual cycle including:

1. Dermoid cysts. Also called teratomas, these can contain tissue, such as hair, skin, or teeth because they form from embryonic cells. They’re rarely cancerous.
2. Cystadenomas. These develop on the surface of an ovary and might be filled with a watery or mucous material.
3. Endometriomas. These develop as a result of a condition in which uterine endometrial cells grow outside your uterus (endometriosis). Some of the tissue can attach to your ovary and form a growth, for instance.

PCOS (Polycystic ovary syndrome)

Polycystic ovary syndrome (PCOS) is a part of various conditions of ovaries. It is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels, for instance. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

Symptoms

Signs and symptoms of PCOS often develop around the time of the first menstrual period during puberty. Sometimes PCOS develops later, for example, in response to substantial weight gain.

Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:

1. Firstly, irregular periods. Infrequent, irregular, or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year, more than 35 days between periods, and abnormally heavy periods.
2. Secondly, excess androgen. Elevated levels of male hormones may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.
3. And thirdly, polycystic ovaries. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.

What causes PCOS

See your doctor if you have concerns about your menstrual periods, if you’re experiencing infertility or if you have signs of excess androgen such as worsening hirsutism, acne, and male-pattern baldness.

Ovarian cancer

Cancer of the ovary is not common, but it causes more deaths than other female reproductive cancers. The sooner ovarian cancer is found and treated, the better your chance for recovery. But ovarian cancer is hard to detect early. Women with ovarian cancer may have no symptoms or just mild symptoms until the disease is in an advanced stage. Then it is hard to treat. Symptoms may include:

• A heavy feeling in the pelvis
• Pain in the lower abdomen
• Bleeding from the vagina
• Weight gain or loss
• Abnormal periods
• Unexplained back pain that gets worse
• Gas, nausea, vomiting, or loss of appetite, for instance

Types

1. Epithelial ovarian cancers start in the cells covering the ovaries and are the most common type of ovarian cancer
2. Germ cell ovarian tumors are rare and usually affect girls and young women up to their early 30s. Ovarian teratoma is the most common type.
3. Sex cord-stromal ovarian tumors can be non-cancerous (benign) or cancerous (malignant). Granulosa cell tumors are the most common type.
4. Borderline ovarian tumors are abnormal cells that form in the tissue covering the ovary.

Premature ovarian failure

This is a part of various conditions of the ovaries where ovarian insufficiency occurs. It happens when the ovaries stop functioning as they should before age 40. When this happens, your ovaries don’t produce typical amounts of the hormone estrogen or release eggs regularly.

Women with primary ovarian insufficiency can have irregular or occasional periods for years and might even get pregnant. But women with premature menopause stop having periods and can’t become pregnant.

Restoring estrogen levels in women with primary ovarian insufficiency helps prevent some complications that occur as a result of low estrogens, such as osteoporosis.

Symptoms

• Irregular or skipped periods, which might be present for years or develop after a pregnancy or after stopping birth control pills
• Difficulty getting pregnant
• Hot flashes
• Night sweats
• Vaginal dryness
• Dry eyes
• Irritability or difficulty concentrating
• Decreased sexual desire

Causes

• Chromosome changes. Some genetic disorders are associated with primary ovarian insufficiency. These include conditions in which you have one typical X chromosome and one altered X chromosome (mosaic Turner syndrome) and in which X chromosomes are fragile and break (fragile X syndrome).
• Toxins. Chemotherapy and radiation therapy are common causes of toxin-induced ovarian failure. As a result, these therapies can damage the genetic material in cells. Other toxins such as cigarette smoke, chemicals, pesticides, and viruses might hasten ovarian failure.
• Immune system response to ovarian tissue (autoimmune disease). In this rare form, your immune system produces antibodies against your ovarian tissue, harming the egg-containing follicles and damaging the egg. What triggers the immune response is unclear, but exposure to a virus is one possibility.
• Unknown factors. The cause of primary ovarian insufficiency is often unknown (idiopathic). But, your health care provider might recommend further testing to find the cause, but in many cases, the cause remains unclear.

Ovarian torsion

This is a condition of the ovaries wherein the ovary, and sometimes the fallopian tube, twist on the tissues that support them. This cuts off the blood supply to the ovary, which if not treated promptly, can cause tissue in the organ to die.

Diagnosis of conditions of the ovaries

A series of examinations and investigations will help in the diagnosis of conditions of the ovaries. These methods of investigation generally include tests like:

• Blood test
• Pelvic examination
• Transvaginal ultrasound
• Trans-abdominal ultrasound