What Do Ovaries Look Like?

The ovaries are glands that produce eggs and hormones that support the reproductive system and other tissues in the body. The ovaries are about the size and shape of a walnut and they are attached to the uterus with one ovary on each side and in close proximity to the fallopian tubes.

This article discusses the anatomy and function of ovaries, as well as conditions that affect these glands. It also shows what an ovary looks like.

Anatomy

The ovaries are a pair of glands in the female reproductive system responsible for producing eggs and the sex hormones progesterone and estrogen. They are solid structures (around the size and shape of a walnut) located on each side of the uterus. They are held in place and supported by ligaments that attach to the uterus, fallopian tubes and the pelvic side walls.

The ovary consists of an outer cortex and an inner medulla. Embedded within the cortex are many ovarian follicles—tiny fluid-filled sacs where eggs grow. The medulla is made up of loose connective tissue containing blood vessels, lymphatic vessels, and nerve fibers.

Function

The main function of the ovaries is to develop and release mature eggs and produce sex hormones for menstruation, pregnancy, reproductive function, and to support other tissues.

Ovarian Follicles

At birth, a female baby has about 1 million ovarian follicles. Each ovarian follicle contains a hollow ball of cells with an immature egg in the center.

During childhood, approximately half of the ovarian follicles are absorbed by the body. By the time of puberty and the beginning of an individual's menstrual cycle, only about 400,000 ovarian follicles are left to develop into mature eggs.

Although only one egg usually fully matures during each ovulation, between 10 and 20 follicles begin the process of maturation monthly. The excess ovarian follicles are reabsorbed before ovulation occurs.

Ovulation

Around the middle of the menstrual cycle (typically day 14 of a 28-day cycle, though this timing may vary), the process of ovulation is initiated.

The steps leading up to ovulation are as follows:

• Gonadotropin-releasing hormone (GnRH) from the hypothalamus acts on the pituitary gland to increase its secretion of follicle-stimulating hormone (FSH).
• FSH acts on the ovaries to stimulate the growth and development of follicles, which initially contain immature eggs.
• As the follicles grow, they produce and secrete estrogen, which helps perpetuate the development of the follicles and eggs.
• When estrogen reaches a certain threshold, it triggers the release of luteinizing hormone (LH), which helps the egg mature, initiates progesterone production, and triggers ovulation.
• Once the LH peaks, ovulation, or the release of an egg from the follicle in the ovary, occurs 10 to 12 hours later.
• After the egg is released from the ovary, it is captured by the fimbriated end of the fallopian tube, where sperm may fertilize it.
• The inside of the fallopian tubes is lined with cilia, which are microscopic hairs that help move sperm towards the egg.

Conception (the fertilization of an egg with sperm) most often occurs in the part of the fallopian tube that is nearest the ovary. Five to six days are required for the fertilized egg to reach the uterus.

After ovulation, if pregnancy has not occurred, the empty follicle, called the corpus luteum, is reabsorbed into the body. If pregnancy does occur, the corpus luteum produces hormones that help to maintain the pregnancy.

When a person reaches menopause, the supply of eggs is very low, and the ovaries stop ovulating. Although the ovaries continue to make some hormones, their production of estrogen and other hormones decreases significantly. The ovaries also become slightly smaller in size after menopause.

Why Do My Ovaries Hurt?

You might experience a twinge, a cramp, or some discomfort in your lower back or abdomen when ovulation occurs. Some people notice a small amount of vaginal discharge.

Ovary pain during ovulation is called "mittelschmerz," or midcycle pain. For some people, this pain is severe enough to be mistaken for an ectopic pregnancy (when a fertilized egg implants outside the uterus) or appendicitis (inflammation of the appendix, on the lower right side of the abdomen). During ovulation, some people may experience other symptoms such as breast tenderness, bloating, or headache.

Disease and Conditions

Listed below are some conditions that can affect the ovaries.

Ovarian Torsion

Rarely, an ovary can twist around the ligament that's holding it in place. This condition is known as ovarian torsion and can result in severe pain. Ovarian torsion is considered a medical emergency because the twisting (torsion) can cut off blood supply to the ovary and fallopian tube.

The initial symptoms are severe pelvic pain, typically on one side, along with nausea and vomiting. Immediate surgery is usually required to restore the blood supply and preserve the ovary.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs similar to blisters that can form on the ovaries. Ovarian cysts are common during the reproductive years.

Ovarian cysts commonly form during ovulation or pregnancy. In some cases, they may result from hormonal treatments, including fertility treatments. Other causes are PCOS, endometriosis, or a pelvic infection.

Most types of ovarian cysts are harmless and go away without any treatment.

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects an estimated 7% of all people with ovaries. It is the most common hormonal disorder among females. According to experts, the actual number of people affected by PCOS may be as high as 1 out of 10.

Many cases of PCOS are undiagnosed because the symptoms can vary from person to person. It also is often difficult to accurately diagnose. Because polycystic ovary syndrome can cause significant long-term health consequences, getting an accurate diagnosis, followed by proper treatment, is important.

Ovarian Cancer

Ovarian cancer is often called the "silent killer" because it usually doesn't cause symptoms until the disease has progressed to an advanced stage. In the United States, ovarian cancer ranks fifth in cancer deaths among women, making it the deadliest gynecological cancer.

Fallopian Tube Damage

Fallopian tubes that have been damaged by diseases, infections, or other conditions may be scarred or damaged, which increases the risk of an ectopic (tubal) pregnancy and infertility.

If the fallopian tubes are damaged or blocked, it can make it difficult or impossible for the egg and sperm to meet and, therefore, create an embryo. If you suspect that you may have tubal damage or if you are struggling to get pregnant, tests can assess the health of the tubes. Talk to a fertility specialist to learn more.

Some of the causes of fallopian tube damage are pelvic inflammatory disease (PID, an infection in the upper reproductive system) and endometriosis (tissue that normally grows inside the uterus develops outside this organ). Some sexually transmitted infections (STIs) and other pelvic infections can also damage the fallopian tubes.

Summary

The ovaries are small, oval-shaped structures located on each side of the uterus. These glands are responsible for storing and releasing eggs (ova), as well as producing sex hormones for menstruation and pregnancy. Diseases and conditions that affect ovaries include ovarian cysts, polycystic ovarian syndrome (PCOS), and ovarian cancer.

Some of these conditions may require treatment. See your healthcare provider if you experience symptoms such as pelvic pain, abnormal vaginal bleeding, or irregular menstruation.