Ovary

Almond shaped organs about 4cm long and 2 wide. They are attached to the back of the broad ligament. They are covered with the tunica albuginea, like the testis, then outside this with the germinal epithelium, a modified layer of peritoneum.

During pregnancy the ovaries move out of the ovarian fossa, which is the angle between the external and internal iliac artery – but then again, pretty much everything moves in pregnancy.

The obturator nerve runs past the ovary, and supplies the medial muscles of the thigh (which are used for adduction) so if you have ovarian pain it can be referred to the thigh, which is a useful marker.

The ovaries produce the ova (female germ cells), and the sex hormones oestrogen and progesterone.

Clinical Conditions

If you want these in more depth, check out the page on female reproductive tract problems.

Polycystic ovaries

Symptoms of amenorrhoea and hyperoestrogenism – maleisation symptoms. There are multiple follicular cysts of the ovary. Common cause of infertility since it prevents ovulation. No link with PKD

Endometriosis

The presence of endometrium anywhere except the uterus. Important cause of morbidity in women, and can cause pelvic inflammation, infertility and pain. Common sites are the pouch of Douglas, pelvic peritoneum and the ovary – but it can happen anywhere near the uterus really. There is a weak link between this and ovarian cancer.

Ovarian cancer

5th leading cause of death in women. In the West, 1 in 50 chance of getting it. It is a difficult one to diagnose, since its symptoms are non specific – vaginal bleeding, weight change, abnormal periods, worsening back pain. This means it is rarely caught early, with a resultant poor prognosis.

Many types. Most common malignant one is the epithelial, followed by germ cell and sex cord tumours. Pregnancies and oral contraceptive decrease risk, whilst family history greatly increases risk.

Metastasis is common, especially to the liver and colon and spread to uterine tubes is usual in stage 2 disease.