Everything You’ve Ever Wanted to Know About Your Ovaries

Ovaries are to women as testicles are to men: an essential part of the reproductive system. Due to a lack of sex education in most U.S. middle and high schools, many women go through life without any solid knowledge of how their ovaries work, the purposes they serve, and the potential problems they can cause.

You’ll be better able to advocate for your reproductive health when you’re armed with knowledge about your body.

Keep reading for an in-depth look at everything you need to know about your ovaries.

What are Ovaries and What do they do?

Your ovaries are a pair of almond-shaped glands located on either side of your uterus. The ovaries connect to the fallopian tubes which then connect to the uterus. They are, without a doubt, the most important female reproductive organ.

The ovaries serve two main functions: acting as glands to produce female sex hormones and acting as gonads to produce eggs (ovum). Let’s take a closer look at each function of the ovaries and how they work together.

How does ovulation work?

From the time you’re born, your ovaries contain all of the egg cells (also called oocytes) you’ll ever have—about two million. By the time a woman reaches puberty, her ovaries will have approximately 300,000 eggs left. Once you begin menstruating, your ovaries release an egg per month during ovulation. As you age, the number of eggs you have decreases and the quality of each egg declines. Once you have fewer than 1,000 eggs, you’re considered to be in menopause.

During your reproductive years, that is, after puberty but before menopause, your body goes through a monthly cycle made up of four phases. In order to understand how ovulation works, it’s important to understand each phase.  

The 4 phases of the feminine cycle

  • Menstrual phase: This phase begins on the first day of your period and can last for 5–7 days. During this time, your uterus sheds the lining it developed the month prior because you didn’t become pregnant. If you had become pregnant, you wouldn’t have a period because the egg you released during ovulation would have implanted into the uterus.
  • Follicular phase: Also beginning on the first day of your period, the follicular phase lasts for about 13 days. Your pituitary gland releases follicle-stimulating hormone and luteinizing hormone, which stimulates the egg cells in your ovaries to begin developing. One of those eggs cells will start maturing in a follicle in one of your ovaries. At the same time, your ovaries release the hormone estrogen to stimulate your uterine to begin developing a new lining, made of soft tissue (endometrium) and blood vessels.
  • Ovulation phase: If you have an average cycle of 28 days, ovulation occurs around the fourteenth day. Your pituitary gland releases the sex hormone progesterone as your ovaries release a mature egg and it travels down to your fallopian tube, where it will wait to be fertilized by sperm.
  • Luteal phase: The egg only stays in the fallopian tube for 24 hours. If it isn’t fertilized, it dissolves and is absorbed into the uterine lining. At that point, all the progesterone released by your ovaries gets used up and causes the uterus to shed the unused lining. This is when your period begins. However, if you do get pregnant, your ovaries will produce higher levels of both estrogen and progesterone, so that more eggs won’t mature and you won’t get your next period.

Your ovaries and the hormones they control

Your ovaries are responsible for the production of two main hormones: progesterone and estrogen. Estrogen is responsible for many things, not the least of which is the development of female characteristics like breast development and the development of reproductive organs. Progesterone, as we learned above, helps the body prepare for and maintain a pregnancy.

Your ovaries also produce the hormone relaxin. Relaxin helps relax the ligaments in your pelvis and widen your cervix before you give birth.

What Conditions can Affect the Ovaries?

Despite being tiny, your ovaries are powerhouses. They control your entire menstrual cycle, from the time you start puberty to when you start menopause. They can also be the cause of certain reproductive conditions.


A painful disease affecting about 178 million women, endometriosis is a reproductive disorder in which the tissue that normally grows inside of the uterus grows on the surrounding organs. This can cause blockage or scarring of the fallopian tubes, which results in infertility for about 40 percent of women affected by the disorder.

It can take up to 12 years to diagnose endometriosis correctly because symptoms often go unrecognized by women and their doctors. Unfortunately, the only reliable way of diagnosing endometriosis is to have laparoscopic surgery. During this surgery, a doctor will make a small incision in the abdomen and insert a tiny tube with a light at the end (a laparoscope) so they can look at the organs and determine whether endometriosis is an issue.

What are the symptoms of endometriosis?

Often, symptoms of endometriosis are hard to identify, largely because all of the symptoms can be attributed to other issues. If you have any of the following symptoms, or if you have a family history of endometriosis, it’s a good idea to talk to your doctor.

  • Painful menstrual cramps
  • Painful intercourse
  • Heavy menstrual periods
  • Infertility (you’ve been trying and unable to conceive for 12 months)
  • Depression
  • Fatigue
  • Painful urination
  • Blood in the urine
  • Constipation/diarrhea

Can endometriosis be treated?

Endometriosis, once diagnosed, can be treated. This is usually done by using hormonal birth control or other hormonal therapy. If you have a very serious case of endometriosis, your doctor may recommend a hysterectomy.  

Ovarian Cysts

Ovarian cysts are blister-like sacs filled with fluid that form on the ovaries. There are several different types of cysts:

  • Functional cysts: This type of cyst starts as a sac that forms during ovulation. It holds a maturing egg and disappears when the egg is released. If the egg is not released or the sac closes after the egg is released, it can swell with fluid. Functional ovarian cysts are generally harmless and don’t need to be treated.
  • Polycystic ovarian syndrome cysts: These types of cysts form due to a buildup of follicles on the ovaries. They can make the ovaries become larger and create a thick outer coating, preventing ovulation from happening. PCOS cysts are linked to fertility problems.
  • Endometrioma cysts: Women with endometriosis can have endometrioma cysts. They form when tissue that resembles uterine lining attaches to the ovaries. Also known as chocolate cysts, they can form on and around the ovaries.

What are the symptoms of ovarian cysts?

Most ovarian cysts don’t cause any symptoms but this varies from woman to woman. Some possible symptoms of ovarian cysts include:

  • Dull ache or pressure in the lower abdomen
  • Painful intercourse
  • Irregular or very painful periods

How are ovarian cysts treated?

Hormonal birth control is the most common method of treating ovarian cysts. In some cases, a doctor may advise having the cyst(s) removed and tested for cancer. If they’re cancerous, they may recommend a hysterectomy.

Pelvic inflammatory disease

When foreign bacteria enters the cervix, it can infect the uterus, cervix, and fallopian tubes. This leads to an infection called pelvic inflammatory disease (PID). Chlamydia and gonorrhea are sexually transmitted infections (STIs) that are known to cause PID. Women can also get PID from bacterial vaginosis, pelvic surgery, or any other type of gynecological procedure on the cervix or uterus. This is a very serious infection that can cause chronic pain and infertility.  

What are the symptoms of pelvic inflammatory disease?

  • Pain in the lower abdomen
  • Painful intercourse
  • Painful urination
  • Lower back pain
  • Excessive, foul-smelling vaginal odor
  • Fever
  • Fatigue
  • Diarrhea and constipation

How is PID treated?

If caught early, pelvic inflammatory disease can be treated with antibiotics. If left untreated, surgery may be necessary to fix or remove some of your reproductive organs. It can cause long-term damage so it’s important to see your doctor if you have any signs of infection.

Ovarian cancer

Affecting about 200 thousand women per year, ovarian cancer is very serious and is a leading cause of death in women. Most ovarian cancers start as tumors in the cells that cover the outside of the ovaries. However, tumors can start in the eggs (ova) or on the tissues of the ovary that produce estrogen and progesterone. Most tumors are benign, or noncancerous, and never leave the ovary. If the tumors are cancerous (or malignant), they can spread to other parts of the body. All women can be affected by ovarian cancer.

Some of the symptoms of ovarian cancer include:

Ovarian cancer can be hard to detect because its symptoms are similar to those of gastrointestinal issues. If you have any of the following symptoms, you should see your doctor. Early detection is the best way to prevent the spread of ovarian cancer.  

  • Bloating
  • Pelvic or abdominal pain
  • Frequent urination
  • Fatigue
  • Trouble eating
  • Feeling full quickly
  • Upset stomach
  • Heartburn
  • Back pain
  • Pain during sex
  • Constipation
  • Changes to your menstrual cycle

Ovarian Cancer Treatment

Like other types of cancer, ovarian cancer can be treated. The most common treatment is surgical removal of the cancerous tumors. Some women will choose to have a hysterectomy to completely remove the ovaries. Alternatively, chemotherapy may be an option.

The ovaries are such a critical part of your reproductive system which, by nature, makes them complicated. It controls your female sex hormones, your ovulation, and your ability to conceive and maintain a pregnancy. Even once you’ve gone through menopause, your ovaries act as a hormonal hub—the decrease in estrogen they produce contributes to many symptoms of menopause. Knowing the signs of an ovarian condition can help you know when to seek medical advice and what kinds of questions you need to ask. The more you know about your body, the more in control of it you are.

Featured image by Madeleine Morlet

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