Functions of the ovarian hormones

Human body structure and function IV

Abstract

The principal organs of the human female reproductive tract, including the ovaries,
fallopian tubes (also called uterine tubes), uterus, and vagina. Reproduction begins with
the development of ova in the ovaries. In the middle of each monthly sexual cycle, a
single ovum is expelled from an ovarian follicle into the abdominal cavity near the open
fimbriated ends of the two fallopian tubes. This ovum then passes through one of the
fallopian tubes into the uterus; if it has been fertilized by a sperm, it implants in the
uterus, where it develops into a fetus, a placenta, and fetal membranes—and eventually
into a baby.

Ovaries

Anatomy

The ovaries form part of the female reproductive system. Each woman has two ovaries.
They are oval in shape, about four centimeters long and lie on either side of the womb
(uterus) against the wall of the pelvis in a region known as the ovarian fossa. They are
held in place by ligaments attached to the womb but are not directly attached to the rest
of the female reproductive tract, e.g. the fallopian tubes.  

Function

The ovaries have two main reproductive functions in the body. They produce oocytes
(eggs) for fertilization and they produce the reproductive
hormones, estrogen and progesterone. The function of the ovaries is controlled
by gonadotropin-releasing hormone released from nerve cells in
the hypothalamus which send their messages to the pituitary gland to
produce luteinizing hormone and follicle stimulating hormone. These are carried in the
bloodstream to control the menstrual cycle. The ovaries release an egg (oocyte) at the
midway point of each menstrual cycle. Usually, only a single oocyte from one ovary is
released during each menstrual cycle, with each ovary taking an alternate turn in
releasing an egg. A female baby is born with all the eggs that she will ever have. This is
estimated to be around two million, but by the time a girl reaches puberty, this number
has decreased to about 400,000 eggs stored in her ovaries. From puberty to
the menopause, only about 400–500 eggs will reach maturity, be released from the
ovary (in a process called ovulation) and be capable of being fertilized in the fallopian
tubes/uterine tube/oviduct of the female reproductive tract. In the ovary, all eggs are
initially enclosed in a single layer of cells known as a follicle, which supports the
egg. Over time, these eggs begin to mature so that one is released from the ovary in
each menstrual cycle. As the eggs mature, the cells in the follicle rapidly divide and the
follicle becomes progressively larger. Many follicles lose the ability to function during
this process, which can take several months, but one dominates in each menstrual
cycle and the egg it contains is released at ovulation.  As the follicles develop, they
produce the hormone estrogen. Once the egg has been released at ovulation, the
empty follicle that is left in the ovary is called the corpus luteum. This then releases the
hormones progesterone (in a higher amount) and estrogen (in a lower amount). These
hormones prepare the lining of the uterus for potential pregnancy (in the event of the
released egg being fertilized). If the released egg is not fertilized and pregnancy does
not occur during a menstrual cycle, the corpus luteum breaks down and the secretion of
estrogen and progesterone stops. Because these hormones are no longer present, the
lining of the womb starts to fall away and is removed from the body through
menstruation. After menstruation, another cycle begins. The menopause refers to the
ending of a woman's reproductive years following her last menstruation. This is caused
by the loss of all the remaining follicles in the ovary that contain eggs. When there are
no more follicles or eggs, the ovary no longer secretes the hormones estrogen and
progesterone, which regulate the menstrual cycle. As a result, menstruation ceases.  

Hormones

The major hormones secreted by the ovaries are estrogen and progesterone, both
important hormones in the menstrual cycle. Estrogen production dominates in the first
half of the menstrual cycle before ovulation, and progesterone production dominates
during the second half of the menstrual cycle when the corpus luteum has formed. Both
hormones are important in preparing the lining of the womb for pregnancy and the
implantation of a fertilized egg, or embryo. If conception occurs during any one
menstrual cycle, the corpus luteum does not lose its ability to function and continues to
secrete estrogen and progesterone, allowing the embryo to implant in the lining of the
womb and form a placenta. At this point, development of the fetus begins.

Diseases and Disorders of the Ovaries

 Osteoporosis: Osteoporosis is commonly associated with menopause, just like mood
swings and hot flashes. Menopause is marked by the rapid loss of estrogen. The role
estrogen play in bone loss can best be described in terms of a battle
between osteoclasts (bone absorbing cells) and osteoblasts (bone producing cells).
Estrogen is on the side of the osteoblasts, but as the estrogens diminish, the
osteoblasts are discouraged from producing more bone. As such, the osteoclasts win by
absorbing more bone than is being produced by the osteoblasts. Estrogen replacement
therapy during menopause protects bone mass and helps protect against the risk of
osteoporotic fractures.
 Ovarian Cancer: Ovarian cancer is an extremely serious, but rare, disease. Its
symptoms usually don’t become apparent until the cancer has progressed into the later
stages. Symptoms of ovarian cancer include: persistent abdominal pain, indigestion,
bloating, abnormal uterine bleeding, and pain during sexual intercourse. These are
common problems, so in the great majority of cases, they will not indicate cancer.
 Ovarian Cysts: Ovarian cysts are fluid-filled sacs that affect women of all ages, though
mostly women of child-bearing age. Cysts are very common—and they can range in
size from a pea to a grapefruit. The majority of cysts are harmless, though larger cysts
(those larger than 5 cm in diameter) may need to be surgically removed because large
cysts can twist the ovary and disrupt its blood supply. Cysts can form for a variety of
reasons. Oftentimes, they’re simply part of normal menstruation. Person may
experience no symptoms, and the cysts will go away after a few cycles. These are
known as functional cysts. The great majority of cysts are benign. But abnormal or
pathological cysts, such as those in polycystic ovary syndrome (PCOS), may cause
painful symptoms. Treatment for ovarian cysts depends on the size and type of cyst.
Below are some common symptoms of pathological cysts:

 The most telltale symptom is pain and discomfort in the abdomen, vagina, low back, or
thighs

 Breast tenderness

 Bloating

 Increased hair growth on face, back, and chest

 Pain before or after menstrual cycle and irregular periods

 Infertility

 Weight gain

 Fatigue

Polycystic Ovary Syndrome: Polycystic means “many cysts.” Interestingly, the

National Institutes of Health (NIH) criteria for diagnosing PCOS do not require the
presence of polycystic ovaries by pelvic ultrasound. The NIH criteria are based on signs
of hyperandrogenism (or elevated androgens) and oligo/amenorrhea.  Other key
characteristics include infertility, irregular menstruation, acne, and increased hair growth
on the face and body. PCOS is essentially caused by a hormone imbalance—many of
the symptoms are caused by increased production of androgens. These patients usually
have high free testosterone levels. It’s not uncommon for those diagnosed with PCOS
to be overweight, insulin resistant, and have type 2 diabetes. Many of the symptoms of
PCOS fade with weight loss. The ovaries have an immensely important role not only in
the female reproductive system but in the endocrine system as a whole. The hormones
they secrete ensure the proper development of the female body and promote healthy
fertility.

Female hormonal system

Estrogen and Progesterone

The control of reproduction in females is more complex. As with the male, the anterior
pituitary hormones cause the release of the hormones FSH and LH. In addition,
estrogens and progesterone are released from the developing follicles. Estrogen is the
reproductive hormone in females that assists in endometrial regrowth, ovulation, and
calcium absorption; it is also responsible for the secondary sexual characteristics of
females. These include breast development, flaring of the hips, and a shorter period
necessary for bone maturation. Progesterone assists in endometrial re-growth and
inhibition of FSH and LH release. In females, FSH stimulates development of egg cells,
called ova, which develop in structures called follicles. Follicle cells produce the
hormone inhibin, which inhibits FSH production. LH also plays a role in the development
of ova, induction of ovulation, and stimulation of estradiol and progesterone production
by the ovaries. Estradiol and progesterone are steroid hormones that prepare the body
for pregnancy. Estradiol produces secondary sex characteristics in females, while both
estradiol and progesterone regulate the menstrual cycle.

Estrogen

Estrogen, a steroid hormone, carries physiological messages to body organs and

systems. These messages differ for each body organ and system. Estrogen sends
messages to the uterus to grow and replace the lining that is shed during the previous
menses. The three major naturally occurring estrogens in women are estrone (E1),
estradiol (E2), and estriol (E3). Estradiol is the predominant estrogen during
reproductive years both in terms of absolute serum levels as well as in terms of
estrogenic activity. During menopause, estrone is the predominant circulating estrogen
and during pregnancy estriol is the predominant circulating estrogen in terms of serum
levels. Though estriol is the most plentiful of the three estrogens it is also the weakest,
whereas estradiol is the strongest with a potency of approximately 80 times that of
estriol.

Progesterone

Progesterone is a hormone produced primarily in the ovaries, but also in smaller

quantities by the adrenal glands, and in the placenta of pregnant women. The hormone
helps regulate menstruation, prepares the body for pregnancy, and aids in nourishing
the uterine environment to support implantation of the fertilized egg, as well as growth of
the placenta. Progesterone levels may be monitored through simple blood serum testing
if necessary.

Estrogen function
The primary function of estrogens is development of female secondary sexual
characteristics. These includes breasts, endometrium, regulation of the menstrual cycle
etc. In males estrogen helps in maturation of the sperm and maintenance of a healthy
libido. Estrogen is responsible for development of the female body and the secondary
sexual characters. It helps decelerate height increase in females during puberty,
accelerates burning of body fat and reduces muscle bulk. Estrogens reduce bone
resorption and increase bone formation. They help in protein synthesis, increase
hepatic production of binding proteins, coagulation proteins (factors II, VII, IX, X,
plasminogen). Estrogens increase platelet adhesiveness and reduce antithrombin III.
Estrogens increase good cholesterol (HDL) and also increase triglycerides. They
decrease LDL and promote fat deposition. On fluids and electrolytes estrogens cause
salt (sodium) and water retention. In the gastrointestinal tract they reduce bowel motility
and increase cholesterol in bile. They also improve lung functions. 

Progesterone function

Progesterone decreases the target organs response to estrogen by decreasing the

number of receptors the organ has for estrogen. Receptors are molecules on the cells
that recognize specific hormones and allows them to carry their message to the cell.
Progesterone also decreases breast cell growth. It is involved in the maturation of
breast cells and decreases the rate of multiplication. Progesterone also promotes
normal cell death in the breast which is important in the prevention of cancer. While
estrogen decreases the rate of bone breakdown, progesterone stimulates bone
osteoblasts. Osteoblasts are responsible for making new bone to replace old bone. By
decreasing thyroid binding globulin, progesterone increases the activity of thyroid
hormone. Thyroid hormone increases metabolism, and utilizes the fat stored under
estrogen influence for energy. Normal progesterone levels are important for a normal
body composition. Low progesterone levels can lead to weight gain. Progesterone
stimulates normal sex drive because it can be converted to testosterone which is
involved in male and female sex drive. It blocks aldosterone receptors. Aldosterone
promotes water retention and swelling. Progesterone blocks aldosterone causing
normal fluid loss and decreasing swelling. Progesterone decreases uterine muscle
contractions which cause menstrual cramps by promoting uterine muscle relaxation.

Testosterone

Small amounts of testosterone come from the adrenal glands and ovaries. This
hormone plays a role in several body functions, including:

 sexual desire

 regulation of the menstrual cycle

 bone and muscle strength

A blood test can determine testosterone level. The normal range for females is 15 to 70

nanograms per deciliter (ng/dL).

The Ovarian Cycle and the Menstrual Cycle

The ovarian cycle governs the preparation of endocrine tissues and release of eggs,

while the menstrual cycle governs the preparation and maintenance of the uterine lining.
These cycles occur concurrently and are coordinated over a 22–32 day cycle, with an
average length of 28 days.

The first half of the ovarian cycle is the follicular phase. Slowly rising levels of FSH and
LH cause the growth of follicles on the surface of the ovary. This process prepares the
egg for ovulation. As the follicles grow, they begin releasing estrogens and a low level of
progesterone. Progesterone maintains the endometrium to help ensure pregnancy. The
trip through the fallopian tube takes about seven days. At this stage of development,
called the morula, there are 30-60 cells. If pregnancy implantation does not occur, the
lining is sloughed off. After about five days, estrogen levels rise and the menstrual cycle
enters the proliferative phase. The endometrium begins to regrow, replacing the blood
vessels and glands that deteriorated during the end of the last cycle. Just prior to the
middle of the cycle (approximately day 14), the high level of estrogen causes FSH and
especially LH to rise rapidly, then fall. The spike in LH causes ovulation: the most
mature follicle, ruptures and releases its egg. The follicles that did not rupture
degenerate and their eggs are lost. The level of estrogen decreases when the extra
follicles degenerate. Following ovulation, the ovarian cycle enters its luteal phase and
the menstrual cycle enters its secretory phase, both of which run from about day 15 to
28. The luteal and secretory phases refer to changes in the ruptured follicle. The cells in
the follicle undergo physical changes and produce a structure called a corpus luteum.
The corpus luteum produces estrogen and progesterone. The progesterone facilitates
the regrowth of the uterine lining and inhibits the release of further FSH and LH. The
uterus is being prepared to accept a fertilized egg, should it occur during this cycle. The
inhibition of FSH and LH prevents any further eggs and follicles from developing, while
the progesterone is elevated. The level of estrogen produced by the corpus luteum
increases to a steady level for the next few days.

If no fertilized egg is implanted into the uterus, the corpus luteum degenerates and the
levels of estrogen and progesterone decrease. The endometrium begins to degenerate
as the progesterone levels drop, initiating the next menstrual cycle. The decrease in
progesterone also allows the hypothalamus to send GnRH to the anterior pituitary,
releasing FSH and LH and starting the cycles again.

Menopause

As women approach their mid-40s to mid-50s, their ovaries begin to lose their sensitivity
to FSH and LH. Menstrual periods become less frequent and finally cease; this
is menopause. There are still eggs and potential follicles on the ovaries, but without the
stimulation of FSH and LH, they will not produce a viable egg to be released. The
outcome of this is the inability to have children. The side effects of menopause include
hot flashes, heavy sweating (especially at night), headaches, some hair loss, muscle
pain, vaginal dryness, insomnia, depression, weight gain, and mood swings. Estrogen is
involved in calcium metabolism and, without it, blood levels of calcium decrease. To
replenish the blood, calcium is lost from bone which may decrease the bone density and
lead to osteoporosis. Supplementation of estrogen in the form of hormone replacement
therapy (HRT) can prevent bone loss, but the therapy can have negative side effects.
While HRT is thought to give some protection from colon cancer, osteoporosis, heart
disease, macular degeneration, and possibly depression, its negative side effects
include increased risk of: stroke or heart attack, blood clots, breast cancer, ovarian
cancer, endometrial cancer, gall bladder disease, and possibly dementia.

References:
https://www.endocrineweb.com/endocrinology/overview-ovaries#:~:text=Ovaries
%20produce%20and%20release%20two,puberty%20and%20to%20ensure%20fertility.

https://www.yourhormones.info/glands/ovaries/

Guyton and hall textbook of medical physiology

https://www.creative-diagnostics.com/blog/index.php/estrogen-and-progesterone/

https://opentextbc.ca/biology/chapter/24-4-hormonal-control-of-human-reproduction/