Ovaries

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Anatomy and Physiology

The ovaries are two almond shaped glands each about 1¼" long with a combined weight of about ¼ ounce. At puberty a female has about 400,000 egg cells of which about 450 matures in ones life. The ovaries are composed of thousands of sacs called graafian follicles each of which contains an immature egg.

In this chapter we will discuss the menstrual cycle, functions of estrogen and progesterone, LH, and FSH.

Estrogen is a steroid (made from cholesterol) compound, secreted by the follicles and corpus luteum, the adrenals, and during pregnancy by the placenta. Estrogen performs the following functions during puberty:

1) Growth of uterus, fallopian tubes, vagina, endometrium, ovaries, breasts (and aids in developing them into milk producing organs).

2) Growth of bones and closing of epiphyses, broadening of pelvis.

3) Deposition of fat in thighs and gluteal region.

4) Increases synthesis of protein.

Estrogen after puberty also causes hypertrophy of the uterus, sodium and water retention, and inhibition of LH and FSH secretion.

Progesterone is produced by the corpus luteum (we are discussing it here instead of in the uterus chapter due to its interreactions with estrogen, FSH, and LH), adrenal cortex, and placenta (during pregnancy). Progesterone prepares the fallopian tube to supply nutrients to the fertilized egg and prepares the uterus for implantation of the egg. It also contributes in developing the breasts as milk secreting organs. Progesterone can block the effects of estrogen, and estrogen can inhibit progesterone. Large quantities of progesterone can inhibit LH and FSH. The thyroid gland may in some way regulate progesterone production also. The liver deactivates excess estrogen and progesterone.

The menstrual cycle has two main functions: to release a mature egg and prepare the uterus for its implantation.

Following menstruation FSH is secreted from the anterior pituitary. This leads to growth and maturation of the egg and stimulates the secretion of estrogen by the follicles. Estrogen secretion increases till about 1-2 days before ovulation. During this time it is causing thickening of the endometrium and inhibiting large quantities of LH and FSH from being produced. One to two days before ovulation estrogen secretion drops sharply, followed by an approximately 800% increase in LH secretion and a doubling of FSH secretion. This causes final growth, swelling, and then rupture of the follicle and the egg is released. The follicle then forms the corpus luteum (due to influence of LH).

Just prior to ovulation LH and FSH secretions drop off. During the second half of the cycle (post ovulation) estrogen and progesterone levels rise for the first 7-10 days. This rise inhibits both LH and FSH thus preventing any more eggs from maturing during this cycle. The estrogen and progesterone prepare the uterus for implantation of the fertilized egg. Progesterone causes swelling, increased blood flow and nutrient storage in the endometrium.

If no egg has been fertilized by about the 22nd or 23rd day, progesterone and estrogen secretion starts to decrease and the corpus luteum begins to degenerate. As degeneration continues, estrogen and progesterone continue to decrease and FSH and LH begin to rise. The corpus luteum is totally degenerated about the 26th day. Loss of hormonal stimulation causes the outer layers of endometrial tissue to die and blood seeps in. After approximately 28 days, the outer tissue layers separate from the uterus and cause contraction to expel the uterine contents; menstruation begins. Meanwhile the increase in FSH and LH levels are beginning egg maturation for the next cycle.

Symptoms of Ovary Dysfunction

Most symptoms of ovarian dysfunction before menopause are related to improper ratios of estrogen as compared with progesterone. Any menstrual pain at all is not normal and is a signal of some dysfunction in the body.

If there is too much estrogen secretion in relation to progesterone the woman’s flow will be heavy and last up to 7 days. Water retention, breast soreness, and cramping will be likely and the cycle will usually be less than 28 days.

If there is too much progesterone in relation to estrogen the flow will be light and last only 1-2 days. Water retention and cramps will be rare, the cycle will last 30-40 days. The ideal is much closer to this latter description than to the over secretion of estrogen.

Symptoms of dysmenorrhea and premenstrual tension can include depression, tension, cramping (very severe at times), water retention, backaches, tender breasts, fainting spells, nausea, vomiting, diarrhea, irregular cycles. Some very severe cases are bedridden the 1st few days of each period.

Menopause is the time in a woman’s life when menstruation ceases. It should be a relatively easy transition. Signs of abnormal menopause and possible dysfunction (though usually adrenal or pituitary dysfunction) include numbness, heart palpitation, hot flashes, chills, sweats, headaches, insomnia, depression, pelvic pain, and mental instability.

Causes of Ovarian Dysfunction

1) Pituitary malfunction causing an imbalance in ovarian hormone secretion (usually from increased ACTH)
2) Nerve pressure in the lumbar or sacral nerves (see Appendix A)
3) Liver sluggishness not breaking down excess ovarian hormones (especially estrogen)
4) X-rays without properly shielding the ovaries
5) Not enough sunlight. Sunlight regulates melatonin production (see pineal chapter). Melatonin can retard ovulation and delay sexual maturation.
6) Pain due to ileocecal valve syndrome can be misdiagnosed as right ovary pain.
7) Hypoadrenia can cause estrogen/progesterone imbalance.
8) Causes of Dysmenorrhea
    a) Adrenal, pineal, or thyroid dysfunction
    b) Calcium deficiency can be due to decreased assimilation (see stomach chapter), thyroid or parathyroid     imbalance, or too high a protein intake causing increased calcium excretion.
    c) Chilling of extremities due to improper clothing, or too tight waist bands, corsets, etc.
    d) Mental stress (due to its effect on adrenals, pituitary, thyroid)
    e) Uterine malposition (see uterus chapter)
    f) Constipation and ileocecal valve syndrome will aggravate dysmenorrhea
    g) Spinal and pelvic misalignment, especially if back pain accompanies it

9) Causes of amenorrhea can be anemia, protein deficiency due to hypochlorhydria (see stomach chapter) or due to blood sugar handling problems, hyperthyroidism, adrenal malfunction, obesity. A gynecologist to check for persistent luteal tissue should examine amenorrhea after pregnancy, miscarriage, or abortion.

10) Causes of difficult menopause: as menopause approaches, properly functioning adrenal glands should produce enough estrogen to make the transition symptom free. If hypoadrenia is present, the pituitary will increase production of ACTH and FSH, which will exhaust the adrenals even more, causing the automatic nervous system to cause the symptoms we previously listed.

Other Indications of Ovary Malfunction

1) One of the following muscles may exhibit weakness on manual muscle testing: gluteus maximus, gluteus medius, piriformis, adductors (see Appendix C and figures 5.1, 5.2, 5.3, 5.4).

2) Check indications of adrenal malfunction to see if the problem is secondary to hypoadrenia.

3) To see if calcium deficiency may exist, put a blood pressure cuff on your leg and inflate it to about 80mm. Hg pressure. Leave it on for 4 minutes and if your muscle cramps, it is a good indication of a possible calcium deficiency. Remember if you are deficient in calcium, it is probably due to either too much protein in the diet, thyroid or parathyroid imbalance or, poor assimilation (decreased hydrochloric acid secretion). It is less often due to a deficiency in the diet itself. Correct the cause.

Prevention and Treatment of Ovarian Dysfunction

1) Get out in the sun (to regulate melatonin), eat a diet that is about 10-15% protein (not higher), get ample exercise and avoid sexually stimulating books, TV shows, and movies. This will help keep hormone production regular.

2) If you suspect nerve pressure (you would thus probably get backaches during your premenstrual time), see a good chiropractor who could correct the condition (see Appendix A).

3) Make sure your liver is functioning properly especially if you suffer from dysmenorrhea (a B vitamin deficiency or toxic bowel can overtax the liver and decrease its ability to break down estrogen).

4) Try to trace the problem back to its cause; remember malfunctioning adrenals, thyroid, pituitary, can all lead to an imbalance of ovarian hormones.

5) If you suspect a calcium deficiency, try lowering your protein intake, make sure your hydrochloric acid secretion is adequate (see stomach chapter) and eat lots of dark greens (broccoli, kale, etc.).

6) Dropped uterus, ileocecal valve syndrome, food allergies, and constipation can all aggravate premenstrual symptoms, correct these conditions if they exist (see respective chapters).

7) Kelp tends to help regulate ovarian hormones.

8) For dysmenorrhea: avoid pepper, mustard, vinegar, sugar, tobacco, caffeine, and chocolate. Minimize your oil, margarine and salt intake. Wear loose clothing and don’t overeat. Get enough sleep. A 20- minute hot foot and leg bath (113°F), a warm enema at onset, or a heating pad on the abdomen (for up to a few hours) will help relieve the pain. The following herb teas may reduce symptoms and help overcome dysmenorrhea: catnip, peppermint, sorrel, shave grass, plantain, red raspberry leaf, crampbark, yarrow, amaranth, red sage.

9) Premenstrual edema can be helped by minimizing salt intake and eating lots of garlic, watermelon, and cucumber. Also get lots of vigorous exercise.

10) Chamomile tea and also aloe vera juice can help bring on a late period.

11) Sassafras tea is reported to help in cases of amenorrhea.

12) For a difficult menopause fix your adrenal glands if malfunctioning, get lots of outdoor exercise (3-5 hours daily), a 20-minute 110°F hot sitz bath may help, lots of sleep. A 30-minute neutral bath daily can help relieve symptoms. The following herbal teas are reported helpful for difficult menopause: licorice root, elder, unicorn root, sarsaparilla (all contain natural estrogens).

Stay on the adrenal recovery diet (see adrenal chapter). Also eating foods high in natural plant sterols will ease the transition. These include sesame seeds, sunflower seeds, rice bran, chestnuts, potatoes, tomatoes, eggplant, pepper, barley, peas (women with premenstrual symptoms of increased estrogen listed in the symptoms section of this chapter may benefit by avoiding these foods).

13) Rubbing the following reflex points for 2 minutes every other day for 8 days can help restore normal ovarian function. The points are located on the anterior superior part of the pubic bone (one point on each side) (see Appendix B).

14) One patient of mine had a four-year-old son, and had for 3 years been unsuccessfully trying to have a second child. She was found to have hypoadrenia, pituitary-cranial malfunction, and ovarian disturbances. We put her on the adrenal recovery diet, rubbed the adrenal and ovarian reflex areas, and fixed the cranial malfunction, and within three months she became pregnant and has since given birth to a healthy child.

15) Synthetic estrogen is often prescribed to women for vaginitis, menopausal symptoms, breast cancer, and prevention of after pregnancy breast engorgement, and post hysterectomy hormone replacement therapy. It is also a component in birth control pills. The medications reportedly increase the risk of endometrial cancer up to 1400%. If given to a pregnant woman the fetus will have an and increased likelihood of cancer of the reproductive tract, heart defects and a decreased number of limbs. Other possible adverse reactions in the user include ovarian atrophy, blood clots, hypertension, excessive uterine bleeding, depression, kidney disease, vomiting, hair loss, increased weight. In test animals, these medications have increased the risk of breast, cervix, vaginal, and liver cancer too. Please investigate all other possibilities before taking these medications.