Fallopian Tubes and Ovaries

Fallopian Tubes

Fellopian (felo-´pe-en) , either of a pair of tubes extending from the uterus to the paired ovaries in the human female, also called oviducts, technically known as the uterine tube. At one end the long, slender fallopian tube opens into the uterus; the other end expands into a funnel shape near the ovary. The epithelium that lines the tube is covered with cilia that beat continuously toward the uterus. When an ovum is expelled into the peritoneal cavity from the ovary during ovulation, it is propelled into the wide-mouthed opening of the fallopian tube, through the tube, and into the uterus by the wavelike motion of the cilia.

If the ovum is fertilized, an event that normally takes place in the fallopian tube, and the embryo (fertilized ovum) implants in the tube, or another area outside the uterus, an ectopic pregnancy occurs. About 98% of ectopic implantations occur in the tubes, but other sites include the abdomen, ovary, and cervix. Immediate surgical removal of the products of conception is necessary to prevent hemorrhage and other complications resulting from ectopic pregnancy. The fallopian tubes are also the site of the most common surgical procedures used to prevent conception or cause infertility in women. Usually the tubes are tied off in a procedure known as tubal ligation, although they are also sometimes excised or occluded by other methods.

Ovaries

Ovaries are the small, oblong, pearl-colored organs that lie just below the fallopian tubes on each side of the uterus. Ovaries produce ripe eggs about once a month, from about age 14 or 15 onward. As the egg develops each month, a nourishing fluid-filled sac forms around it, so that it is encapsulated or walled off from the rest of the ovary. This fluid-filled area, known as a cyst, is physiologically completely normal, a fact that many women don’t appreciate. At ovulation, when the egg is released and picked up by the fallopian tube, the cyst actually bursts as part of the ovulatory process, and the surrounding fluid is released into the pelvic cavity along with the egg.

After ovulation, in the space where the egg used to be, a second small cystic area known as the corpus luteum develops and begins to secrete progesterone. The corpus luteum eventually gets reabsorbed by the ovary. Frequently the process of egg development begins and a small cyst forms, but ovulation doesn’t occur at that particular site. In this case, a small cyst will be left in that area of the ovary for a while. Because of this monthly process of egg development and cyst formation, it is perfectly normal for a woman to have small fluid-filled ovarian cysts at almost any time throughout her reproductive life. In fact, ovaries nearly always have small cysts in them.

Whenever a woman gets a pelvic ultrasound for chronic pelvic pain, a fibroid, or for any other reason, her ovaries are also scanned and these cysts show. Small 1–3-cm cysts are usually normal, because producing small physiological cysts that come and go is part of what normal ovaries do. They gestate little eggs, little cyst — or in energy medicine terms, young ideas ripe with potential.

Ovaries also produce hormones — including estrogen, progesterone and androgens — throughout the life-cycle, though the amounts they produce change (not necessarily declining), depending upon a woman’s age. It has been commonly thought that ovaries become essentially nonfunctional after a woman stops having periods, but studies in healthy women have proven that ovaries maintain their ability to produce steroid hormones for several decades after menopause. Parts of the ovaries do start to decrease in size when a woman is in her thirties, and they do lose mass more rapidly after age 45 on average, but they are not the inert fibrous tissue masses they’ve been thought to be.

As women age, only the outermost covering (theca) of the ovary regresses, the part where the eggs grow and develop and where physiological (“functional”) cysts form. In midlife, the innermost part of the ovary (inner stroma) becomes quite active for the first time in our lives (see Reference 2, link below). Studies have shown that our ovaries can produce androgens, as well as progesterone and estradiol, long after menopause. These hormones are significant in preventing osteoporosis and also maintaining energy and libido.

As women age, only the outermost covering (theca) of the ovary regresses, the part where the eggs grow and develop and where physiological (“functional”) cysts form. In midlife, the innermost part of the ovary (inner stroma) becomes quite active for the first time in our lives . Studies have shown that our ovaries can produce androgens, as well as progesterone and estradiol, long after menopause. These hormones are significant in preventing osteoporosis and also maintaining energy and libido.