Optimal ovarian health is crucial when you want to successfully conceive a child. In this interview with Baby Talk, Dr Ida Lilywaty Md Latar, an Obstetrics and Gynaecology (O&G) Specialist at Pantai Hospital Cheras (PHC), shares her thoughts about ovarian health and how it impacts fertility.
Why is ovarian health important? Can you talk about its function and how it affects a woman’s overall health and fertility?
The ovaries are two small rounded female organs in the pelvis. These are attached on each side of the uterus, near the opening of the fallopian tubes. The ovaries contain female gamete cells, called the oocytes or the eggs.
Ovaries are important for a woman’s ovulation. The ovary releases the egg, which potentially may be fertilised by a sperm resulting in pregnancy. It also produces the female hormones: oestrogen and progesterone.
These two hormones are essential in stimulating the development of secondary sexual characteristics. Besides facilitating pregnancies, they also assist in birth and lactation for women. As women age and go through menopause, the number of oocytes depletes progressively, and subsequently, ovaries stop producing these hormones and releasing eggs, physiologically leading to menopause.
What are some common health issues or diseases associated with ovaries?
Common health problems include ovarian cysts, which can be benign or malignant and can lead to a medical emergency such as ovarian torsion, rupture, or bleeding inside the cyst.
Another common health issue that has been increasing in incidence among women globally due to current lifestyles and obesity is polycystic ovarian syndrome (PCOS). Primary ovarian insufficiency leading to premature menopause is also another common problem.
What are some signs that point to problems with the ovaries?
Signs vary according to the diagnosis. Frequently, ovarian cysts are found during routine follow up and annual check-ups. These cases are physiological, needing only regular monitoring.
Larger ovarian cysts can cause discomfort or pain, which can be severe and acute, especially in ovarian accidents like torsion, rupture, or haemorrhage. Other types of ovarian cysts like endometrioma may present with menstrual pain in various severity.
On the other hand, patients with PCOS commonly have a history of irregular or infrequent menses with accompanying acne and hirsutism (increase in body or facial fair) due to hormonal imbalances.
As for those with ovarian cancer, it is unfortunate that more than two-thirds of ovarian cancer are detected at later stages. Patients would show symptoms like abdominal discomfort due to accumulation of fluid in the abdomen, pressure symptoms, and other constitutional symptoms like loss of weight and appetite.
What is PCOS and what are the treatments available?
Polycystic ovary syndrome (PCOS) occurs when a woman’s ovaries or adrenal glands produce more male hormones than normal. PCOS causes small cysts to grow on the peripheries of the ovaries.
Symptoms include irregular/infrequent menstrual periods, excess hair growth on the face and body (hirsutism) and acne or oily skin. Often women with PCOS are obese, and most of them may have issues with fertility. Women with PCOS are at higher risk of diabetes, metabolic syndrome, heart disease and high blood pressure.
PCOS is diagnosed via the typical clinical presentation mentioned above with supporting features of polycystic ovaries on pelvic ultrasound and some hormonal blood test changes, especially in severe cases. There is no cure for the disease, but diet, exercise, and hormonal medicines like birth control pills to balance hormonal levels can help control the symptoms.
Can you explain more about ovarian cancer? What are the preventive steps?
Ovarian cancer is one of the commonest cancers in women worldwide. Unfortunately, unlike cervical cancer, there is no reliable and efficient screening test for this cancer. More than 75% of women present late with significant symptoms, leading to a poorer prognosis. Thus, recognising the risk factors among us is crucial.
Up to 25% of ovarian cancers result from an inherited mutation in specific genes. In view of this, knowing the patient’s background or family history and informing the healthcare provider regarding this significant history may lead to earlier assessment and detection of ovarian cancer.
Using birth control pills for five or more years, for example, has been associated with lower chances of getting ovarian cancer, and this has been used as a preventive measure among the high-risk group.
Women who give birth after the age of 35 or who never have carried a pregnancy have a higher risk of ovarian cancer, so completing a family earlier may reduce the risks, especially in high-risk groups. Some studies suggested that breastfeeding itself reduces the risk of ovarian cancer.
Can you provide tips on improving ovarian health?
A healthy lifestyle is crucial in maintaining ovarian health, as this is closely related to a woman’s metabolism issues. A balanced diet and regular exercise prevent obesity, which may be the precursor of PCOS and hormonal imbalances.
A healthy lifestyle also includes avoiding smoking and alcohol intake. Regular health check-ups, especially in high-risk women, are also important to detect earlier ovarian issues, as frequently, ovarian diseases are detected incidentally.
Effective family planning is also one of the factors that may lead to improved ovarian health as it may reduce the risks of ovarian cancer by avoiding pregnancy at a later age. Breastfeeding should also be encouraged as one of the preventive measures for ovarian cancer.
By: Dr Ida Lilywaty Md Latar
Obstetrics and Gynaecology (O&G),
Pantai Hospital Cheras (PHC)
