Nature and the Ovaries
Dr. Nelson Soucasaux, Brazilian gynecologist
As it is widely known, the estrogens are the most important hormonal
factors responsible for the woman's sexual maturation and the preservation
of the main physical features of femininity. Given their multiplicity of
effects on the female organism, the estrogens are also the main factors
responsible for the development and maintenance of many of the other women's
sexual characteristics. As the main sources of estrogens in women are the
ovaries, the importance of these organs for the female sex is obviously
enormous (footnote 1, after the article).
Regrettably however, nature did not take this into consideration when
it made the ovaries as organs that become completely depleted about the
age of 50. In fact, this depletion of the follicular population of the ovaries
begins very early even in embryonic life, continues throughout childhood,
increases at each ovarian cycle along the menacme (the menovulatory period
of women's lives), and is finished at menopause. When nature designed the
female gonads, it seems it did not give the deserved attention to their
endocrine function, being only worried with the reproductive one.
It is quite understandable that the reproductive function of the ovaries
has a limited duration along life. Nevertheless, the same cannot be said
of their endocrine function, given the disastrous effects of the estrogenic
deprivation upon the female body. Concerning the ovarian function, nature
has prepared a very special betrayal for women: it is just the way the ovaries
get old, which differs too much from what happens to the other organs of
the body. As we have seen, the female gonads not only get old, but literally
consume and deplete themselves as a result of the gradual and inexorable
waste and disappearance of the ovarian follicles, their basic functional
structures or unities.
In the ovarian follicles, the endocrine and reproductive functions are
histologically and functionally linked because the granulosa and the theca
cells that surround the oocytes are the main structures responsible for
the estrogenic secretion. These follicles are endocrine and reproductive
unities that possess a limited duration (those that last the most do not
exceed the age of 50), that can or cannot fulfill their entire cycle of
development and that are totally incapable of originating new follicles.
Relatively speaking, only a few follicles reach their complete development,
being able to produce high estrogenic levels, ovulate and become luteinized.
The immense majority of them is condemned to regression and disappearance
through the process of follicular death or atresia even before completing
their first or second stage of growth. The waste of follicles along women's
lives is amazing, and it is just the ovarian endocrine function that is
harmed as a result of this process. As the formation of new follicles is
impossible due to reasons linked to the embryology of the ovaries, this
fact leads to the definitive depletion of these organs about the age of
50 and, consequently, to menopause.
Considering the enormous anatomical and physiological overload that
pregnancy and childbirth impose on women, nature had its reasons for finishing
the female reproductive life before the age of 50. Nevertheless, it made
a great mistake by making the ovarian estrogenic production also decline
and cease from that moment on, causing a quick atrophy of the genitals,
breasts and all the other female sexual features. The main mistake of nature
concerning the female gonads lies just at the aforementioned anatomical
and functional link between the endocrine and the reproductive structures
of the ovaries, both placed in the same functional unities. With the depletion
of the follicular population of the ovaries, both their reproductive and
endocrine functions cease (2). Only the ovarian
stroma still maintains some capacity of hormonal production.
Even during the fertile period of women's lives, most of the time the
ovaries are much more important as sources of estrogens than of oocytes,
since these hormones are the main trophic factors for everything that is
typically female in women's bodies. Besides, it is a fact that the overwhelming
majority of modern women only want to become pregnant and have children
in a very limited time in their lives. Throughout most of their fertile
years, pregnancy is undesired and avoided and, if it happens by accident
or neglect, it is almost always voluntarily interrupted.
Considering all of this, without intending to deny the obvious importance
of the ovarian reproductive function, I believe it is valid to consider
the endocrine one as the most important along the greatest part of the female
existence. Moreover, concerning the reproductive needs of most women we
can say that in conditions of normal fertility, the ovaries satisfactorily
fulfill this function. On the other hand, the same cannot be said of their
endocrine function, which abruptly ceases about the age of 50, leaving women,
from that moment on, in serious estrogenic deficiency. The regrettable consequences
of this "physiological" event for women are widely known, due
to the quick post-menopausal atrophy of all tissues of their bodies that
depend on the estrogens, as their sexual organs and other physical features
of femininity.
Fortunately, the recent advancements on the hormonal replacement therapy
seem to present new perspectives for women at menopause and post-menopause,
trying to counterbalance, at least in part, this betrayal perpetrated by
nature against the female sex. I want to make it clear that I say "trying
to counterbalance, at least in part" because, obviously, there is no
hormonal treatment that can stop or prevent aging, and the normal menopause
is an event associated with aging. I also have to emphasize that all kinds
of hormonal therapy in menopause must be done very carefully and under constant
medical assistance. Special attention must be given to the breasts and the
endometrium.
Note 1: Though in embryonic life the ovaries
are not the factors that determine the sexual differentiation of the female
genitals ( the feminization of the embryo takes place spontaneously in the
absence of testicles and of adequate androgenic action ), the importance
of the female gonads in postnatal life is fundamental for the woman's sexual
maturation and for the trophicity of all typically female tissues in her
body.
Note 2: This is a disadvantage of the female
gonads when compared to the male ones. In men, the testicular cells that
produce androgens are histologically independent from the reproductive ones,
that originate the spermatozoa. For that reason, the testicular endocrine
function is autonomous in relation to the reproductive one. The testicles
do not deplete and their aging is very slow, not only concerning their endocrine
function but also the reproductive. Therefore, the concept of "andropause"
seems to be very relative.
The text above is an excerpt from my book "Os Órgãos
Sexuais Femininos: Forma, Função, Símbolo e Arquétipo"
("The Female Sexual Organs: Shape, Function, Symbol and Archetype"),
published by Imago Editora, Rio de Janeiro, 1993. For more information on
the book, see page http://www.nelsonginecologia.med.br/orgaos.htm,
from my Web site www.nelsonginecologia.med.br.
Copyright Nelson Soucasaux 1993, 2002
_________________________________________________
Nelson Soucasaux is a gynecologist dedicated to clinical, preventive
and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina
da Universidade Federal do Rio de Janeiro, Brazil, he is the author of several
articles published in medical journals and of the books "Novas Perspectivas
em Ginecologia" ("New Perspectives in Gynecology") and "Os
Órgãos Sexuais Femininos: Forma, Função, Símbolo
e Arquétipo" ("The Female Sexual Organs: Shape, Function,
Symbol and Archetype"), published by Imago Editora, Rio de Janeiro,
1990, 1993.
©2002 Harry Finley. It is illegal
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