Atrophy of the ovary

by Emily Goebel, MD FRCPC
September 5, 2024

Atrophy of the ovary refers to the shrinking or decrease in size of the ovary. This occurs when the ovarian tissue loses its normal function and structure, leading to a reduction in hormone production and a loss of healthy ovarian cells. Atrophy of the ovary is a normal part of the aging process. It is typically seen around the time or after a woman has reached menopause.

What causes atrophy of the ovary?

Ovarian atrophy can result from several causes, including:

• Menopause: As women age, the ovaries naturally stop producing eggs and decrease their production of hormones like estrogen and progesterone, leading to atrophy. This is a normal process during menopause.
• Surgical removal or damage: Surgical procedures like oophorectomy (removal of the ovaries) or treatments such as radiation therapy and chemotherapy can cause the ovaries to shrink due to damage or removal of ovarian tissue.
• Hormonal imbalances: Prolonged use of certain hormonal medications, like those used for birth control or hormone replacement therapy, can affect ovarian function and lead to atrophy over time.
• Autoimmune conditions: Some autoimmune diseases can lead to inflammation and damage to the ovaries, resulting in atrophy.
• Genetic conditions: Certain genetic disorders, such as Turner syndrome or premature ovarian insufficiency (POI), can cause ovarian atrophy at an earlier age than typical menopause.

What are the symptoms of ovarian atrophy?

The symptoms of ovarian atrophy are often related to reduced hormone production and loss of ovarian function. Common symptoms include:

• Irregular or absent menstrual periods: As the ovaries stop functioning, periods may become irregular or stop altogether.
• Hot flashes and night sweats: These are common symptoms of reduced estrogen levels, similar to those experienced during menopause.
• Vaginal dryness: Lower estrogen levels can lead to thinning and drying of the vaginal tissues, which may cause discomfort.
• Decreased libido: Hormonal changes associated with ovarian atrophy can reduce sexual desire.
• Infertility: If the ovaries are no longer producing eggs, it can lead to difficulties in conceiving.

What does atrophy of the ovary look like under the microscope?

When examined under the microscope, no developing ova (eggs) are seen, and there is less stroma than a reproductive-age woman’s ovary. As a result, the ovary is smaller, and ovulation stops.