Oophorectomy

What is an oophorectomy?

Oophorectomy is the surgical removal of the ovaries, the part of a woman's reproductive system that stores and releases eggs for fertilization and produces female sex hormones.

Oophorectomy is often necessary when pelvic disease, such as ovarian cancer or severe endometriosis, is present. In the United States, more than 600,000 hysterectomies (the surgical removal of a woman's uterus) are performed each year. About half of these involve removal of the ovaries, too.

Oophorectomy is sometimes recommended when the hormones produced by the ovaries are making a disease such as breast cancer or severe endometriosis worse.

In rare cases, the ovaries are removed in an attempt to reduce the possibility of developing a future disease, such as ovarian cancer. This is called a prophylactic oophorectomy.

What are the reasons to have an oophorectomy?

About 10% of women who have a hysterectomy also have a condition or disease that may increase the need for an oophorectomy.¹ These conditions or diseases include:

• Heredity (inherited) diseases. Women who have certain abnormal genes (known as BRCA1 and BRCA2) have an increased risk for developing ovarian cancer before age 70. These women often develop cancer around age 45, which is about 20 years earlier than women who do not have these genes. If your mother or sister has had ovarian cancer, or you know that you have an abnormal BRCA gene, you may consider having your ovaries removed. You will not be able to become pregnant after having this surgery, but your risk for developing ovarian cancer will be reduced to nearly zero. Talk to your doctor about if this choice is right for you.
• Breast cancer. Hormones produced by the ovaries increase the risk of breast cancer. Oophorectomy may reduce the risk of breast or ovarian cancer in women who have the abnormal genes BRCA1 or BRCA2. Oophorectomy is sometimes recommended to treat breast cancer, because it eliminates the hormones produced by the ovaries.
• Suspected disease. When a premenopausal woman is scheduled to have one ovary removed during the surgical removal of the uterus (hysterectomy) because disease is suspected, removal of both ovaries may be recommended if disease is found.

What are the reasons not to have an oophorectomy?

If you do not have an increased risk of ovarian cancer or another disease that requires the removal of your ovaries, consider the benefits of not having your ovaries removed. These benefits include:

• Hormones. When an oophorectomy is done before a woman's natural age of menopause, estrogen replacement therapy (ERT) may be prescribed afterward to reduce the risk of osteoporosis, hot flashes, and other menopausal symptoms. Ask your doctor about other problems that may be related to using ERT.
• Fewer fractures. Removal of the ovaries increases the risk for developing weak and brittle bones (osteoporosis), because the body no longer produces a large amount of estrogen. The risk for developing osteoporosis following an oophorectomy is greater in young women.
• Long-term survival benefits. Women younger than age 65 who do not have their ovaries removed have a slight increase in long-term survival. This increase may occur because women who have their ovaries have fewer fractures and are less likely to develop heart disease.¹

Citations

1. Parker WH, et al. (2005). Ovarian conservation at the time of hysterectomy for benign disease. Obstetrics and Gynecology, 106(2): 219–226.