Hysterectomy: Should I also have my ovaries removed?

1. Get the Facts

Your options

Have your uterus and your ovaries removed (hysterectomy with oophorectomy).
Have your uterus removed, but keep your ovaries (hysterectomy only).

Key points to remember

The main reason doctors recommend removing the ovaries during hysterectomy is to lower the risk of ovarian cancer. Studies show that if you are at high risk, surgery greatly lowers your risk.
If you are not at high risk for cancer, having your ovaries removed isn't recommended.
It's important to know your risk for cancer when deciding whether to have your ovaries removed during your hysterectomy. Your doctor will help you find out your risk by talking to you about your medical history and your family history.
Removing the ovaries may increase your risk of heart disease and osteoporosis.
If you have your ovaries removed before menopause, you will go into early menopause. You may get hot flashes and other symptoms.

FAQs

What is oophorectomy?

Surgery to remove the ovaries is called oophorectomy (say “oh-uh-fuh-REK-tuh-mee”). The ovaries are an important part of the female reproductive system . They store eggs and produce sex hormones, including estrogen.

Of women who have a hysterectomy, about half of them have their ovaries removed at the same time.¹ The main reason doctors recommend removing the ovaries along with the uterus is to reduce the risk of ovarian cancer. Studies show that if you are at high risk, surgery greatly lowers your risk.

What are the benefits of oophorectomy?

For women at average risk—this means no personal or family history of ovarian or breast cancer—there is no clear benefit to removing the ovaries at any age. Hysterectomy itself can reduce your risk of ovarian cancer.¹

If you have severe premenstrual syndrome (PMS), removing the ovaries can stop hormone changes. This may help you feel better.

If you are at high risk for breast or ovarian cancer, having your ovaries removed can greatly lower your risk. Women at high risk for these cancers include those who:

Have a BRCA gene change (BRCA stands for BReast CAncer).
Have a family history of ovarian cancer before age 50.

To learn more about your choices if you are at high risk for breast or ovarian cancer, see:

Breast cancer: What should I do if I'm at high risk?

Ovarian cancer: Should I have my ovaries removed to prevent ovarian cancer?

If you don't know if you are at high risk for breast or ovarian cancer, talk to your doctor. If your doctor thinks you could be at risk, you may want to think about gene testing. For more information, see:

Breast cancer risk: Should I have a BRCA gene test?

Removing the ovaries is sometimes advised when hormones produced by the ovaries make severe endometriosis worse. If you are thinking about surgery for this reason, see:

Endometriosis: Should I have a hysterectomy and oophorectomy?

What are the risks of having your ovaries removed?

When your ovaries are removed, you lose the estrogen that they produce. Without estrogen, you will go into early menopause. This can cause hot flashes and other symptoms.

Having your ovaries removed before age 65 may increase your chance of getting:¹

Osteoporosis, which can lead to broken bones and hip fractures.
Heart disease, which is the number one cause of death in women in the United States.

Women who choose to have their ovaries removed can take estrogen replacement therapy. This treatment does not prevent heart disease, but it helps to lower your risk of osteoporosis. If you already have bone loss, other medicines can help protect your bones.

Why might your doctor recommend having your ovaries removed?

Your doctor may recommend having your ovaries removed when you have a hysterectomy if:

You have a BRCA gene change.
You have a strong family history of early ovarian cancer. You have a higher risk of ovarian cancer if a close family member, especially your mother or sister, has had breast cancer.
You have a type of breast cancer that estrogen causes to grow.
You have severe premenstrual syndrome that could be helped by having your ovaries removed.
You have had pelvic pain that involved your ovaries.

2. Compare Options

	Have ovaries removed along with hysterectomy	Have hysterectomy only
What is usually involved?	The ovaries are removed through the same incision made for the hysterectomy. You stay in the hospital for 1 to 2 days. Some women stay for up to 4 days. You may take estrogen replacement therapy.	You stay in the hospital for 1 to 2 days. Some women stay for up to 4 days.
What are the benefits?	If you are at high risk for breast cancer or ovarian cancer, removing the ovaries greatly reduces your risk. If you have severe PMS or endometriosis, you may feel better after you have your ovaries removed.	For women at average risk: The benefits of keeping the ovaries usually outweigh the risks, especially for younger women. Hysterectomy itself can reduce the risk of ovarian cancer.
What are the risks and side effects?	Removing the ovaries increases the risk of heart disease and osteoporosis. If you have your ovaries removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms. Removing the ovaries during hysterectomy poses no additional surgical risks than having a hysterectomy alone.	If you are at high risk for breast cancer or ovarian cancer, you will still be at risk. But you may be able to lower your breast cancer risk with medicines.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topic Hysterectomy.

Personal stories about having an oophorectomy with a hysterectomy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

" My mother died of ovarian cancer when she was 48, so that's always been one of my biggest fears. I have severe endometriosis and don't plan to have children, so I decided to have a hysterectomy. And I'm going to have my ovaries taken out at the same time. Knowing my risk of ovarian cancer is reduced will give me more peace of mind. "

— Cynda, age 39

" I have a very large fibroid, so I have decided to have a hysterectomy to remove it. But I plan to keep my ovaries so that I don't go into early menopause. "

— Joyce, age 40

" My mother and two of her sisters had breast cancer when they were in their 40s. I'm an Ashkenazi Jew, so even though I haven't had the BRCA test, I know chances are good that I have the breast cancer gene. I had decided to have a hysterectomy to put an end to years of heavy menstrual bleeding. I am also going to have an oophorectomy to reduce my risk of breast and ovarian cancer. "

— Minnie, age 37

" I am going to have a hysterectomy to treat uterine prolapse. When my older sister had her hysterectomy, they also took her ovaries. But my doctor said it's probably a good idea to save my ovaries, especially since I am small-boned and my mother has osteoporosis. "

— Perdita, age 52

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have your ovaries removed during hysterectomy

Reasons not to have your ovaries removed during hysterectomy

I will worry less about cancer if I have my ovaries removed.

I'm not that worried about cancer.

More important

Equally important

More important

I don't mind going into early menopause.

I don't want to go into early menopause.

More important

Equally important

More important

I think that removing my ovaries will help with my severe PMS symptoms.

I don't have severe PMS symptoms.

More important

Equally important

More important

I feel that there are more benefits to removing my ovaries than keeping them.

I feel that there are more benefits to keeping my ovaries than removing them.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having my ovaries removed

NOT having my ovaries removed

Leaning toward

Undecided

Leaning toward

5. Quiz Yourself

Check the facts.

1. If you are at high risk for ovarian cancer, will you benefit by having your ovaries removed during a hysterectomy?

Yes
No
I'm not sure

You're right. Studies show that if you are at high risk for ovarian cancer, surgery to remove your ovaries may greatly lower your risk.

2. Can you have menopause at the normal time of life if you have your ovaries removed?

Yes
No
I'm not sure

You're right. If you have your ovaries removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms.

3. Can removing your ovaries increase your chances of getting heart disease and osteoporosis?

Yes
No
I'm not sure

You're right. Having your ovaries removed before age 65 can increase your chances of getting heart disease and osteoporosis.

Decide what's next.

1. Do you understand the options available to you?

Yes
No

2. Are you clear about which benefits and side effects matter most to you?

Yes
No

3. Do you have enough support and advice from others to make a choice?

Yes
No

Certainty.

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

Nothing. I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.