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Hysterectomy: Should I Also Have My Ovaries Removed?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Hysterectomy: Should I Also Have My Ovaries Removed?
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 aren't 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 if you're at risk is a different decision than if you're not at risk.
- 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.
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.
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.
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 therapy. This treatment doesn't 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.
Compare your options
Compare
What is usually involved? |
| |
What are the benefits? |
| |
What are the risks and side effects? |
|
- 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 therapy.
- If you are at high risk for breast cancer or ovarian cancer, removing the ovaries greatly reduces your risk.
- If you have severe PMS, you may feel better after you have your ovaries removed.
- 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.
- You stay in the hospital for 1 to 2 days. Some women stay for up to 4 days.
- 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.
- If you are at high risk for breast cancer or ovarian cancer, you will still be at risk.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
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 PMS 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
What matters most to you?
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.
I don't mind going into early menopause.
I don't want to go into early menopause.
I think that removing my ovaries will help with my severe PMS symptoms.
I don't have severe PMS symptoms.
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.
My other important reasons:
My other important reasons:
Where are you leaning now?
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
What else do you need to make your decision?
Check the facts
If you are at high risk for ovarian cancer, will you benefit by having your ovaries removed during a hysterectomy?
- YesYou're right. Studies show that if you are at high risk for ovarian cancer, surgery to remove your ovaries may greatly lower your risk.
- NoSorry, that's not right. Studies show that if you are at high risk for ovarian cancer, surgery to remove your ovaries may greatly lower your risk.
- I'm not sureIt may help to go back and read "Get the Facts." Studies show that if you are at high risk for ovarian cancer, surgery to remove your ovaries may greatly lower your risk.
Can you have menopause at the normal time of life if you have your ovaries removed?
- YesSorry, that's not right. If you have your ovaries removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms.
- NoYou're right. If you have your ovaries removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms.
- I'm not sureIt may help to go back and read "Get the Facts." If your ovaries are removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms.
Can removing your ovaries increase your chances of getting heart disease and osteoporosis?
- YesYou're right. Having your ovaries removed before age 65 can increase your chances of getting heart disease and osteoporosis.
- NoSorry, that's not right. Having your ovaries removed before age 65 can increase your chances of getting heart disease and osteoporosis.
- I'm not sureIt may help to go back and read "Get the Facts." Having your ovaries removed before age 65 can increase your chances of getting heart disease and osteoporosis.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
Certainty
How sure do you feel right now about your decision?
Check what you need to do before you make this decision.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Credits | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
| Specialist Medical Reviewer | Kirtly Jones, MD - Obstetrics and Gynecology |
Hysterectomy: Should I Also Have My Ovaries Removed?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
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 aren't 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 if you're at risk is a different decision than if you're not at risk.
- 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.
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.
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.
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 therapy. This treatment doesn't 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 your options
| Have ovaries removed along with hysterectomy | Have hysterectomy only | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
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 PMS 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. What matters most to you?
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.
I don't mind going into early menopause.
I don't want to go into early menopause.
I think that removing my ovaries will help with my severe PMS symptoms.
I don't have severe PMS symptoms.
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.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
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
5. What else do you need to make your decision?
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
2. Can you have menopause at the normal time of life if you have your ovaries removed?
- Yes
- No
- I'm not sure
3. Can removing your ovaries increase your chances of getting heart disease and osteoporosis?
- Yes
- No
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- 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.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
| Specialist Medical Reviewer | Kirtly Jones, MD - Obstetrics and Gynecology |
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Last Revised: January 9, 2012
Author: Healthwise Staff
Medical Review: Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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