Menopause occurs when women stop menstruating and are no longer able to get pregnant naturally. With menopause, various changes take place in the body, leading to several symptoms like hot flashes, vaginal dryness, mood swings, and more. Additionally, menopausal women tend to become more prone to serious health problems, including ovarian cancer.
Therefore, for those approaching menopause or past the stage, the question of whether to remove the ovaries, often during surgeries like hysterectomy, can be a challenging one. While ovary removal, also known as oophorectomy, may reduce the risk of ovarian and breast cancers, it also comes with potential downsides. Here's what to know about the procedure and things to consider.
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Why Some Women Opt For Ovary Removal
StatPearls Publishing describes oophorectomy as the surgical removal of one or both ovaries and may also involve the removal of the fallopian tubes.
Speaking with the OnlyMyHealth team, Dr Shipra Kunwar, Consultant - Obstetrician and Gynaecologist, Manipal Hospital, Kharadi, Pune, says, “Some women choose to have their ovaries removed at the time of hysterectomy, especially if they are over 50 years of age, as this might lower their risk of developing ovarian cancer.”
She explains that this is particularly the case with people who have a family history of the disease or genetic predispositions such as BRCA mutations. “Ovaries may also be removed in cases of endometriosis or chronic ovarian cysts to stop the symptoms from getting worse,” she adds, suggesting that some women with chronic pelvic pain will also opt for removal, as this may help in reducing the pelvic pain post-surgery.
Benefits Of Removing Ovaries
According to the American Cancer Society (ACS), most ovarian cancers develop after menopause, and half of all ovarian cancers are found in women 63 years of age or older. This risk can be considerably reduced by ovary removal, highlights Dr Kunwar. Removing the ovaries eliminates the primary source of cancer cells. Additionally, fallopian tubes are often removed during this procedure, through a procedure called salpingo-oophorectomy, as some cancers may start there as well.
Moreover, the risk of endometriosis recurrence is lowered if the ovaries are removed at the time of uterus removal, also called hysterectomy. In some cases, it could improve quality of life by reducing chronic pain or other problems that less intrusive treatments can't handle.
Also, removal of ovaries reduces the chances of developing ovarian cysts and repeated surgeries at a later date.
Risks And Side Effects Of Ovary Removal
While there are many benefits of removing ovaries, surgical problems, haemorrhage, or harm to nearby organs are risks associated with ovary removal, warns Dr Kunwar.
Oophorectomy may also cause menopause to start suddenly, especially in premenopausal women, resulting in severe symptoms like mood swings, hot flashes, and night sweats.
Moreover, removing the ovaries can end up in long-term health consequences that impact general health and wellness, such as decreased bone density, cardiovascular issues, and a potential elevated risk of premature ageing.
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It is also important to note that hormone levels immediately drop after the ovaries are removed because the generation of progesterone and oestrogen is significantly decreased. This is known as surgical menopause, explains Dr Kunwar, who adds, "Due to the absence of oestrogen's preventive properties, it may raise the risk of osteoporosis and Cardiovascular Diseases (CVDs) over time.
To lessen these side effects and preserve hormonal balance, Hormone Replacement Treatment, or HRT, may be recommended. Also, postmenopausal ovaries are also not non-functional but may secrete some amount of hormones, which is involved in maintaining well-being.
Conclusion
Deciding whether to remove the ovaries after menopause isn’t easy. While it may lower the risk of some cancers, it can also bring new health challenges. For women who wish to keep their ovaries, there’s an option which involves removing just the fallopian tubes, also called salpingectomy, done during a hysterectomy. Research shows that many ovarian cancers actually start in the tubes, making this a safer alternative.
At the end of the day, it’s important for every woman to sit down with her surgeon, understand the pros and cons, and choose what feels right for her body and her future.