When a woman needs to have a hysterectomy (have her uterus removed), doctors often will recommend removing the ovaries (oophorectomy) at the same time. This is especially true for older women. In the United States, almost half of women over 40 who have a hysterectomy have their ovaries removed.
Women who have the abnormal breast cancer genes BRCA1 and BRCA2 have a higher than average risk of both breast and ovarian cancer. For these women, having their ovaries removed is an option they can choose that can lower the risk of breast and ovarian cancer, whether or not they need a hysterectomy.
Premenopausal women diagnosed with breast cancer also may choose to have their ovaries removed as part of their overall treatment plan because oophorectomy reduces the risk of the breast cancer coming back or a new breast cancer developing. But for most women who have an average risk of ovarian and breast cancer, the overall health benefits of opting to remove the ovaries isn't clear.
Two small research studies that followed the health of more than 360 women who had a hysterectomy. Some of the women had their ovaries removed at the same time and some didn't. The researchers found that there was no difference in overall health after the surgery between the women who did have their ovaries removed at the time of hysterectomy and the women who didn't.
In women with an average risk of ovarian and breast cancer, removing the ovaries at the same time as hysterectomy greatly reduces the risk of ovarian cancer and somewhat lowers future breast cancer risk. But removing the ovaries also has some negative health effects. If the ovaries are still producing normal amounts of estrogen at the time of surgery, removing them can cause troublesome menopausal symptoms such as hot flashes to develop abruptly. Removing the ovaries also can contribute to more serious health problems in the future, including a higher risk of osteoporosis or having a heart attack.
Most medical decisions require you and your doctor to consider the overall health benefits of each option, weighing the benefits against the risks. If your doctor recommends that you have a hysterectomy, you should talk about the benefits and risks of removing the ovaries at the same time. Ask your doctor for an assessment of your unique situation and your individual risk of both ovarian and breast cancer. If your risk of ovarian or breast cancer is higher than average, removing your ovaries during hysterectomy surgery may make sense for you. If your risk of ovarian and breast cancer are considered average, the study reviewed here suggests that there may be no overall health benefit to removing the ovaries during hysterectomy. Together, you and your doctor can evaluate your choices and make the decision that's best for YOU based on your overall health profile.