Risks of Prophylactic Ovary Removal

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Like all surgeries, prophylactic ovary removal involves some risks. For premenopausal women, it puts the body directly into menopause, which can cause uncomfortable symptoms and other side effects. Also, the long-term health effects of surgical menopause are not fully understood.

Risks immediately after surgery

Possible risks include:

  • bleeding or infection
  • scar tissue formation, especially if you have abdominal surgery (instead of the minimally invasive laparoscopic surgery). Scar tissue can be painful.
  • intestinal blockage and/or injury to internal organs, although these are rare

Short-term risks

The following side effects can occur in the days or weeks after surgery:

  • pain as a result of either the incision(s) or the inflation of the abdominal cavity for laparoscopic surgery
  • fatigue for 3-4 weeks after laparoscopic surgery and possibly up to 6 weeks for surgery that involves a larger abdominal incision
  • changes in the digestive system, including lack of appetite, less frequent bowel movements, and the need to eat smaller meals
  • the start of menopausal symptoms related to the loss of estrogen, such as intense hot flashes, fatigue, mood swings, and vaginal dryness and irritation. These are typically more intense for women who have not yet started menopause naturally.

Long-term risks

  • Prophylactic ovary removal is permanent and irreversible.
  • Women who undergo prophylactic ovary removal can no longer have children.
  • Premenopausal women often experience surgical menopause, which increases the risk of osteoporosis (thinning of the bones) and uncomfortable menopausal symptoms, including hot flashes/night sweats, vaginal dryness and irritation, and lessened sex drive.
  • After ovary removal, some women experience depression or anxiety about their loss of fertility. Women may have other side effects such as decreased sex drive and vaginal dryness. All of these can affect relationships.
  • There are conflicting opinions about whether or not women should take hormone replacement therapy (HRT) after ovary removal. HRT can relieve menopausal symptoms and may provide other health benefits to younger women. Studies suggest that short-term HRT is safe for women who need relief from the immediate effects of surgical menopause. However, individual doctors may have different opinions about this. Making decisions about HRT could cause some women confusion and anxiety.
  • Although prophylactic ovary removal significantly reduces the risk of ovarian cancer, it cannot completely eliminate the risk of developing an ovarian-cancer-like illness called primary peritoneal cancer. This form of cancer originates in the peritoneum, the tissue lining the ovaries and pelvic cavity. Peritoneal cancer looks and behaves very much like ovarian cancer. It also is difficult to detect early.

Some women have reported a range of other physical symptoms after prophylactic ovary removal:

  • joint and muscle pain
  • chest pain/heart palpitations
  • muscle spasms
  • insomnia (difficulty sleeping)
  • recurrent urinary tract and yeast infections
  • urinary incontinence (difficulty controlling the urge to urinate)
  • emotional effects such as anxiety, depression, and mood swings

Prophylactic ovary removal may have other long-term risks yet to be discovered. Doctors do not fully understand how the loss of estrogen could impact heart health, mental functioning, memory, and other aspects of women’s health. A 2006 Mayo Clinic study of more than 2,500 women found that women under 45 who had ovary removal without hormone replacement therapy were at increased risk of dying from a range of medical conditions later in life. These women also were at increased risk of dementia and other changes in mental function.

Until doctors know more about how ovary removal in younger women affects long-term health, each woman needs to work with her own doctor to weigh the risks and benefits of this procedure.

If you’re at high risk of developing breast and ovarian cancer, it’s important to discuss all your options for risk reduction with your doctor and loved ones. It’s also important to seek a second opinion about whether or not prophylactic ovary removal is a strategy that works for the whole you — your medical situation and your quality of life.

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