Ovary Removal Side Effects

The ovaries are the main source of estrogen in the body before menopause. If you have your ovaries removed before menopause (called prophylactic ovary removal or prophylactic oophorectomy), your estrogen levels will drop suddenly. Medical menopause (also called medically induced menopause) is different from the natural transition into menopause, which involves a gradual drop in estrogen. Medical menopause can cause uncomfortable symptoms and other side effects. 

Prophylactic ovary removal can reduce the risk of ovarian and breast cancers, but as with all surgeries, there’s a chance you’ll experience some side effects from surgery.

Short-term side effects of oophorectomy can occur in the days and weeks after surgery. These side effects include:

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  pain as a result of either the incision(s) or the inflation of the abdominal cavity for laparoscopic surgery

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  fatigue for three to four weeks after laparoscopic surgery and possibly up to six weeks for surgery that involves a larger abdominal incision (called laparotomy)

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  changes in the digestive system, including constipation and lack of appetite

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  the start of menopausal symptoms related to the loss of estrogen, such as intense hot flashes, fatigue, mood swings, and vaginal dryness and irritation

Prophylactic ovary removal can also lead to long-lasting changes to your body. Some of these changes will be immediate and others could take years to develop or not develop at all.

The ovaries produce and release eggs, so if you undergo prophylactic ovary removal, you’ll no longer be able to get pregnant naturally. 

Being launched into menopause may reduce your interest in sex and intimacy (called loss of libido). The changes in hormones can also cause vaginal dryness and vaginal thinning, which can make sex uncomfortable.

Estrogen helps keep your bones strong, so removing the ovaries can increase your risk of osteoporosis and osteopenia. Having osteoporosis or osteopenia means your bones are weaker than they should be, which increases your risk of breaking a bone. Studies show that premenopausal women who have ovary removal surgery are at an increased risk of bone loss and osteoporosis. It's not clear if the same is true for people who have the surgery after menopause; research on the topic has been mixed.

Research shows that ovary removal before menopause can increase the risk of heart problems later in life. Research shows that people who have had their ovaries removed before going through menopause are more likely to have heart problems than people who haven't had this surgery. 

Other side effects that some people have after prophylactic ovary removal include:

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  joint pain and muscle pain

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  chest pain/heart palpitations

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  muscle spasms

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  insomnia (difficulty sleeping)

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  recurrent urinary tract and yeast infections

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  urinary incontinence (difficulty controlling when you urinate)

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  anxiety, depression, and mood swings

If you’re experiencing side effects from having your ovaries removed, it’s important to tell your care team. There are a few different ways these side effects may be treated.

Certain lifestyle changes — including eating foods rich in calcium and vitamin D, and lifting weights — can help treat osteoporosis and osteopenia. Getting exercise can also help to improve your mood.

There are medicines for treating some symptoms of menopause, including flibanserin (brand name: Addyi) and bremelanotide (brand name: Vyleesi) for low libido; bisphosphonates for bone loss; and antidepressants for depression, anxiety, and hot flashes.

Hormone replacement therapy (HRT) after ovary removal can relieve menopausal symptoms, but systemic HRT is currently not recommended for women with a history of breast cancer. Research suggests that topical HRT, such as low-dose vaginal estrogen creams, tablets, and rings do not increase breast cancer risk because most of the hormones stay in the vaginal tissue.

If having a biological child is important to you, you may want to freeze your eggs before you have surgery. Some people without ovaries can get pregnant through IVF.

Talking with someone about your feelings about ovary removal, sudden menopause, infertility, decreased sex drive, and other challenges you may be facing may help you feel less alone. These can be one-on-one conversations with a loved one or therapist, or you might consider sharing with a group of people in similar situations. Breastcancer.org has free, virtual meetups that provide a safe space to share.

Vaginal moisturizers can improve the strength and suppleness of vaginal tissue. Vaginal lubricants can help reduce friction and pain during sex. These products, which are available without a prescription, can help make sex more comfortable.