What Is It, Indications, Benefits and Risks, and More
Author: Emily Miao, PharmD
Editor: Alyssa Haag
Editor: Ian Mannarino, MD, MBA
Editor: Kelsey LaFayette, DNP
Illustrator: Jessica Reynolds, MS
Copyeditor: David G. Walker
Modified: May 13, 2024
What is an oophorectomy?
An oophorectomy is a surgical procedure that involves the removal of one (i.e,. unilateral oophorectomy) or both (i.e., bilateral oophorectomy) of the ovaries. The ovary and fallopian tube are structures of the genetic female reproductive system that produce hormones like estrogen and facilitate the release of ova (i.e., reproductive egg cells), respectively. An oophorectomy can be performed through robot-assisted surgery, which utilizes a surgical robot device to help surgeons perform complex procedures with precision and control, or via laparoscopic surgery, a type of surgery that utilizes a few small incisions on the surface of the abdomen and a camera to gain surgical access to the intraoperative field. Because small cuts are used in laparoscopic surgery and robot-assisted surgery, they are often referred to as minimally invasive approaches, resulting in a faster healing process with less internal scarring.
Individuals may be required to stay in the hospital after their surgery for postoperative monitoring. If the surgery was uncomplicated and without postoperative complications (i.e., incision site infection, hemorrhage, nearby organ damage, delayed wound healing), individuals may be discharged on the same day. Individuals may also schedule an outpatient follow-up appointment with their surgeon one to two weeks after surgery to ensure adequate recovery.
How does an oophorectomy differ from a hysterectomy?
An oophorectomy, which is a procedure to remove one or both of the ovaries, differs from a hysterectomy, which is the surgical removal of the uterus and, depending on the type of hysterectomy, the cervix. A hysterectomy is often indicated for the management of similar aforementioned disease processes and conditions. There are two subtypes of hysterectomy, including partial hysterectomy and total hysterectomy. A partial hysterectomy is the partial removal of the uterus (i.e., usually the upper part), which leaves the cervix (i.e., the bottom part of the uterus) intact. A total hysterectomy is the complete removal of the uterus and cervix. Finally, a total hysterectomy with bilateral salpingo-oophorectomy is the entire removal of the uterus, cervix, ovaries, and fallopian tubes. All of these surgeries may be performed with various surgical approaches, including open, laparoscopic, or robot-assisted laparoscopic.
What are the indications for an oophorectomy?
The various indications for oophorectomy include treatment and removal of primary ovarian neoplasm(s) or metastatic ovarian lesions from another type of cancer (e.g., uterine cancer); prevention of reproductive system cancers in individuals with pathologic genetic mutations (e.g., BRCA1 and BRCA2) that predispose them to high risk of ovarian cancer; prevention and treatment of complications from gynecologic conditions (e.g., a large ovarian cyst that is at risk for rupture, abnormal bleeding, or chronic pain from endometriosis, ovarian torsion with necrotic ovaries, or pelvic inflammatory disease requiring removal of necrotic tissue); and in cases where individuals who identify as transgender want to decrease the presence of systemic hormones as part of their transition process.
What are the risks and benefits of having an oophorectomy?
An oophorectomy has its risks and benefits; therefore, individuals considering this procedure should consult with their healthcare provider to discuss if this procedure is right for them. Benefits include cancer treatment (i.e., complete removal of the source of cancerous cells) and prevention. In individuals with a high risk of ovarian cancer, a prophylactic oophorectomy can prevent the development of ovarian cancer. An oophorectomy can also prevent or resolve symptoms and complications secondary to an underlying gynecologic disease process (e.g., ovarian cyst, endometriosis, pelvic inflammatory disease).
Risks include early menopause and hormonal imbalances, due to the removal of ovaries that secrete hormones, like estrogen and progesterone; infertility due to the loss of oocyte production and ovulation; and intraoperative complications (i.e., iatrogenic damage to surrounding structures and its blood supply or neuropathies due to poor patient positioning during surgery). The long-term risks of reduced estrogen levels from an oophorectomy include increased risk of cardiovascular disease, including dyslipidemia and hypercholesterolemia, as well as osteoporosis.
Does menstruation stop after an oophorectomy?
Menstruation may stop after an oophorectomy. If only one ovary is removed, the other ovary will continue to produce hormones like estrogen and progesterone, which will continue to regulate the menstrual cycle. If both ovaries are removed, then the individual will no longer produce adequate levels of estrogen and progesterone to support menstruation. Therefore, bilateral oophorectomy results in surgical menopause. After the procedure, individuals may experience menopausal symptoms such as hot flashes, vaginal dryness, and mood changes, which are all associated with an abrupt decrease in estrogen levels.
What are the most important facts to know about an oophorectomy?
An oophorectomy is a surgical procedure that involves the removal of one (i.e., unilateral oophorectomy) or both (i.e., bilateral oophorectomy) of the ovaries. The ovary and fallopian tube are structures of the genetic female reproductive system that produce hormones like estrogen and progesterone and facilitate the release of ova (i.e., reproductive egg cells), respectively. Indications for oophorectomy include removal of primary ovarian neoplasms, prevention of ovarian cancer in high-risk individuals, and management of complications related to certain gynecologic conditions. While an oophorectomy may be beneficial in addressing underlying conditions, there are also associated risks, including early menopause, hormonal imbalances, and intraoperative complications. An oophorectomy differs from a hysterectomy in that an oophorectomy is the removal of ovaries, whereas a hysterectomy is the surgical removal of the uterus. Finally, menstruation may continue in individuals where only one ovary was removed as the other intact ovary can continue to produce hormones to support menstruation. In those who undergo bilateral oophorectomy, menstruation will stop due to the inadequate production of estrogen.
