When a person has one or both ovaries surgically removed, the medical procedure is called an oophorectomy. The term is derived from the Greek words oophoros (“egg-bearing”) and ektome (“a cutting out of”). The ovaries are small, almond-shaped organs that sit on either side of the uterus. This surgery is performed to treat or prevent various medical conditions, as the ovaries produce the majority of reproductive hormones and house the eggs.
Defining Oophorectomy
Oophorectomy describes the surgical removal of the ovary. The procedure is categorized based on the number of ovaries removed, which impacts future hormonal and reproductive function. A unilateral oophorectomy involves removing only one ovary, often leaving the remaining ovary to continue producing hormones and releasing eggs.
When both ovaries are removed, the procedure is termed a bilateral oophorectomy. This complete removal causes immediate changes in the body’s hormonal environment. Surgeons primarily use two methods: laparoscopy, a minimally invasive technique using small incisions, or a traditional laparotomy, which involves a larger abdominal incision. The choice of approach depends on the reason for the surgery and the complexity of the case.
Indications for the Procedure
A physician may recommend an oophorectomy for managing chronic disease or preventing future cancers. A primary reason is the treatment of ovarian cancer, requiring removal of the affected ovary or both ovaries to eliminate malignant tissue. The surgery is also performed as a prophylactic measure for individuals who carry high-risk genetic mutations, such as BRCA1 or BRCA2, which increase the risk of developing ovarian and breast cancer.
Other indications involve treating benign conditions that have not responded to less invasive therapies. These include severe endometriosis, where tissue similar to the uterine lining grows on the ovaries, causing large, painful cysts (endometriomas). Persistent or large ovarian cysts that cause chronic pelvic pain or are suspicious for malignancy may also necessitate removal. Oophorectomy may also be indicated in cases of ovarian torsion, where the ovary twists on its supporting tissues, cutting off its blood supply.
Immediate Hormonal Effects
Bilateral oophorectomy induces “surgical menopause.” Since the ovaries are the primary source of estrogen and progesterone, their abrupt removal causes a sudden decline in circulating hormone levels. This instantaneous hormonal withdrawal is often more intense than the gradual transition experienced during natural menopause.
The sudden lack of hormones triggers a rapid onset of menopausal symptoms, including frequent hot flashes and night sweats. Patients often experience changes in mood, such as increased irritability or depression, and may notice a decline in cognitive functions like memory. The immediate loss of estrogen also affects long-term health, as this hormone protects bone density and cardiovascular health. For younger patients who have not reached natural menopause, Hormone Replacement Therapy (HRT) is frequently prescribed following bilateral oophorectomy. HRT mitigates severe symptoms and protects against increased risks of osteoporosis and heart disease by replacing the lost estrogen.
Related Surgical Procedures
Oophorectomy is often performed in conjunction with other procedures involving the female reproductive system. It is important to distinguish oophorectomy (removal of the ovary) from a hysterectomy (removal of the uterus). While a hysterectomy eliminates menstruation and the ability to become pregnant, it does not cause surgical menopause if the ovaries remain intact.
A salpingectomy is the removal of one or both fallopian tubes. Because research suggests many ovarian cancers may originate there, salpingectomy is often performed even when the ovaries are preserved, especially in risk-reduction surgeries. When the ovary and its corresponding fallopian tube are removed together, the combined operation is called a salpingo-oophorectomy. The most comprehensive procedure is a total hysterectomy with bilateral salpingo-oophorectomy (THBSO), which removes the uterus, cervix, both fallopian tubes, and both ovaries. Understanding these terms is necessary because each procedure affects fertility, hormone production, and disease risk differently.