What happens after ovary and fallopian tube removal depends largely on whether you had one or both ovaries taken out, and whether the surgery was minimally invasive or open. In either case, you can expect three to six weeks of restricted activity, but the hormonal and long-term effects differ dramatically between losing one ovary and losing both.
The First Days After Surgery
If your surgery was laparoscopic (through small incisions), you may go home the same day or after an overnight stay. An open abdominal procedure typically requires up to three days in the hospital. Either way, walking for a few minutes two or three times a day starting right after surgery helps reduce fatigue, prevent muscle loss, and lower the risk of blood clots.
You’ll have specific instructions for caring for your incision sites. Keep your hands clean when checking wounds, and follow your surgical team’s guidance on bathing and showering, which varies depending on whether your incision was closed with stitches, staples, or adhesive strips. Watch for signs of infection: thick or cloudy discharge, an unpleasant smell, redness spreading beyond the incision line, warmth around the site, or the wound appearing deeper or wider than before. Any of these warrant a call to your surgeon.
Avoid heavy lifting for at least four weeks, and return to it gradually after that. Your surgeon may recommend a longer restriction depending on the extent of surgery. Low-impact exercise like walking is safe early on, but high-impact activities like running should wait until your care team clears you.
One Ovary Removed vs. Both
If you still have one ovary, the hormonal picture is reassuring. The remaining ovary compensates through mechanisms researchers don’t fully understand yet, maintaining enough hormone production to prevent menopausal symptoms. Women who keep one ovary reach natural menopause only about one year earlier than women with both ovaries intact. You won’t need hormone therapy, and your body will continue producing estrogen and progesterone on its own.
If both ovaries were removed and you hadn’t already gone through menopause, the situation is very different. You’ll enter surgical menopause, and it starts immediately rather than unfolding over years the way natural menopause does. That abrupt hormonal drop is the source of most side effects people search for when looking up this surgery.
What Surgical Menopause Feels Like
Compared to natural menopause, surgical menopause tends to hit harder. The rapid decline in estrogen and other ovarian hormones causes more severe hot flashes and night sweats, higher rates of mood changes including depression and anxiety, sleep disturbances, joint pain, and reduced quality of life overall. These symptoms can begin within days of surgery.
The mood effects have a biological basis. Estrogen influences serotonin activity in the brain, so when levels plummet overnight rather than tapering gradually, women are more vulnerable to depression and anxiety. Women who had preexisting mood or psychological concerns before surgery tend to experience a worsening of those issues afterward. This doesn’t mean the surgery was a mistake, but it does mean being prepared and having support in place matters.
Changes to Sexual Health
Loss of libido and vaginal dryness are the most commonly reported sexual side effects after both ovaries are removed. The drop in sex drive can be more pronounced than in natural menopause because the ovaries, even after natural menopause, continue producing some androgens (hormones that influence desire). When both ovaries are removed, that source disappears entirely.
Women who were premenopausal at the time of surgery tend to experience a greater decline in sexual function. Hormone therapy can improve these symptoms but often doesn’t eliminate them completely. Vaginal moisturizers and lubricants help with dryness on a practical level. Testosterone therapy and other pharmacological options exist but have limited long-term safety data in this group, so they’re worth discussing with your doctor if standard hormone therapy isn’t enough.
Hormone Therapy After Surgery
If both ovaries were removed before you reached natural menopause, medical guidelines are clear: hormone therapy is recommended even if you aren’t experiencing obvious symptoms like hot flashes. The North American Menopause Society advises prescribing it for women who had surgical menopause before age 45, assuming no medical reasons to avoid it.
This recommendation exists because of what happens without hormone replacement. A major study found that women who had both ovaries removed before age 45 and did not take estrogen had an 84% higher risk of dying from cardiovascular disease compared to women who kept their ovaries. Women in the same age group who did take estrogen showed no increased risk. The protective role of estrogen is significant enough that skipping hormone therapy after early surgical menopause carries real, measurable consequences for heart health.
Some research also suggests that combined estrogen and androgen therapy correlates with less anxiety, less hostility, and more positive mood compared to estrogen alone, though this approach isn’t standard for everyone.
Bone and Heart Health Over Time
Estrogen plays a direct role in maintaining bone density. After both ovaries are removed, bone loss accelerates, increasing the risk of osteoporosis and fractures over the following years. This is especially concerning for younger women who may live decades without ovarian hormones if they don’t take replacement therapy.
Cardiovascular risk follows a similar pattern. The same study that documented the heart risks found that bilateral removal before age 45 increased cardiovascular mortality by 44% overall. The risk was concentrated among women who did not receive estrogen therapy. For women who did take estrogen at least through age 45, the elevated risk essentially disappeared. Recurrent urinary tract infections and cognitive changes, including memory difficulties, are additional long-term concerns that can emerge after surgical menopause.
If the Surgery Was for Cancer Prevention
For women with BRCA1 or BRCA2 gene mutations or other hereditary cancer genes, removing the ovaries and fallopian tubes is one of the most effective preventive measures available. The procedure reduces ovarian cancer-associated mortality by 94% and overall mortality by 68% in high-risk populations. For BRCA carriers, there is also evidence of reduced breast cancer risk, though data supporting this benefit is currently limited to BRCA1 and BRCA2 carriers specifically.
These numbers are significant enough that the trade-offs of surgical menopause, while real, are generally considered worthwhile for women at high hereditary risk. The key is managing those trade-offs proactively with hormone therapy and ongoing monitoring rather than simply accepting the symptoms as inevitable.
What the First Few Months Look Like
Most women return to normal daily activities within three to six weeks, though energy levels may take longer to fully recover. If you entered surgical menopause, the first few months are typically the most intense for vasomotor symptoms like hot flashes and night sweats. Hormone therapy, if started promptly, can significantly blunt these effects. Sleep disruption is common early on and feeds into fatigue, mood changes, and difficulty concentrating, so addressing it directly with your care team is worthwhile.
Emotionally, it’s normal to feel a sense of grief or loss, particularly around fertility. Even women who weren’t planning future pregnancies sometimes find the finality more affecting than expected. This reaction is common and doesn’t indicate a problem. It’s part of adjusting to a significant physical change.