Hysterectomy: Should I Also Have My Ovaries Removed?

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You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Hysterectomy: Should I Also Have My Ovaries Removed?

Get the facts

Your options

  • Have your uterus and your ovaries removed (hysterectomy with oophorectomy).
  • Have your uterus removed, but keep your ovaries (hysterectomy only).

Key points to remember

  • The main reason doctors recommend removing the ovaries during hysterectomy is to lower the risk of ovarian cancer. Studies show that if you are at high risk, surgery greatly lowers your risk.
  • If you aren't at high risk for cancer, having your ovaries removed isn't recommended.
  • It's important to know your risk for cancer when deciding whether to have your ovaries removed during your hysterectomy. Your doctor will help you find out your risk by talking to you about your medical history and your family history. Removing the ovaries if you're at risk is a different decision than if you're not at risk.
  • Removing the ovaries may increase your risk of heart disease and osteoporosis.
  • If you have your ovaries removed before menopause, you will go into early menopause. You may get hot flashes and other symptoms.
FAQs

What is oophorectomy?

Surgery to remove the ovaries is called oophorectomy (say "oh-uh-fuh-REK-tuh-mee"). The ovaries are an important part of the female reproductive system. They store eggs and produce sex hormones, including estrogen.

Of women who have a hysterectomy, about half of them have their ovaries removed at the same time.footnote 1 The main reason doctors recommend removing the ovaries along with the uterus is to reduce the risk of ovarian cancer. Studies show that if you are at high risk, surgery greatly lowers your risk.

What are the benefits of oophorectomy?

For women at average risk-this means no personal or family history of ovarian or breast cancer-there is no clear benefit to removing the ovaries at any age. Hysterectomy itself can reduce your risk of ovarian cancer.footnote 1

If you have severe premenstrual syndrome (PMS), removing the ovaries can stop hormone changes. This may help you feel better.

If you are at high risk for breast or ovarian cancer, having your ovaries removed can greatly lower your risk. Women at high risk for these cancers include those who:

  • Have a BRCA gene change (BRCA stands for BReast CAncer).
  • Have a family history of ovarian cancer before age 50.

If you don't know if you are at high risk for breast or ovarian cancer, talk to your doctor. If your doctor thinks you could be at risk, you may want to think about gene testing.

What are the risks of having your ovaries removed?

When your ovaries are removed, you lose the estrogen that they produce. Without estrogen, you will go into early menopause. This can cause hot flashes and other symptoms.

Having your ovaries removed before age 65 may increase your chance of getting:footnote 1

  • Osteoporosis, which can lead to broken bones and hip fractures.
  • Heart disease, which is the number one cause of death in women in the United States.

Women who choose to have their ovaries removed can take estrogen therapy. This treatment doesn't prevent heart disease, but it helps to lower your risk of osteoporosis. If you already have bone loss, other medicines can help protect your bones.

Why might your doctor recommend having your ovaries removed?

Your doctor may recommend having your ovaries removed when you have a hysterectomy if:

  • You have a BRCA gene change.
  • You have a strong family history of early ovarian cancer. You have a higher risk of ovarian cancer if a close family member, especially your mother or sister, has had breast cancer.
  • You have a type of breast cancer that estrogen causes to grow.
  • You have severe premenstrual syndrome that could be helped by having your ovaries removed.
  • You have had pelvic pain that involved your ovaries.

Compare your options

Compare

What is usually involved?

















What are the benefits?

















What are the risks and side effects?

















Have ovaries removed along with hysterectomy Have ovaries removed along with hysterectomy
  • The ovaries are removed through the same incision made for the hysterectomy.
  • You stay in the hospital for 1 to 2 days. Some women stay for up to 4 days.
  • You may take estrogen therapy.
  • If you are at high risk for breast cancer or ovarian cancer, removing the ovaries greatly reduces your risk.
  • If you have severe PMS, you may feel better after you have your ovaries removed.
  • Removing the ovaries increases the risk of heart disease and osteoporosis.
  • If you have your ovaries removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms.
  • Removing the ovaries during hysterectomy poses no additional surgical risks than having a hysterectomy alone.
Have hysterectomy only Have hysterectomy only
  • You stay in the hospital for 1 to 2 days. Some women stay for up to 4 days.
  • For women at average risk:
    • The benefits of keeping the ovaries usually outweigh the risks, especially for younger women.
    • Hysterectomy itself can reduce the risk of ovarian cancer.
  • If you are at high risk for breast cancer or ovarian cancer, you will still be at risk.

Personal stories about having an oophorectomy with a hysterectomy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My mother died of ovarian cancer when she was 48, so that's always been one of my biggest fears. I have severe PMS and don't plan to have children, so I decided to have a hysterectomy. And I'm going to have my ovaries taken out at the same time. Knowing my risk of ovarian cancer is reduced will give me more peace of mind.

Cynda, age 39

I have a very large fibroid, so I have decided to have a hysterectomy to remove it. But I plan to keep my ovaries so that I don't go into early menopause.

Joyce, age 40

My mother and two of her sisters had breast cancer when they were in their 40s. I'm an Ashkenazi Jew, so even though I haven't had the BRCA test, I know chances are good that I have the breast cancer gene. I have decided to have a hysterectomy to put an end to years of heavy menstrual bleeding. I am also going to have an oophorectomy to reduce my risk of breast and ovarian cancer.

Minnie, age 37

I am going to have a hysterectomy to treat uterine prolapse. When my older sister had her hysterectomy, they also took her ovaries. But my doctor said it's probably a good idea to save my ovaries, especially since I am small-boned and my mother has osteoporosis.

Perdita, age 52

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have your ovaries removed during hysterectomy

Reasons not to have your ovaries removed during hysterectomy

I will worry less about cancer if I have my ovaries removed.

I'm not that worried about cancer.

More important
Equally important
More important

I don't mind going into early menopause.

I don't want to go into early menopause.

More important
Equally important
More important

I think that removing my ovaries will help with my severe PMS symptoms.

I don't have severe PMS symptoms.

More important
Equally important
More important

I feel that there are more benefits to removing my ovaries than keeping them.

I feel that there are more benefits to keeping my ovaries than removing them.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having my ovaries removed

NOT having my ovaries removed

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, If you are at high risk for ovarian cancer, will you benefit by having your ovaries removed during a hysterectomy?
2, Can you have menopause at the normal time of life if you have your ovaries removed?
3, Can removing your ovaries increase your chances of getting heart disease and osteoporosis?

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits and References

Credits
AuthorHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology

References
Citations
  1. Parker WH, et al. (2005). Ovarian conservation at the time of hysterectomy for benign disease. Obstetrics and Gynecology, 106(2): 219-226.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Hysterectomy: Should I Also Have My Ovaries Removed?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have your uterus and your ovaries removed (hysterectomy with oophorectomy).
  • Have your uterus removed, but keep your ovaries (hysterectomy only).

Key points to remember

  • The main reason doctors recommend removing the ovaries during hysterectomy is to lower the risk of ovarian cancer. Studies show that if you are at high risk, surgery greatly lowers your risk.
  • If you aren't at high risk for cancer, having your ovaries removed isn't recommended.
  • It's important to know your risk for cancer when deciding whether to have your ovaries removed during your hysterectomy. Your doctor will help you find out your risk by talking to you about your medical history and your family history. Removing the ovaries if you're at risk is a different decision than if you're not at risk.
  • Removing the ovaries may increase your risk of heart disease and osteoporosis.
  • If you have your ovaries removed before menopause, you will go into early menopause. You may get hot flashes and other symptoms.
FAQs

What is oophorectomy?

Surgery to remove the ovaries is called oophorectomy (say "oh-uh-fuh-REK-tuh-mee"). The ovaries are an important part of the female reproductive system . They store eggs and produce sex hormones, including estrogen.

Of women who have a hysterectomy, about half of them have their ovaries removed at the same time.1 The main reason doctors recommend removing the ovaries along with the uterus is to reduce the risk of ovarian cancer. Studies show that if you are at high risk, surgery greatly lowers your risk.

What are the benefits of oophorectomy?

For women at average risk-this means no personal or family history of ovarian or breast cancer-there is no clear benefit to removing the ovaries at any age. Hysterectomy itself can reduce your risk of ovarian cancer.1

If you have severe premenstrual syndrome (PMS), removing the ovaries can stop hormone changes. This may help you feel better.

If you are at high risk for breast or ovarian cancer, having your ovaries removed can greatly lower your risk. Women at high risk for these cancers include those who:

  • Have a BRCA gene change (BRCA stands for BReast CAncer).
  • Have a family history of ovarian cancer before age 50.

If you don't know if you are at high risk for breast or ovarian cancer, talk to your doctor. If your doctor thinks you could be at risk, you may want to think about gene testing.

What are the risks of having your ovaries removed?

When your ovaries are removed, you lose the estrogen that they produce. Without estrogen, you will go into early menopause. This can cause hot flashes and other symptoms.

Having your ovaries removed before age 65 may increase your chance of getting:1

  • Osteoporosis, which can lead to broken bones and hip fractures.
  • Heart disease, which is the number one cause of death in women in the United States.

Women who choose to have their ovaries removed can take estrogen therapy. This treatment doesn't prevent heart disease, but it helps to lower your risk of osteoporosis. If you already have bone loss, other medicines can help protect your bones.

Why might your doctor recommend having your ovaries removed?

Your doctor may recommend having your ovaries removed when you have a hysterectomy if:

  • You have a BRCA gene change.
  • You have a strong family history of early ovarian cancer. You have a higher risk of ovarian cancer if a close family member, especially your mother or sister, has had breast cancer.
  • You have a type of breast cancer that estrogen causes to grow.
  • You have severe premenstrual syndrome that could be helped by having your ovaries removed.
  • You have had pelvic pain that involved your ovaries.

2. Compare your options

  Have ovaries removed along with hysterectomy Have hysterectomy only
What is usually involved?
  • The ovaries are removed through the same incision made for the hysterectomy.
  • You stay in the hospital for 1 to 2 days. Some women stay for up to 4 days.
  • You may take estrogen therapy.
  • You stay in the hospital for 1 to 2 days. Some women stay for up to 4 days.
What are the benefits?
  • If you are at high risk for breast cancer or ovarian cancer, removing the ovaries greatly reduces your risk.
  • If you have severe PMS, you may feel better after you have your ovaries removed.
  • For women at average risk:
    • The benefits of keeping the ovaries usually outweigh the risks, especially for younger women.
    • Hysterectomy itself can reduce the risk of ovarian cancer.
What are the risks and side effects?
  • Removing the ovaries increases the risk of heart disease and osteoporosis.
  • If you have your ovaries removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms.
  • Removing the ovaries during hysterectomy poses no additional surgical risks than having a hysterectomy alone.
  • If you are at high risk for breast cancer or ovarian cancer, you will still be at risk.

Personal stories

Personal stories about having an oophorectomy with a hysterectomy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My mother died of ovarian cancer when she was 48, so that's always been one of my biggest fears. I have severe PMS and don't plan to have children, so I decided to have a hysterectomy. And I'm going to have my ovaries taken out at the same time. Knowing my risk of ovarian cancer is reduced will give me more peace of mind."

— Cynda, age 39

"I have a very large fibroid, so I have decided to have a hysterectomy to remove it. But I plan to keep my ovaries so that I don't go into early menopause."

— Joyce, age 40

"My mother and two of her sisters had breast cancer when they were in their 40s. I'm an Ashkenazi Jew, so even though I haven't had the BRCA test, I know chances are good that I have the breast cancer gene. I have decided to have a hysterectomy to put an end to years of heavy menstrual bleeding. I am also going to have an oophorectomy to reduce my risk of breast and ovarian cancer."

— Minnie, age 37

"I am going to have a hysterectomy to treat uterine prolapse. When my older sister had her hysterectomy, they also took her ovaries. But my doctor said it's probably a good idea to save my ovaries, especially since I am small-boned and my mother has osteoporosis."

— Perdita, age 52

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have your ovaries removed during hysterectomy

Reasons not to have your ovaries removed during hysterectomy

I will worry less about cancer if I have my ovaries removed.

I'm not that worried about cancer.

       
More important
Equally important
More important

I don't mind going into early menopause.

I don't want to go into early menopause.

       
More important
Equally important
More important

I think that removing my ovaries will help with my severe PMS symptoms.

I don't have severe PMS symptoms.

       
More important
Equally important
More important

I feel that there are more benefits to removing my ovaries than keeping them.

I feel that there are more benefits to keeping my ovaries than removing them.

       
More important
Equally important
More important

My other important reasons:

My other important reasons:

  
       
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having my ovaries removed

NOT having my ovaries removed

       
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. If you are at high risk for ovarian cancer, will you benefit by having your ovaries removed during a hysterectomy?

  • Yes
  • No
  • I'm not sure
You're right. Studies show that if you are at high risk for ovarian cancer, surgery to remove your ovaries may greatly lower your risk.

2. Can you have menopause at the normal time of life if you have your ovaries removed?

  • Yes
  • No
  • I'm not sure
You're right. If you have your ovaries removed before menopause, you will go into early menopause. This can cause hot flashes and other symptoms.

3. Can removing your ovaries increase your chances of getting heart disease and osteoporosis?

  • Yes
  • No
  • I'm not sure
You're right. Having your ovaries removed before age 65 can increase your chances of getting heart disease and osteoporosis.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

     
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.
 
Credits
ByHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology

References
Citations
  1. Parker WH, et al. (2005). Ovarian conservation at the time of hysterectomy for benign disease. Obstetrics and Gynecology, 106(2): 219-226.

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