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A bilateral oophorectomy is a medical procedure in which both ovaries are surgically removed. This procedure often is carried out in conjunction with a hysterectomy, in which the uterus is removed. A woman who has had a bilateral oophorectomy loses the ability to produce hormones such as progesterone and estrogen, and she will no longer have menstrual periods. The effect of the procedure is similar to what happens when a woman goes through menopause, except that after this surgery, these effects occur rapidly rather than over a period of several years.
An oophorectomy can be performed for a number of reasons. These include to treat endometriosis and to remove ovarian cysts, abscesses or malignant cancers. In addition, this procedure might be performed as a preventative treatment for women who have a high risk of developing ovarian cancer or estrogen-dependent breast cancer. This breast cancer is associated with mutations in genes called BRCA1 and BRCA2, and the risk of the cancer occurring in women with the genetic mutation is decreased significantly after bilateral oophorectomy. This is because this breast cancer is more likely to develop in the presence of estrogen, so removal of the ovaries reduces the cancer risk.
Oophorectomy typically is carried out via an incision made in the abdomen. This procedure can be carried out laparoscopically, which leaves much smaller scars and has a shorter recovery time, but an abdominal incision is preferred by many surgeons because it provides a better overall view of the interior of the abdominal cavity. After surgery, recovery can take two to six weeks, depending on whether hysterectomy was performed in addition to oophorectomy and whether the procedure was carried out laparoscopically.
After bilateral oophorectomy, the supply of estrogen in the body reduces almost immediately, leading to the development of menopausal symptoms that often are much more severe than would be experienced by a woman undergoing natural, age-associated menopause. This so-called surgical menopause can include severe hot flashes, night sweats and sleep disturbances. To counteract these effects, most women are prescribed hormone replacement medications after undergoing bilateral oophorectomy.
The value of bilateral oophorectomy for reducing the risk of ovarian and breast cancers is proven, but the overall desirability of the procedure is still under debate. This is because removal of the ovaries prior to menopause increases the risk of cardiovascular disease and osteoporosis because of the loss of estrogen. Women who have this procedure can use hormone replacement therapy until they reach natural menopause age, but the risk of cardiovascular disease and osteoporosis remains higher than normal.