Understanding the Consequences of Losing an Ovary: Cognitive and Physical Effects

Over 50,000 women undergo an oophorectomy, the removal of one or both ovaries, every year in the United States. The decision to have a bilateral oophorectomy or a unilateral oophorectomy carries significant implications for a woman's physical and mental health. This article explores the effects of removing an ovary and the subsequent need for hormone replacement therapy (HRT).

What is an Oophorectomy?

An oophorectomy is the surgical removal of one or both ovaries. This procedure deprives the body of hormones produced in the ovaries, such as estrogen and progesterone. As a result, women may experience symptoms commonly associated with menopause, such as hot flashes, vaginal dryness, and other menopausal signs and symptoms.

Effects of Oophorectomy

Depending on the extent of the oophorectomy — whether one or both ovaries are removed — the effects can vary significantly. Women who undergo a bilateral oophorectomy (removal of both ovaries) will go into immediate menopause, which can be more severe than natural menopause. On the other hand, women who undergo a unilateral oophorectomy (removal of one ovary) may not experience noticeable changes in their daily life. However, fertility may be impaired in some cases.

Primary Reasons for Oophorectomy

The most common reasons for an oophorectomy include cancer or genetic risks of ovarian cancer. In some cases, it might be necessary for treating an ectopic pregnancy, although surgeons now take great care to preserve the ovary whenever possible.

Adverse Impacts of Oophorectomy

Both ovaries being removed can result in sterility and immediate menopause. However, a woman's chance of pregnancy is not necessarily eliminated. Natural conception with one ovary and one fallopian tube is possible, although the likelihood may be reduced if the fallopian tube is problematic. Women have successfully conceived even without medical assistance.

Incomplete Ovary Removal: Potential for Fertility

Remarkably, even if only a small portion of an ovary remains, it may still support fertility. A medical report from the past discusses a successful pregnancy with only one quarter of one ovary left after a procedure known as ovarian wedging. Ovarian wedging, a process used to reduce the total volume of the ovaries for the treatment of polycystic ovarian syndrome (PCOS), is sometimes associated with successful pregnancies.

Hormone Replacement Therapy Post-Oophorectomy

Women who undergo an oophorectomy often require hormone replacement therapy (HRT) to minimize menopausal symptoms and maintain overall health. HRT is particularly crucial for those who have had both ovaries removed and may also be considered for those whose uterus was also removed. Women who have an intact uterus and want HRT need to take both progesterone and estrogen to prevent the endometrial cancer risk from unopposed estrogen. Conversely, women who do not have a uterus can take estrogen alone.

Conclusion

While an oophorectomy can have significant impacts on a woman's physical and emotional well-being, the risks and recovery are variable depending on the procedure and individual circumstances. It is essential for women to discuss the implications and subsequent steps with healthcare providers before making decisions about oophorectomy.