I’m Having a Hysterectomy. Will I Keep My Ovaries?

If you’re preparing for a hysterectomy, you’re not alone. With more than 600,000 hysterectomies performed every year, it’s the second-most common surgical procedure for women, after cesarean sections. But there are some common misconceptions about the procedure. 

For example, many people believe that a hysterectomy always includes the removal of the ovaries. In truth, ovary removal, called an oophorectomy, is typically only performed when medically necessary. 

Before your hysterectomy, you may be given the choice whether to remove your ovaries. Understanding what your ovaries do and how removal will affect your health may help you make your decision.

4 Types of Hysterectomies 

There are four types of hysterectomies, based on which tissues and organs are removed during the procedure: 

• Total hysterectomy. Removal of the uterus and cervix, but not the ovaries. This is the most common type of hysterectomy.

• Hysterectomy with oophorectomy. Removal of the uterus, fallopian tubes and one or both ovaries.  

• Supracervical hysterectomy. Removal of the uterus that leaves the cervix intact. Ovaries and fallopian tubes may or may not be removed.

• Radical hysterectomy. Removal of the uterus, cervix and surrounding tissues. In certain cases, pelvic lymph nodes may also be removed.

In Most Cases, Ovaries Can Stay Put

The ovaries are an important part of the female reproductive system. These almond-shaped glands store eggs and produce sex hormones, including estrogen.

The main reason ovaries are removed is to lower a woman’s risk of ovarian cancer. If you have a family history of breast or ovarian cancers or know you have the BRCA1 or BRCA2 genetic mutations that predispose you to reproductive or hormonal cancers, an oophorectomy may greatly lower your risk of these cancers. 

Other common reasons for ovary removal include: 

• Endometriosis

• Ovarian cysts

• Ovarian torsion (twisting of the ovary)

• Pelvic inflammatory disease/tubo-ovarian abscess

• Personal choice 

Menopause will begin almost immediately after the oophorectomy. You may experience hot flashes, night sweats, mood changes and other symptoms.

Keeping Your Ovaries Might Be a Good Idea 

If the decision is yours whether you keep your ovaries, consider the benefits: 

• Hormone replacement therapy (HRT) may not be necessary. While HRT can help reduce menopause systems such as hot flashes and mood swings, it does come with an increased risk of developing blood clots, heart disease, breast cancer and stroke.

• Reduced risk of chronic health conditions. Research shows that premenopausal women who had their ovaries removed are at an increased risk for developing multiple chronic health conditions, including arthritis, depression, heart disease, memory loss and osteoporosis.

• Stronger bones. Oophorectomy increases the risk of developing weak bones (osteoporosis) because the body is no longer producing estrogen. 

The decision to remove your ovaries is a personal one, and it can be difficult to know what to choose. Talk with your doctor and/or a genetic counselor about your medical and family history. They can determine your risk for ovarian cancer and help make the best choice for you.