Medical Oncologist
CION Cancer Clinics
Are the ovaries removed with the womb? | CION Cancer Clinics
Often, but not always. For womb cancer and ovarian cancer both tubes and ovaries are usually removed with the womb. For early cervical cancer, and for some younger women with a low-risk womb cancer, they can often be kept. It is a separate decision from the hysterectomy, it depends on your cancer and your age, and it should be explained to you before the day. This page sets out how it is made. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Are the ovaries removed with the womb in a cancer hysterectomy?
- What usually happens, depending on the cancer
- The words that describe this decision, in plain language
- What changes, and when, after the ovaries are removed
- Four things families tell us about the ovaries
- What this page cannot tell you
- Common questions about the ovaries and hysterectomy
The short answer
Are the ovaries removed with the womb in a cancer hysterectomy?
Often, yes, but not always. For womb cancer and ovarian cancer, both fallopian tubes and both ovaries are usually removed with the womb. For early cervical cancer, and for some younger women with a low-risk early womb cancer, the ovaries can often be left in place. It is a separate decision from the hysterectomy itself, and it should be discussed with you before the day.
Why the ovaries are often taken
Womb cancer can spread to the ovaries. Removing the tubes and ovaries takes away a place the cancer can hide, lets the pathologist check them, and, in hormone-driven womb cancer, removes the main source of the oestrogen that feeds it. After the menopause the ovaries have mostly stopped working, so removing them costs little.
Why they are sometimes kept
Before the menopause the ovaries make the hormones that protect the bones, the heart and mood. Taking them out starts the menopause the same day, suddenly rather than gradually. Where the cancer is unlikely to involve the ovaries, as in most early cervical cancers, the team may judge that keeping them does more good than harm.
"Hysterectomy" on its own does not include the ovaries. If they are being removed, the consent form will say "salpingo-oophorectomy" or "BSO" as well.Cancer by cancer
What usually happens, depending on the cancer
These are the usual patterns, not rules. Your own plan may differ, and your surgeon should tell you why.
Womb (endometrial) cancer
Tubes and ovaries are usually removed with the womb, because the cancer can spread there and is often fed by oestrogen. In a young woman with a very early, low-grade cancer, the team may consider keeping the ovaries after weighing the risks.
Cervical cancer
Cervical cancer rarely spreads to the ovaries, so in women who have not reached the menopause the ovaries are often kept. If radiotherapy is likely afterwards, the surgeon may move the ovaries higher, out of the beam, in the same operation.
Ask about
- Whether radiotherapy is likely after surgery
- Whether moving the ovaries is possible for you
Ovarian and tube cancer
Both ovaries and both tubes are removed, along with the womb and the fatty apron over the bowel, because the cancer starts there and spreads across the surfaces of the pelvis. Keeping an ovary is considered only in a very early cancer in a young woman who wants children.
A strong family history
If you carry a BRCA gene change or have Lynch syndrome, your team may advise removing the tubes and ovaries even when the cancer itself would not need it, to lower the risk of a second cancer later. A genetic counsellor can explain what your result means.
Ask whether genetic testing has been done or is planned. It can change this decision.Not sure whether this applies to you?
Ask an oncologistOn your consent form
The words that describe this decision, in plain language
- Oophorectomy
- Removal of an ovary. "Bilateral" means both sides.
- Salpingectomy
- Removal of a fallopian tube. The tubes are almost always taken with the ovaries, and sometimes on their own.
- BSO
- Bilateral salpingo-oophorectomy: both tubes and both ovaries removed together. Written after TAH or TLH on the consent form.
- Surgical menopause
- The menopause that starts straight after both ovaries are removed in a woman who was still having periods. It is sudden rather than gradual.
- Ovarian transposition
- Moving the ovaries higher in the tummy, away from the pelvis, so that later radiotherapy does not damage them.
- Oestrogen-sensitive
- A cancer that grows faster in the presence of oestrogen. Most womb cancers are, which is one reason the ovaries are removed.
If both ovaries go
What changes, and when, after the ovaries are removed
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Nothing, if you were already past the menopause
The ovaries had largely stopped making hormones. Removing them does not restart symptoms you have already been through. This is most women having a hysterectomy for womb cancer.
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The first days, if you were still having periods
Hot flushes, sweats and disturbed sleep can begin within days of the operation, because the hormone level falls at once. Tell the ward team. It is expected, and it is not a sign that something has gone wrong.
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The first months
Mood changes, vaginal dryness and tiredness are common. Some women are offered hormone replacement; for some cancers it is not advised. Whether it is right for you depends on the type of cancer, so ask your oncologist rather than a chemist.
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The years after
Bone thinning and heart risk rise a little earlier than they would have. Weight-bearing exercise, enough calcium and vitamin D, not smoking, and a bone density scan when advised all help. This is planned care, not something to fear.
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Commonly believed
Four things families tell us about the ovaries
"Take everything out. It is safer to have nothing left."
For some cancers that is exactly right. For a young woman with early cervical cancer, removing healthy ovaries brings the menopause forward by years for no gain against the cancer. Safer depends on the cancer, not on how much is removed.
"Without her ovaries she will not be a woman any more."
The ovaries make hormones; they do not make a woman. The changes are real, and they can be treated. Women who have had their ovaries removed work, raise families, have sex and live full lives.
"If the ovaries are kept, the cancer will come back in them."
The team keeps ovaries only when the cancer is unlikely to involve them, and you are followed up afterwards. Where the risk is real, they are removed. Keeping them is a judgement made for your case, not a corner cut.
"Hormone tablets after cancer are always dangerous."
It depends on the cancer. After some cancers hormone replacement is not advised. After others, including many cervical cancers, it can be used and makes a big difference to daily life. This is a question for your oncologist.
Did you know
Many ovarian cancers are now thought to begin in the fallopian tube, not the ovary. That is why surgeons remove the tubes whenever they remove the ovaries, and sometimes remove the tubes alone even when the ovaries are kept.
Being straight with you
What this page cannot tell you
This page cannot tell you whether your ovaries should be removed. That depends on the type and stage of your cancer, your age, whether you have reached the menopause, your family history and what matters to you. It is a decision for you and your surgical oncologist.
Who keeping the ovaries does not suit
Keeping the ovaries is not offered for ovarian or tube cancer, for most womb cancers after the menopause, for higher-grade or advanced womb cancers, or for women with a gene change that raises ovarian cancer risk. There, removing the ovaries is part of treating the cancer.
What to ask before you sign
Ask directly: are my ovaries and tubes being removed? If yes, ask why, and what the menopause will mean for you. If no, ask what the follow-up plan is for them. If radiotherapy may follow, ask whether the ovaries can be moved out of the way. If you are young, ask about hormone replacement and, where it matters to you, about egg freezing before the operation.
If the consent form lists BSO and nobody has explained it, do not sign until someone has.Questions we are asked
Common questions about the ovaries and hysterectomy
If my ovaries are kept, will I still have periods?
No. Periods come from the lining of the womb, and the womb has been removed. Your ovaries will carry on making hormones as before, so you will not have menopause symptoms, but you will have no bleeding. You will reach the natural menopause at about the age you would have anyway.
Can I keep one ovary and lose the other?
Sometimes. If one ovary looks abnormal on the scan or during the operation, the surgeon may remove that one and keep the other, provided the cancer type allows it. One healthy ovary makes enough hormone to avoid the menopause. Ask your surgeon whether this is part of the plan for you.
I am fifty-eight. Does removing my ovaries matter?
Very little, in terms of hormones. After the menopause the ovaries have mostly stopped working, so removing them does not bring on symptoms you have already had. For womb cancer at your age they are almost always removed, because keeping them gives little and risks leaving cancer behind.
Can I take hormone replacement after my ovaries are removed?
It depends on the cancer. After cervical cancer it is usually fine. After some womb cancers your oncologist may advise against it, because the cancer was hormone-driven. Do not start or stop any hormone medicine on your own; ask the oncologist who knows your pathology report.
What does "ovaries look normal" on my scan report mean?
It means the scan saw nothing unusual in their size or appearance. It is reassuring, but a scan cannot see microscopic cancer cells. That is why, for womb cancer, the ovaries are usually removed and examined by the pathologist even when the scan is normal.
Will removing the ovaries change how I feel about sex?
It can, mainly through vaginal dryness and a drop in desire after a sudden menopause. Both can be treated, with moisturisers, local treatments and sometimes hormone replacement. Raise it with your team; it is a normal medical question.
Will I get an ovarian cancer later if they are kept?
The risk is low for most women, and lower still if the fallopian tubes are removed at the same time. It is higher if you carry a BRCA gene change or have a strong family history, which is why those women are usually advised to have the ovaries removed. Ask whether genetic testing applies to you.
Can we decide about the ovaries on the day of surgery?
Please do not leave it that late. The decision should be made and written on the consent form before you are admitted, with time to ask questions. The surgeon may still change the plan if something unexpected is found during the operation, and the form will say what you have agreed to.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Sources
- NHS — Hysterectomy
- Cancer Research UK — Surgery for womb cancer
- Cancer Research UK — Surgery for cervical cancer
- Macmillan Cancer Support — Hysterectomy
- National Cancer Institute — Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ) Patient Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Keeping Your Ovaries: When It Is PossibleThe other side of this decision, in detailHormones after hysterectomyWhat a surgical menopause feels like and how it is managedHysterectomy in young womenFertility, hormones and the questions to ask earlyHysterectomy for Cancer: What the Operation InvolvesEvery part that may be removed, and whyThe Pathology Report After SurgeryWhat the report says about the ovaries once examined
Talk to us
Is BSO on your consent form and nobody has explained it?
Send us the form or the biopsy report, or call the helpline. A surgical oncologist will explain what is planned for the ovaries and why. One helpline serves every CION centre.