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CION Cancer Clinics
One ovary or both: what decides | CION Cancer Clinics
Whether one ovary or both are removed depends mainly on why you are having surgery, whether you have reached menopause, what the other ovary looks like, and whether you want children. Keeping one healthy ovary usually keeps your hormones and periods going. Removing both brings menopause at once if it has not already happened. This page explains what your team weighs and what to ask before you sign. 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
- What decides whether one ovary or both are removed?
- What does your surgical team weigh before deciding?
- How does removing one ovary compare with removing both?
- How is the decision made before and during the operation?
- What do the words on your form mean?
- What do families often believe about this choice?
- What should you ask before you sign the consent form?
- Common questions about removing one ovary or both
The short answer
What decides whether one ovary or both are removed?
The biggest factor is the reason for the operation. A single harmless-looking cyst in a younger woman is often dealt with by removing one ovary, or only the cyst, while a suspected cancer, an inherited gene fault or surgery after menopause usually means both.
Why keeping one ovary matters
A single healthy ovary makes enough hormones for the body on its own. Periods usually continue, menopause arrives at around the usual age, and natural pregnancy is still possible. That is why surgeons try to keep healthy ovarian tissue in women who have not reached menopause, when it is safe to do so.
Why both are sometimes removed
If cancer is found or strongly suspected, leaving an ovary behind can leave disease behind. If you carry a BRCA1 or BRCA2 fault, the remaining ovary carries the same raised risk as the one removed. After menopause, the ovaries make far less hormone, so the trade-off shifts.
What this page cannot decide
It cannot tell you which is right for you. That depends on your scans, blood tests, family history and what the surgeon finds on the day. It can tell you what the team weighs, so the conversation makes sense.
The factors
What does your surgical team weigh before deciding?
No single factor settles it. The team puts these together, and your own wishes are one of them.
The reason for surgery
A twisted ovary or a harmless-looking cyst can often be managed on one side. A lump that looks like cancer on the scan changes the plan.
What they look at
- How the lump looks on the scan
- The CA-125 blood test
- How fast the lump has grown
Whether you have reached menopause
Before menopause, removing both ovaries brings menopause straight away, with effects on bones, heart and mood. After menopause, that cost is much smaller.
The other ovary
If the other ovary looks normal on the scan and during surgery, keeping it is often reasonable. If it also looks abnormal, keeping it may not be safe.
Your gene result
A BRCA1, BRCA2 or Lynch syndrome result means both ovaries carry a raised risk. A genetic counsellor should be part of this conversation before any date is set.
Your plans for children
If you still hope to become pregnant, say so clearly and early. It can change the operation or its timing, or lead to a talk about egg freezing first.
Other treatment you are on
For some hormone-sensitive breast cancers, removing both ovaries lowers oestrogen. Medicines can do the same job, so it is a choice worth talking through.
Not sure whether this applies to you?
Ask an oncologistSide by side
How does removing one ovary compare with removing both?
One ovary (unilateral)
Both ovaries (bilateral)
Hormones and periods usually carry on
Menopause starts at once if not already reached
Natural pregnancy is usually still possible
Natural pregnancy is no longer possible
The remaining ovary may still need watching
No ovary left to watch, though a small risk remains in the lining of the abdomen
Often suits a harmless cyst or a twisted ovary in a younger woman
Often suits suspected cancer, a gene fault, or surgery after menopause
How it is settled
How is the decision made before and during the operation?
Scans and blood tests
An ultrasound, sometimes an MRI or CT, and a CA-125 blood test build a picture of how likely it is that the lump is cancer. Some centres combine these into a risk score.
The planning conversation
The surgeon explains the options, and you explain what matters to you. If a gene result or fertility is part of it, a counsellor or fertility specialist may join in.
The consent form
The form often covers more than one possibility, such as one ovary, and both if cancer is found. Read it slowly and ask what each line means before you sign.
Findings on the day
The surgeon may send tissue for a quick check while you are asleep, called a frozen section. It helps, but the full report takes longer and is more reliable.
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On your consent form
What do the words on your form mean?
- Unilateral
- One side. A unilateral oophorectomy removes one ovary.
- Bilateral
- Both sides. A bilateral oophorectomy removes both ovaries.
- Salpingo-oophorectomy
- Removal of an ovary together with its fallopian tube.
- Cystectomy
- Removal of the cyst only, leaving the rest of the ovary in place.
- Frozen section
- A quick look at tissue under the microscope during the operation. It guides the surgeon and is confirmed by the full report later.
- Ovarian conservation
- Keeping one or both ovaries when it is judged safe, to protect hormones and fertility.
Commonly believed
What do families often believe about this choice?
"Take both out while you are in there, just to be
safe."
For a woman who has not reached menopause and has no raised risk, removing a healthy ovary brings early menopause and its long-term effects on bones and heart. Safe depends on the whole picture. Ask what keeping it would actually mean for you.
"If one ovary had a cyst, the other will get one
too."
Not necessarily. Many cysts are one-off events. The other ovary is checked on the scan and during surgery, and it is kept or removed according to what is seen.
"With one ovary left, I cannot get pregnant."
One healthy ovary and tube can still release and carry eggs. Many women conceive naturally after losing one ovary. Treatment after surgery, such as chemotherapy, can affect fertility more than the operation itself, so ask about it.
"The surgeon has decided, so there is nothing to
discuss."
The surgeon brings the medical view. You bring what matters in your life. The consent conversation is where both meet, and asking for time or a second opinion is reasonable.
Before you sign
What should you ask before you sign the consent form?
Go into the appointment with your questions written down, and bring the person who will support you after surgery. Ask the surgeon to say, in plain words, which ovary or ovaries they plan to remove and why.
About the plan
Is the plan one ovary or both? What would make you change it during the operation? Will the tubes or the womb be removed as well? Is removing only the cyst an option?
About the effects
If both come out, will I go into menopause at once? Could I take hormone replacement afterwards? How will my bones and heart be looked after? If one ovary stays, how will it be checked in future?
About children and genes
Could I still become pregnant afterwards? Should I see a fertility specialist first? Should I have a gene test before surgery, and would the result change the plan?
If you are unsure what your consent form says, bring it to the helpline and someone will go through it with you.Questions we are asked
Common questions about removing one ovary or both
Will I go into menopause if only one ovary is removed?
Usually not. The remaining ovary normally makes enough hormones to keep periods and hormone levels going. Menopause may come a little earlier than it otherwise would, but the change is gradual. Menopause starts straight away only when both ovaries are removed before it would have happened naturally.
Can the surgeon change the plan while I am asleep?
Yes, if you have agreed to that possibility beforehand. This is why consent forms often list more than one option. A surgeon should not remove both ovaries unless the form covers it. Before signing, ask exactly what would make them change the plan.
I am past menopause. Is there any reason to keep an ovary?
The hormone benefit is smaller after menopause, which is why both are often removed. Some doctors still weigh a small benefit from the hormones older ovaries make. It is a reasonable question to ask, especially if there is no suspicion of cancer and no gene fault.
Can I just have the cyst removed instead?
Sometimes. For a younger woman with a cyst that looks harmless, removing only the cyst keeps the ovary. It is not advised when the scan or blood tests suggest cancer, because opening a cancerous cyst can spill cells. Ask what the scan suggests and whether cyst removal alone is possible.
Does keeping one ovary raise my cancer risk?
For most women with no gene fault, the risk from keeping a healthy ovary is low. For BRCA carriers, the kept ovary carries the same raised risk, which is why both are usually advised once childbearing is finished. Your gene result and family history matter most, so ask a genetic counsellor.
What if the report finds cancer in the removed ovary?
Then a second operation may be suggested to remove the other ovary and check the abdomen more fully, and further treatment may be discussed. This is uncommon when surgery was planned for a harmless-looking cyst. Your surgeon will go through the report and the options with you.
Will I still be able to have children?
With one healthy ovary, tube and womb, natural pregnancy is usually possible. If both ovaries are removed, it is not, although pregnancy using donor eggs or frozen eggs or embryos may be possible if the womb is kept. If children are still wanted, raise it before surgery.
Does recovery take longer if both are removed?
Recovery from the wounds depends mostly on whether the surgery is keyhole or open, not on how many ovaries are removed. What differs is menopause: if both come out before it, the symptoms are a longer part of recovery. Ask your surgeon for a timeline for your own operation.
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Dr. C. Raghavendra Reddy
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- NHS — Ovarian cyst
- Cancer Research UK — Surgery for ovarian cancer
- American Cancer Society — Surgery for Ovarian Cancer
- National Cancer Institute — BRCA Gene Changes: Cancer Risk and Genetic Testing
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
Oophorectomy: What the Operation InvolvesThe day itself, from admission to going homeFertility After Ovary RemovalWhat each choice means for having childrenOvarian Cyst Removal vs Ovary RemovalWhen removing only the cyst is possibleSurgical Menopause: What Happens OvernightWhat changes if both ovaries come outDeciding on Cancer SurgeryHow to weigh any operation with your team
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