Medical Oncologist
CION Cancer Clinics
Oophorectomy in young women: what it changes and what to weigh | CION Cancer Clinics
Removing both ovaries before the natural menopause stops the body's main supply of oestrogen at once. Periods end, natural pregnancy is no longer possible, and menopause symptoms can begin within days. Bones, heart, mood and sex are affected over the years that follow. Every one of these has a plan. This page sets out what changes, what helps, and what to ask before you agree. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What does removing the ovaries do to a young woman?
- What changes after both ovaries are removed young
- What your team weighs before recommending it
- Words you will meet, in plain language
- Three things families say, and what is actually true
- What to ask, and what this page cannot tell you
- Common questions about ovary removal in young women
The short answer
What does removing the ovaries do to a young woman?
Removing both ovaries before the natural menopause switches off the body's main supply of oestrogen overnight. That means periods stop, you can no longer become pregnant naturally, and menopause symptoms can start within days rather than over years. Removing one ovary does none of these things, because the ovary left behind keeps working.
Why age changes the conversation
After the natural menopause the ovaries have already stopped making hormones, so removing them changes little day to day. In a woman in her twenties or thirties, the same operation takes away years of oestrogen that the bones, heart and brain were relying on. The operation is the same. What it costs the body is not.
Why it is still recommended
Surgeons recommend it for a young woman only when the reason is strong: a cancer in the ovary, a cancer elsewhere that oestrogen feeds, or an inherited gene fault such as BRCA1 or BRCA2 that carries a high lifetime chance of ovarian cancer. In each case the team is weighing a known harm from the operation against a serious risk from leaving the ovaries in place.
This page cannot tell you whether the operation is right for you. It can tell you what to ask before you agree.What to weigh
What changes after both ovaries are removed young
Every one of these has something that can be done about it. None of them is a reason to hide the change from your family.
Sudden menopause
Hot flushes, night sweats, poor sleep and vaginal dryness can begin within the first week. Because the hormone drop is abrupt rather than gradual, the symptoms are often stronger than a natural menopause at first, and then settle over months.
Hormone replacement, where your cancer allows it, eases most of this.Bones
Oestrogen protects bone. Losing it early means bone thinning can start decades sooner than it otherwise would. It is silent until a bone breaks, so it is planned for: a baseline bone density scan, calcium, vitamin D, weight-bearing exercise and bone medicines if needed.
Heart and blood vessels
Early loss of oestrogen is linked with a higher chance of heart disease later in life. Blood pressure, cholesterol, blood sugar and weight are worth checking every year from now on.
Fertility
Natural pregnancy is no longer possible once both ovaries are gone. If children matter to you, ask about freezing eggs or embryos before the operation. A womb left in place can still carry a pregnancy from a frozen embryo or a donor egg.
Mood, memory and sex drive
Low mood, brain fog and loss of interest in sex are common in the first months. They are hormonal as much as emotional, and they are treatable. Say so early.
Not sure whether this applies to you?
Ask an oncologistHow the decision is made
What your team weighs before recommending it
Why the ovaries need to go
A cancer in the ovary, a hormone-fed cancer elsewhere, or a gene fault with a high lifetime risk. The strength of this reason sets how much room there is for delay or for keeping one ovary.
Whether one ovary can stay
For some early cancers in one ovary, and for some non-cancer conditions, the other ovary can be left. This keeps hormones and fertility. It is not possible where the reason is an inherited gene fault, because both ovaries carry the same risk.
Whether hormone replacement will be allowed
If the cancer is not fed by oestrogen, hormone replacement after surgery softens most of what is on this page. If the cancer is hormone-driven, it usually cannot be given, and the plan for bones, heart and symptoms has to work without it.
Whether there is time for fertility preservation
Egg or embryo freezing takes a short cycle of injections and one collection procedure. Your surgeon will say whether the cancer can safely wait that long. Sometimes it cannot, and you should be told which.
On your letter
Words you will meet, in plain language
- Oophorectomy
- Removal of an ovary. Unilateral means one side; bilateral means both. Only bilateral removal causes menopause.
- Salpingo-oophorectomy
- Removal of the fallopian tube together with the ovary on that side. The tube is taken because many ovarian cancers are now known to begin in the tube.
- Surgical menopause
- Menopause caused by removing both ovaries, rather than by age. It starts at once and its symptoms are often sharper at first.
- Premature ovarian insufficiency
- The medical name for the ovaries stopping before the age of forty, whatever the cause. You may see it on a letter about bone or heart follow-up.
- HRT
- Hormone replacement therapy. Oestrogen, with or without progesterone, given to replace what the ovaries made. Whether you can take it depends on the type of cancer.
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Commonly believed
Three things families say, and what is actually true
"She is young, so she will bounce back faster than
an older woman."
The wound heals faster, yes. The hormone loss is harder, not easier, because a younger body was relying on oestrogen for far longer. Plan for the months after surgery, not only for the week in hospital.
"Hormone tablets after cancer surgery are
dangerous, so she should not take them."
That depends entirely on the type of cancer. For many young women whose cancer is not hormone-fed, replacement until the age of natural menopause is recommended for the bones and heart. Ask the surgeon directly rather than assuming.
"Once the ovaries are gone, children are out of
the question."
Natural pregnancy is. Pregnancy using eggs or embryos frozen before surgery, or a donor egg, is often still possible if the womb is kept. The conversation has to happen before the operation, which is why it is on this page.
Did you know
For women with an inherited gene fault who are not ready for menopause, the tubes can sometimes be removed first and the ovaries later. This is still being studied and is not right for everyone, but it is a fair question to raise.
Being straight with you
What to ask, and what this page cannot tell you
This page cannot tell you whether your ovaries should be removed, or when. That depends on the reason for surgery, your gene result if you have one, and how you weigh fertility against risk. It can tell you what to put on the table.
Questions worth taking in writing
Does one ovary need to come out, or both? Can hormone replacement be given afterwards, and until what age? Is there time for egg or embryo freezing, and who arranges the referral? Who will look after my bones and heart in the years to come? Write the answers down.
Who this operation does not suit
Removing both ovaries is not a treatment for ordinary period pain, cysts that are clearly benign, or a family worry that has not been tested. A woman with one relative with ovarian cancer and no gene test has not reached the point where this operation is discussed. Genetic counselling comes first.
What happens next
If the operation is for a cancer, the next step is usually a meeting where the surgeon explains the plan. If it is to reduce an inherited risk, the next step is usually a genetic counsellor. Either way, bring the person who will care for you afterwards.
If something on this page has raised a question, call the helpline before the day.Questions we are asked
Common questions about ovary removal in young women
Will I go into menopause straight away?
If both ovaries are removed and you have not yet been through the menopause, yes. Symptoms can begin within days because the hormone supply stops at once. If only one ovary is removed, the other keeps making hormones and your periods usually carry on as before.
Can I still have children afterwards?
Not naturally, once both ovaries are gone. If the womb is kept, a pregnancy using eggs or embryos frozen before surgery, or a donor egg, can still be possible. This has to be arranged before the operation, so raise it at the very first appointment rather than afterwards.
Is hormone replacement safe after ovarian cancer?
It depends on the exact type of cancer. For many ovarian cancers and for women having preventive surgery, hormone replacement until the usual age of menopause is often recommended. For hormone-fed cancers, including many breast cancers, it is usually avoided. Your oncologist will say which applies to you.
Will my bones definitely weaken?
Bone loss is expected without oestrogen, but how much and how fast varies. A bone density scan soon after surgery gives a starting point. Calcium, vitamin D, walking and strength exercise, and bone-protecting medicines where needed, keep most women well. It is a plan, not a sentence.
Why not keep one ovary to avoid all this?
Where it is safe, surgeons do. For some early cancers confined to one ovary, and for many benign conditions, the other ovary stays. Where the reason is an inherited gene fault, or the cancer is hormone-driven, leaving an ovary keeps the very risk the operation is meant to remove.
How long will the menopause symptoms last?
The sharpest phase is usually the first few months. Flushes and sweats tend to ease over the following year or two, faster with treatment. Vaginal dryness and bone loss do not ease on their own, which is why they are managed rather than waited out.
Will it change how I look or feel as a woman?
The operation leaves small scars and nothing visible from outside. Skin, hair and weight can change with the hormone drop, and so can sex drive. These are real, they are common, and they are treatable. A counsellor who works with cancer patients is worth asking for.
Should my daughter be tested for the gene too?
If your surgery is because of an inherited gene fault, close relatives can be offered a blood test through a genetic counsellor. Testing is usually not done in childhood, because nothing is acted on until adulthood. Ask the counsellor who is looking after you which relatives should be seen.
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Dr. Vinay Mamidala
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Sources
- NHS — Early menopause
- Cancer Research UK — Surgery for ovarian cancer
- National Cancer Institute — BRCA Gene Changes: Cancer Risk and Genetic Testing
- National Cancer Institute — Fertility Issues in Girls and Women with Cancer
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.
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