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Preventive ovary and tube removal: when is it done? | CION Cancer Clinics
The usual age for preventive removal of the ovaries and tubes depends on your gene. For BRCA1 carriers, guidelines usually suggest between 35 and 40; for BRCA2 carriers, often between 40 and 45, once childbearing is complete. This page explains why timing matters, how it differs by gene, what an early menopause brings, and what only your own team can decide. 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
- At what age is preventive ovary removal usually done?
- How does timing differ between gene faults?
- What happens when surgery brings on the menopause?
- Having it at the usual age, or waiting longer?
- Four things families tell us, and what is actually true
- Words you will see, in plain language
- Who might it not suit yet, and what can this page not tell you?
- Common questions about the timing of preventive ovary removal
The short answer
At what age is preventive ovary removal usually done?
It depends on the gene. For BRCA1 carriers, guidelines usually suggest removing the ovaries and tubes between 35 and 40, once childbearing is complete. For BRCA2 carriers, whose ovarian risk rises later, it is often delayed to between 40 and 45.
Why the timing matters so much
Ovarian cancer is hard to find early. No scan or blood test has been shown to catch it reliably in carriers, so checks are not a strong alternative the way they are for the breast. That makes surgery the main way to lower the risk. But removing the ovaries before a natural menopause brings one on straight away, with effects on the bones, the heart, sleep and sex. The timing tries to remove the ovaries before the risk climbs, and not years earlier than needed.
Why the tubes are removed too
Many of the most serious ovarian cancers in carriers are now thought to start in the fallopian tube, not the ovary itself. So the operation removes both. You may see it written as a salpingo-oophorectomy, which simply means removal of the tubes and ovaries.
These ages are what guidelines usually suggest. Your team will set your own timing around your gene, your family and your plans.By gene
How does timing differ between gene faults?
Each gene raises ovarian risk by a different amount and at a different age, which is why one timing does not fit all.
BRCA1
The highest ovarian risk, 39%–44% over a lifetime, compared with about 1.2% in the general population. It starts to rise earliest, so surgery is usually discussed first.
BRCA2
A lifetime ovarian risk of 11%–17%, rising later than with BRCA1. This is why surgery is often timed a few years later.
Lynch syndrome
Raises the chance of womb cancer as well as ovarian cancer. Removing the womb, tubes and ovaries together is usually discussed once childbearing is complete.
Other genes
Faults in genes such as RAD51C, RAD51D and BRIP1 raise ovarian risk less, and later. Surgery is usually discussed at an older age, and the evidence is thinner.
Not sure whether this applies to you?
Ask an oncologistWhat changes afterwards
What happens when surgery brings on the menopause?
If you have not reached a natural menopause, the operation starts one the same day. It is often more sudden than a natural menopause, because the hormones stop at once rather than tailing off over years.
What you may notice
Hot flushes and night sweats, poor sleep, vaginal dryness, lower interest in sex, mood changes and trouble concentrating. Over the longer term, bones thin faster and the heart loses some of the protection oestrogen gave it.
Hormone replacement therapy
For carriers who have not had breast cancer, hormone replacement therapy (HRT) is often suggested until around the age a natural menopause would have come. For women who have had a hormone-sensitive breast cancer, HRT is usually avoided and other ways of managing symptoms are used instead. Only your doctors can set this. Never start or stop HRT, or any other medicine, on your own.
Ask for a plan for bone health and menopause symptoms before the operation, not after.Side by side
Having it at the usual age, or waiting longer?
At the usual age for your gene
Waiting beyond it
Lowers ovarian risk before it climbs steeply
Risk keeps rising with each year, with no reliable check to catch it
Brings on menopause earlier than nature would
Keeps natural hormones for longer
Ends the chance of pregnancy with your own eggs
Leaves time to complete a family
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Commonly believed
Four things families tell us, and what is actually true
"A yearly scan and CA-125 blood test will catch it early enough."
For the breast, checks work well. For the ovary they have not been shown to find cancer early enough to rely on in carriers. That is the main reason surgery is discussed at all.
"The earlier the better, so she should have it done now, in her twenties."
Ovarian risk in carriers is low in the twenties and rises later. Removing the ovaries years before that brings years of early menopause without much extra benefit. Timing is set by the gene, not by fear.
"Removing the ovaries will make her old overnight."
It brings on menopause symptoms, and these can be strong. For many carriers HRT eases them a great deal. It does not change who she is, and good planning before surgery makes a real difference.
"Taking out only the tubes is just as good and saves the hormones."
Removing the tubes first and the ovaries later is being studied, and some centres offer it within research. It is not yet the standard, and the team will explain what is and is not known.
On your letter
Words you will see, in plain language
- RRSO
- Risk-reducing salpingo-oophorectomy: removal of both tubes and both ovaries to lower cancer risk. Usually done by keyhole surgery.
- Surgical menopause
- A menopause brought on by removing the ovaries, rather than one that comes naturally with age.
- Salpingectomy
- Removal of the tubes only, keeping the ovaries for now. Being studied as a first step for some carriers.
- Peritoneal cancer
- A cancer of the thin lining inside the abdomen, closely related to ovarian cancer. A small risk remains after surgery.
- Occult cancer
- A very small cancer found only when the removed tubes and ovaries are examined under the microscope. Uncommon, but the reason every sample is checked.
Being straight with you
Who might it not suit yet, and what can this page not tell you?
It may not suit a woman who has not finished having children and is still well before the usual age for her gene. Egg or embryo freezing can sometimes help, and the team can refer you to talk about it. It may also not suit someone with another illness that makes surgery risky, or someone who does not carry a fault that raises ovarian risk.
Questions to take to the appointment
What is the usual timing for my gene, and why? What would waiting mean for my risk? Can the womb be removed at the same time, and should it? What will you do about menopause symptoms and bone health? Is the tissue examined for hidden cancer afterwards?
What this page cannot do
It cannot set your timing or tell you whether to have the operation. It cannot tell you what it will cost you, because cover under Aarogyasri, CGHS, ECHS, EHS or a cashless insurer changes that. Your genetics team, your surgeon and you decide together.
Questions we are asked
Common questions about the timing of preventive ovary removal
I am past the usual age and have not had it done. Is it too late?
No. Risk keeps rising with age, so surgery still lowers it, even though some of the earlier years have passed. Tell your team, who may also check that nothing has already started before planning the operation. It is a common situation, and it is worth raising rather than avoiding.
Is it keyhole surgery?
Usually, yes. The tubes and ovaries are removed through a few small cuts in the tummy, and many women go home the same day or the next. Open surgery is sometimes needed, for example after previous operations. Ask your centre what approach they would use for you and why.
Should my womb be removed at the same time?
For Lynch syndrome carriers, usually yes, because womb cancer is one of the main risks. For BRCA carriers it is not routine, though some women discuss it, particularly if it would make HRT simpler. Ask your team to explain what they recommend for your gene and why.
Can I still get pregnant afterwards?
Not with your own eggs once the ovaries are removed. If you have not finished your family, talk to the team before deciding on timing. Egg or embryo freezing may be possible, and pregnancy using stored embryos can still happen if the womb is kept.
Will HRT raise my breast cancer risk?
For BRCA carriers who have not had breast cancer, studies so far suggest HRT taken until the age of a natural menopause does not add much risk. The evidence is still limited. If you have had breast cancer, the advice is different. Only your doctors can decide this with you.
Will I still need checks after the operation?
Ovary checks are no longer needed. Breast checks continue if you still have your breasts, and bone health checks may be advised because of the early menopause. Report any new swelling or pain in the tummy, because a small risk in the lining of the abdomen remains.
What if a cancer is found in the removed tissue?
This is uncommon, and it is why every sample is examined under the microscope. If a small cancer is found, your team will explain what it means and whether further treatment is needed. Finding it this way usually means it was found early.
Is it covered by Aarogyasri or insurance?
Cover varies and is best checked before anything is booked. Some schemes and insurers cover the operation when a gene fault is documented. Bring your Aarogyasri, CGHS, ECHS or EHS card, or your policy, to the first consultation and the helpline will check your specific cover.
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Sources
- National Cancer Institute — BRCA Gene Changes: Cancer Risk and Genetic Testing
- National Cancer Institute — Genetics of Breast and Gynecologic Cancers (PDQ)
- NHS — Ovarian cancer
- NHS — Menopause
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
Risk-Reducing Hysterectomy in Lynch SyndromeWhen the womb is removed along with the tubes and ovariesHow Much Does Risk Actually Fall After Surgery?What the operation takes away, and what risk remainsGenetic Testing Before Preventive SurgeryThe result that sets your timingDeciding When You Do Not Have Cancer YetWeighing a permanent choice while you are well
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