Oophorectomy in Chicago — Removing an Ovary, and When Not To

An oophorectomy removes an ovary. Unilateral means one ovary; bilateral means both. When a fallopian tube is removed at the same time, the operation is called a salpingo-oophorectomy.

The distinction between one and both matters enormously. Removing one ovary usually leaves your hormones intact — the remaining ovary carries on. Removing both before natural menopause stops ovarian hormone production the same day, and that has consequences across your whole body, not just your cycle.

This page is direct about those consequences, because women are often not told about them until afterward.

Why an oophorectomy is done

Clear indications:

Ovarian cancer, or a mass with features that suggest it
Ovarian torsion where the ovary is no longer viable — an emergency
A high-risk genetic mutation such as BRCA1 or BRCA2, where risk-reducing removal of tubes and ovaries substantially lowers ovarian cancer risk. This is a planned decision made with genetic counseling and timed to your mutation and age.
Severe pelvic infection with a tubo-ovarian abscess that has not responded to antibiotics

Situations where it is often discussed but should be questioned:

A large or persistent benign ovarian cyst — an ovarian cystectomy that removes the cyst and keeps the ovary is frequently possible
Endometriomas — pain from endometriosis rarely requires removing both ovaries in a woman who has not reached menopause
Chronic pelvic pain attributed to the ovaries without a clear structural cause
**"While we're in there" removal during hysterectomy** — this is the most important one. Removing the uterus does not require removing healthy ovaries, and doing so routinely is no longer supported practice.

The consequences of removing both ovaries before menopause

If you have not yet gone through natural menopause, bilateral oophorectomy causes surgical menopause immediately. There is no gradual transition. Hormone levels drop within hours rather than over years.

What you feel:

Hot flashes and night sweats, typically more abrupt and more intense than in natural menopause
Vaginal dryness and pain with intercourse
Sleep disturbance
Reduced libido, partly from the loss of ovarian testosterone production
Mood changes and difficulty concentrating
Permanent loss of fertility

What you do not feel, but that matters just as much:

Bone loss. Estrogen protects bone. Losing it early accelerates bone density loss and raises the long-term risk of osteoporosis and fracture.
Cardiovascular risk. Losing ovarian estrogen well before the natural age of menopause is associated with increased cardiovascular risk over the following decades.
Cognitive and overall health effects. Research links early bilateral oophorectomy without hormone therapy to worse long-term outcomes in several domains.

Because of all this, current practice supports ovarian conservation in benign disease for women who have not reached menopause, unless there is a specific reason to remove the ovaries. If a bilateral oophorectomy is recommended alongside another operation, ask what the specific indication is for your ovaries — not for the primary surgery.

A separate note: removing the fallopian tubes while keeping the ovaries (opportunistic salpingectomy) appears to reduce ovarian cancer risk without causing surgical menopause. It is a reasonable middle path for many women having pelvic surgery, and worth asking about.

Hormone therapy after surgical menopause

For women who undergo bilateral oophorectomy before the natural age of menopause and who have no contraindication, systemic hormone therapy is generally recommended — typically continued until around the average age of natural menopause — to manage symptoms and to protect bone and cardiovascular health. Women with a personal history of hormone-sensitive cancer, or with other contraindications, need an individualized plan and there are non-hormonal options.

This should be planned before surgery, not improvised afterward. See menopause management and hormone replacement therapy.

Removing one ovary

Unilateral oophorectomy is a very different proposition. The remaining ovary generally continues producing hormones and ovulating, cycles usually continue, and menopause typically arrives at close to the expected time — sometimes slightly earlier. Fertility is reduced but usually preserved. Surgical menopause does not occur.

The approaches

Laparoscopic or robotic-assisted. Small incisions, camera guidance, same-day discharge for most patients. This is the standard approach for benign disease. See laparoscopy.

Vaginal. Sometimes possible when done together with a vaginal hysterectomy.

Open (laparotomy). Reserved for large masses, suspected cancer where the specimen must be removed intact, dense adhesions, or emergencies.

Minimally invasive surgery is preferred where it is safe and feasible.

What to expect

Before. Pelvic ultrasound, sometimes MRI, and blood tests that may include tumor markers when a mass is being evaluated. If cancer is suspected, referral to a gynecologic oncologist is appropriate. Medications reviewed, blood thinners stopped as directed, nothing to eat or drink after midnight. If both ovaries are coming out and you are premenopausal, settle your hormone plan at this visit.

During. General anesthesia. A laparoscopic oophorectomy commonly takes about one to two hours; longer with adhesions or when combined with other procedures. The ovary is detached from its blood supply and ligaments and removed, usually in a containment bag.

After. Incision soreness, bloating, and shoulder pain from the carbon dioxide used in laparoscopy. Most patients go home the same day. If both ovaries were removed and you were premenopausal, hot flashes can begin within days.

Recovery timeline

Days 1–3: soreness and gas discomfort peak. Walk frequently — it helps both the gas and clot prevention.
Days 3–7: steady improvement; driving once off narcotic pain medication.
1–2 weeks: most patients return to desk work after laparoscopic surgery.
2–4 weeks: normal activity and light exercise; avoid lifting more than ten to fifteen pounds until cleared.
4–6 weeks: full activity and intercourse, and longer after open surgery, which commonly means six to eight weeks.
First 3 months: if you had surgical menopause, this is when symptoms and hormone therapy get dialed in. Plan a follow-up specifically for that.

Risks

Bleeding and infection
Injury to bowel, bladder, ureters, or blood vessels
Blood clots in legs or lungs
Anesthesia complications
Conversion from laparoscopic to open surgery
Adhesion formation
Surgical menopause and its long-term bone, cardiovascular, sexual, and cognitive effects when both ovaries are removed before natural menopause
Permanent infertility with bilateral removal
Ovarian remnant syndrome — rare, where a small amount of ovarian tissue is left behind and causes ongoing pain

Contact us urgently for fever over 100.4°F, worsening abdominal pain, heavy bleeding, incision drainage, chest pain, difficulty breathing, or calf pain and swelling.

Alternatives to consider first

Observation with repeat imaging. Many ovarian cysts resolve on their own within one or two cycles.
Ovarian cystectomy. Removes the cyst and preserves the ovary — the preferred option for benign cysts in premenopausal women whenever technically possible.
Hormonal suppression for endometriomas or recurrent functional cysts.
Unilateral rather than bilateral removal, when only one ovary is diseased.
Salpingectomy alone, keeping the ovaries, for risk reduction in average-risk women.
Timing. For risk-reducing surgery in a BRCA carrier, the recommended age range is specific to the mutation. It is a scheduling decision made with a genetic counselor, not an urgent one.

Book a consultation

Dr. Adeeb Alshahrour, MD, FACOG, is a board-certified obstetrician-gynecologist at the Women's Health Center of Chicago, 4009 W Fullerton Ave. If ovary removal has been raised with you — on its own or as part of another operation — a consultation will clarify whether it is genuinely indicated, whether one ovary or the ovary-sparing option would serve you better, and what your hormone plan should look like if both do have to come out.

Book a consultation, see our locations, or read about Dr. Alshahrour and our gynecological surgery services.

Medical disclaimer

This page is general education and is not a substitute for personal medical advice. Whether an oophorectomy is appropriate — and whether one or both ovaries should be removed — depends on your diagnosis, age, genetic risk, and health history, and can only be determined by a licensed physician who has evaluated you. Seek emergency care for sudden severe pelvic pain, high fever, chest pain, or difficulty breathing.