A person can live without ovaries, as these organs are not necessary for basic survival functions. The ovaries are small, almond-shaped reproductive glands with two primary roles: producing eggs for reproduction and generating the sex hormones estrogen and progesterone, along with small amounts of testosterone. The surgical removal of one or both ovaries is known as an oophorectomy. When both ovaries are removed, the body immediately loses its primary source of these essential hormones, leading to significant systemic changes.
Why Ovaries Are Removed
The surgical removal of one or both ovaries is typically performed to address specific diseases or to significantly reduce the risk of future cancers. This procedure, often part of a larger surgery called a salpingo-oophorectomy which includes the fallopian tubes, is a treatment option for various gynecological conditions.
One common indication is disease management for conditions like severe endometriosis, or for large, complex, or recurring ovarian cysts. It may also be necessary to treat a tubo-ovarian abscess, which is a pus-filled infection involving the ovary and fallopian tube, or in cases of ovarian torsion, where the ovary twists around its blood supply.
Oophorectomy is a standard treatment for ovarian cancer but is also used in the management of certain breast cancers to eliminate the body’s main source of estrogen, which can fuel hormone-sensitive tumors. Furthermore, many procedures are prophylactic, meaning they are performed to reduce risk in people with specific genetic mutations. Individuals with BRCA1 or BRCA2 gene mutations, which carry a substantially increased lifetime risk of developing ovarian and breast cancer, often elect for risk-reducing oophorectomy.
Immediate Effects: Surgical Menopause
The most immediate effect of removing both ovaries before natural menopause is the abrupt onset of surgical menopause. Unlike natural menopause, which occurs gradually as hormone production slowly declines, surgical menopause causes an immediate cessation of ovarian estrogen and progesterone production. This sudden hormonal withdrawal often results in more severe and acute symptoms compared to a natural transition.
The rapid drop in estrogen levels triggers intense vasomotor symptoms, commonly known as hot flashes and night sweats, which can be disruptive to daily life and sleep. Sexual health is also immediately affected, as the lack of estrogen can cause vaginal dryness, thinning of tissues, and discomfort during intercourse, alongside a potential decrease in libido.
The sudden hormonal shift can also impact mood and psychological well-being. Many individuals experience heightened mood swings, irritability, anxiety, or depression shortly after the surgery. The abruptness of the change, rather than the hormone loss itself, is thought to contribute to the increased severity of these symptoms.
Long-Term Health Risks
The long-term absence of ovarian hormones, particularly estrogen, has systemic consequences, especially if the oophorectomy occurs before the average age of natural menopause (around 51 years). Estrogen is a protective hormone for several body systems, and its premature loss is associated with chronic health conditions.
Skeletal health is significantly affected because estrogen plays a regulatory role in maintaining bone density. Its withdrawal accelerates bone turnover, leading to an increased risk of developing osteoporosis and subsequent fractures, such as hip fractures. This risk is especially pronounced in younger women who lose their ovaries.
Cardiovascular health also faces increased risk due to the loss of estrogen’s protective effects on blood vessels. Premenopausal women who undergo bilateral oophorectomy may have an elevated risk of developing coronary heart disease and stroke. The increased risk of cardiovascular events and all-cause mortality is particularly noted when the surgery is performed before age 45 and is not managed with hormone therapy.
The loss of ovarian hormones is also associated with an elevated risk of cognitive impairment, dementia, and Parkinsonism later in life. This suggests that estrogen plays a complex and protective role in brain function that is lost when the ovaries are removed prematurely.
Managing Life and Hormonal Replacement
Managing life without ovaries centers on mitigating the acute symptoms of surgical menopause and reducing the long-term health risks associated with sustained estrogen deficiency. Hormone Replacement Therapy (HRT) is the most effective approach for achieving these goals, particularly for those who undergo oophorectomy before the age of 50 or 51.
HRT involves replacing the lost estrogen, often using a transdermal patch or oral pill, to restore hormone levels to a premenopausal range. If the person still has their uterus, a progestin must be included alongside the estrogen (combined therapy). If the uterus has been removed, estrogen-only therapy is prescribed. HRT is generally recommended until the age of natural menopause to protect against bone loss and cardiovascular risks.
For individuals who cannot or choose not to use HRT, such as those with certain hormone-sensitive cancers, non-hormonal strategies are utilized. Lifestyle modifications, including regular weight-bearing exercise and a diet rich in calcium and Vitamin D, are important for supporting bone health. Certain non-hormonal medications may also be used to manage vasomotor symptoms.
Regular medical monitoring is essential for long-term health. This includes routine screening for cardiovascular risk factors, such as blood pressure and cholesterol, and periodic checks of bone density using a DEXA scan. Close follow-up ensures the chosen management plan is optimized for both symptom control and disease prevention.