Ovarian ablation is a medical procedure designed to stop or significantly reduce the function of the ovaries. This intervention aims to lower the production of hormones, particularly estrogen, which are primarily produced by the ovaries in premenopausal women. The term “ovarian suppression” is also used to describe this treatment.
What Ovarian Ablation Addresses
Ovarian ablation is primarily considered for medical conditions where reducing estrogen levels benefits the patient. A common application is in the treatment of hormone receptor-positive breast cancer in premenopausal women. Lowering estrogen can help shrink tumors, prevent their spread, and reduce the likelihood of recurrence.
This procedure may also be recommended for individuals at high genetic risk of developing ovarian cancer, such as those with a BRCA gene mutation or a strong family history. In such cases, it can be performed as a risk-reducing measure. While breast cancer is the most common indication, ovarian ablation can also be considered for severe cases of endometriosis or adenomyosis when other treatments have not been effective.
How Ovarian Ablation is Performed
Ovarian ablation can be achieved through several distinct methods.
Surgical Methods
Surgical removal of the ovaries, known as oophorectomy, is one permanent method. This procedure typically involves a laparoscopic (keyhole) approach, where small incisions are made to remove the ovaries, and sometimes the fallopian tubes, in a procedure called a salpingo-oophorectomy. In some instances, an open surgery with a larger incision may be necessary.
Medical Methods
Medical or pharmacological methods involve using hormone-suppressing drugs, such as gonadotropin-releasing hormone (GnRH) agonists like goserelin (Zoladex) or leuprolide (Lupron). These medications temporarily halt ovarian hormone production. This approach offers a reversible form of ovarian suppression, as ovarian function may resume once the medication is discontinued.
Radiation Therapy
Radiation therapy, or ovarian irradiation, permanently shuts down ovarian function by applying concentrated X-rays to the ovaries. While effective, radiation therapy is generally less commonly used for ovarian ablation compared to surgical or medical approaches.
What to Expect After Ovarian Ablation
Following ovarian ablation, individuals can anticipate experiencing symptoms similar to natural menopause due to the sudden drop in estrogen levels. These symptoms can include hot flashes, night sweats, vaginal dryness, and changes in sexual desire or mood swings. These symptoms may be more pronounced than those experienced during natural menopause because of the abrupt hormonal change.
The procedure also has implications for fertility. Surgical removal of the ovaries results in irreversible loss of the ability to bear children. With medical ablation, ovarian function may temporarily cease but can sometimes resume after discontinuing medication, making pregnancy a possibility, though often unlikely.
Recovery time for surgical methods varies. Laparoscopic surgery often allows discharge the same day or within one to two nights. Open surgery requires a longer hospital stay of two to four days, with full recovery at home taking approximately six weeks. For medical methods, side effects like fatigue and mood changes usually subside after treatment is completed.