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Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
1Get the | 2Compare | 3Your | 4Your | 5Quiz | 6Your Summary |
Get the facts
Your options
- Have surgery to remove your ovaries and fallopian tubes.
- Don't have surgery.
This decision aid is for women who are at high risk for ovarian cancer and are thinking of having their ovaries removed to prevent it. It is not for women at average risk for ovarian cancer. Deciding whether to have your ovaries removed when you have a hysterectomy and are at average risk for ovarian cancer is a different decision.
Key points to remember
- You can't make this decision until you know how high your risk is for ovarian cancer. Your doctor or a genetic counselor can help you. If your risk isn't high, removing your ovaries is not recommended.
- Women who have a strong family history of ovarian cancer have a higher chance of getting it themselves. (Family history means having relatives with the disease.)
- Women who have tested positive for gene changes (such as BRCA) may want to consider having their ovaries removed after age 35 if they are finished having children.
- Your decision will depend on how high your risk is. It also depends on your health, your age, and your personal feelings.
- Having the ovaries removed greatly lowers a woman's chances of getting ovarian cancer. The fallopian tubes are removed at the same time.
- If you haven't yet started menopause, having your ovaries removed will cause you to start it. It will also take away your ability to get pregnant.
How do you know if you are at high risk for ovarian cancer?
Your risk depends on your medical and family history of ovarian cancer. For example, having one relative with ovarian cancer means you are more likely than average to get it. But if you have more than one relative with this cancer, your chances of getting it are higher. You may want to talk to a genetic counselor.
Other family cancers may also affect your risk for ovarian cancer. Ovarian cancer and breast cancer can be related to BRCA gene changes. Women from families who inherit the gene changes for Lynch syndrome (also called hereditary nonpolyposis colorectal cancer syndrome, or HNPCC) are also at increased risk for getting ovarian and other cancers.
To understand how a family history of ovarian cancer can affect your chances of getting it, look at the numbers below. Remember that everyone's case is different. These numbers may not show what will happen in your case.
- An average woman has a very low risk. Out of 100 average women, 1 will get ovarian cancer.
- A woman with one family member (mother, sister, daughter) who had this cancer has a slightly higher risk. Out of 100 women with one family member who has had this cancer, 5 will get ovarian cancer.
- A woman with at least two first-degree relatives (meaning mother, sister, or daughter) who had this cancer has a higher risk. Out of 100 women with two relatives who have had it, 7 women will get ovarian cancer.
- Women with the BRCA gene change have the highest risk. Out of 100 women who have the BRCA1 gene change, about 40 will get ovarian cancer. Out of 100 women who have the BRCA2 gene change, about 20 will get ovarian cancer.footnote 1
If you don't know whether you are at high risk, talk to your doctor. A genetic counselor can also help you. Having the BRCA gene test may be an option for some women, but it's not for everyone.
What are the benefits of having your ovaries removed?
The most important benefit of surgery to remove your ovaries is that your chance of getting ovarian cancer goes way down. This may lower your risk so that it is the same or only slightly higher than the average woman's risk.
What are the risks of having your ovaries removed?
- Removing your ovaries makes you start menopause if you haven't started it already. Menopause often has symptoms like hot flashes, vaginal dryness, urinary frequency, and decreased sexual interest. And it raises your risk for other diseases, such as heart disease and osteoporosis.
- When your ovaries are removed, you can no longer get pregnant.
- Removing the ovaries does not always prevent cancer. Sometimes a woman already has cancer before the surgery but doesn't know it because she has no symptoms. And the cancer cells may already have begun to spread outside the ovaries. In that case, removing the ovaries will not remove all of the cancer cells. Cancer can also start on the abdominal lining after the ovaries are removed, but this is rare.
What other choices do you have?
Being at higher risk for ovarian cancer does not mean you will definitely get it. This is why some women choose not to have surgery. If you decide not to have surgery, you have two other options:
- Birth control pills. Studies show that taking birth control pills lowers the risk of getting ovarian cancer.footnote 2
- Extra checkups and testing. The goal is to find any cancer as early as possible, when the chances of treating it successfully are higher.
There is no proof that having extra screening tests helps women live longer by finding ovarian cancer early. Still, some experts recommend that women with an inherited risk of ovarian cancer have these tests at least once a year, starting at age 35:footnote 3
- Transvaginal ultrasound. Ultrasound uses sound waves to make pictures of body parts. A small handheld device is passed back and forth over the area in question. In a transvaginal ultrasound, the device fits into a woman's vagina. The test is used to look for tumors in and around the ovaries.
- CA-125 blood test. CA-125 is a protein in your blood. Having more of it than normal can mean you have cancer. The test is usually used to check how well treatment for ovarian cancer is working or to see if the cancer has returned.
For women who have an average risk for ovarian cancer, experts do not recommend using the CA-125 test as a screening test for ovarian cancer. This is because this test often has false-positive results that can lead to unneeded surgery. But some doctors may recommend the CA-125 test and a transvaginal ultrasound for women who have a very high risk of ovarian cancer, such as those with BRCA gene changes. For these women, the benefits of screening may outweigh the harms.
Why might your doctor recommend that you have your ovaries removed?
Your doctor might recommend this surgery if a gene test shows that you have inherited a gene change, such as BRCA or the one for Lynch syndrome (HNPCC), and you are done having children.
If you have not yet gone through menopause, talk with your doctor about starting hormone therapy after your surgery. Hormone therapy may help you avoid the symptoms and risks of early menopause without raising your risk for breast cancer.footnote 4
Compare your options
Compare
What is usually involved? |
| |
|---|---|---|
What are the benefits? |
| |
What are the risks and side effects? |
|
- You will be asleep during the operation.
- If the operation is laparoscopic (done with very small cuts), you will likely go home the same day. Otherwise you will stay in the hospital for 2 to 3 days.
- Surgery greatly lowers your chances of getting ovarian cancer.
- This surgery will also lower your risk for breast cancer.
- You will not be able to get pregnant.
- You will start menopause. You could have symptoms such as hot flashes, vaginal dryness, frequent urination, and reduced sexual interest.
- You will have an increased risk for other diseases, such as heart disease and osteoporosis.
- You could still get cancer.
- You consider other options,
such as:
- Doing nothing.
- Having regular checkups and testing.
- Taking birth control pills.
- Women of childbearing age can still have children.
- You will go into menopause at your normal time.
- You will continue to have a high risk for ovarian cancer.
Personal stories about having the ovaries removed to prevent ovarian cancer
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I am from one of those families with lots of cancer-including ovarian cancer-in parents, aunts, and cousins. It was a hard decision to have my ovaries removed. I did a lot of research before I made the decision, and now I just feel safer.
Sandra, age 35
I have a couple of relatives with breast or ovarian cancer, but I'm not going to have my ovaries removed. Surgery seems like too drastic a step. I would rather take my chances and hope that cancer is not in the cards for me. I know some people couldn't live with the "threat" of cancer hanging over them, but I'm okay with it.
Dee, age 28
I have had genetic testing and am BRCA-positive, so my risk for ovarian cancer is very high. I had my ovaries removed because I want to do everything I can possibly do to keep from getting the cancer that runs in my family.
Amaia, age 31
My grandmother died of ovarian cancer, and I have a cousin who was just diagnosed with breast cancer. I thought that meant that I was definitely going to get one or both cancers. But I talked to my doctor and found out it's not a definite thing. I don't want to have my ovaries removed, but I am going to have regular checkups and testing. And I have started to take birth control pills too.
Salma, age 27
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have your ovaries removed
Reasons not to have your ovaries removed
I want to do everything I can to keep from getting ovarian cancer.
The thought of surgery scares me more than the thought of getting cancer.
The idea of early menopause doesn't bother me.
I don't want to go into menopause any earlier than I have to.
I am done having children.
I still want to have children.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having my ovaries removed
NOT having my ovaries removed
What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Author | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Wendy Y. Chen, MD, MPH, MD, MPH - Medical Oncology, Hematology |
- Fleming GF, et al. (2009). Epithelial ovarian cancer. In RR Barakat et al., eds., Principles and Practice of Gynecologic Oncology, 5th ed., pp. 763-835. Philadelphia: Lippincott Williams and Wilkins.
- National Cancer Institute (2013). Ovarian Cancer Prevention PDQ-Health Professional Version. Available online: http://nci.nih.gov/cancertopics/pdq/prevention/ovarian/healthprofessional.
- National Cancer Institute (2012). Genetics of Breast and Ovarian Cancer (PDQ)-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/genetics/breast-and-ovarian/healthprofessional.
- Domchek S, Kaunitz AM (2016). Use of systematic hormone therapy in BRCA mutation carriers. Menopause, 23(9): 1026-1027. DOI: 10.1097/GME.0000000000000724. Accessed February 6, 2017.
- Cannistra SA, et al. (2015). Ovarian cancer, fallopian tube carcinoma, and peritoneal carcinoma. In VT DeVita Jr et al., eds., DeVita, Hellman, and Rosenberg's Cancer Principles and Practices of Oncology, 10th ed., pp. 1075-1099. Philadelphia: Walters Kluwer.
- National Cancer Institute (2010). Ovarian Cancer Prevention PDQ-Health Professional Version. Available online: http://nci.nih.gov/cancertopics/pdq/prevention/ovarian/healthprofessional.
- National Cancer Institute (2011). Genetics of Breast and Ovarian Cancer (PDQ)-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/genetics/breast-and-ovarian/healthprofessional.
Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Have surgery to remove your ovaries and fallopian tubes.
- Don't have surgery.
This decision aid is for women who are at high risk for ovarian cancer and are thinking of having their ovaries removed to prevent it. It is not for women at average risk for ovarian cancer. Deciding whether to have your ovaries removed when you have a hysterectomy and are at average risk for ovarian cancer is a different decision.
Key points to remember
- You can't make this decision until you know how high your risk is for ovarian cancer. Your doctor or a genetic counselor can help you. If your risk isn't high, removing your ovaries is not recommended.
- Women who have a strong family history of ovarian cancer have a higher chance of getting it themselves. (Family history means having relatives with the disease.)
- Women who have tested positive for gene changes (such as BRCA) may want to consider having their ovaries removed after age 35 if they are finished having children.
- Your decision will depend on how high your risk is. It also depends on your health, your age, and your personal feelings.
- Having the ovaries removed greatly lowers a woman's chances of getting ovarian cancer. The fallopian tubes are removed at the same time.
- If you haven't yet started menopause, having your ovaries removed will cause you to start it. It will also take away your ability to get pregnant.
How do you know if you are at high risk for ovarian cancer?
Your risk depends on your medical and family history of ovarian cancer. For example, having one relative with ovarian cancer means you are more likely than average to get it. But if you have more than one relative with this cancer, your chances of getting it are higher. You may want to talk to a genetic counselor.
Other family cancers may also affect your risk for ovarian cancer. Ovarian cancer and breast cancer can be related to BRCA gene changes. Women from families who inherit the gene changes for Lynch syndrome (also called hereditary nonpolyposis colorectal cancer syndrome, or HNPCC) are also at increased risk for getting ovarian and other cancers.
To understand how a family history of ovarian cancer can affect your chances of getting it , look at the numbers below. Remember that everyone's case is different. These numbers may not show what will happen in your case.
- An average woman has a very low risk. Out of 100 average women, 1 will get ovarian cancer.
- A woman with one family member (mother, sister, daughter) who had this cancer has a slightly higher risk. Out of 100 women with one family member who has had this cancer, 5 will get ovarian cancer.
- A woman with at least two first-degree relatives (meaning mother, sister, or daughter) who had this cancer has a higher risk. Out of 100 women with two relatives who have had it, 7 women will get ovarian cancer.
- Women with the BRCA gene change have the highest risk. Out of 100 women who have the BRCA1 gene change, about 40 will get ovarian cancer. Out of 100 women who have the BRCA2 gene change, about 20 will get ovarian cancer.1
If you don't know whether you are at high risk, talk to your doctor. A genetic counselor can also help you. Having the BRCA gene test may be an option for some women, but it's not for everyone.
What are the benefits of having your ovaries removed?
The most important benefit of surgery to remove your ovaries is that your chance of getting ovarian cancer goes way down. This may lower your risk so that it is the same or only slightly higher than the average woman's risk.
What are the risks of having your ovaries removed?
- Removing your ovaries makes you start menopause if you haven't started it already. Menopause often has symptoms like hot flashes, vaginal dryness, urinary frequency, and decreased sexual interest. And it raises your risk for other diseases, such as heart disease and osteoporosis.
- When your ovaries are removed, you can no longer get pregnant.
- Removing the ovaries does not always prevent cancer. Sometimes a woman already has cancer before the surgery but doesn't know it because she has no symptoms. And the cancer cells may already have begun to spread outside the ovaries. In that case, removing the ovaries will not remove all of the cancer cells. Cancer can also start on the abdominal lining after the ovaries are removed, but this is rare.
What other choices do you have?
Being at higher risk for ovarian cancer does not mean you will definitely get it. This is why some women choose not to have surgery. If you decide not to have surgery, you have two other options:
- Birth control pills. Studies show that taking birth control pills lowers the risk of getting ovarian cancer.2
- Extra checkups and testing. The goal is to find any cancer as early as possible, when the chances of treating it successfully are higher.
There is no proof that having extra screening tests helps women live longer by finding ovarian cancer early. Still, some experts recommend that women with an inherited risk of ovarian cancer have these tests at least once a year, starting at age 35:3
- Transvaginal ultrasound. Ultrasound uses sound waves to make pictures of body parts. A small handheld device is passed back and forth over the area in question. In a transvaginal ultrasound, the device fits into a woman's vagina. The test is used to look for tumors in and around the ovaries.
- CA-125 blood test. CA-125 is a protein in your blood. Having more of it than normal can mean you have cancer. The test is usually used to check how well treatment for ovarian cancer is working or to see if the cancer has returned.
For women who have an average risk for ovarian cancer, experts do not recommend using the CA-125 test as a screening test for ovarian cancer. This is because this test often has false-positive results that can lead to unneeded surgery. But some doctors may recommend the CA-125 test and a transvaginal ultrasound for women who have a very high risk of ovarian cancer, such as those with BRCA gene changes. For these women, the benefits of screening may outweigh the harms.
Why might your doctor recommend that you have your ovaries removed?
Your doctor might recommend this surgery if a gene test shows that you have inherited a gene change, such as BRCA or the one for Lynch syndrome (HNPCC), and you are done having children.
If you have not yet gone through menopause, talk with your doctor about starting hormone therapy after your surgery. Hormone therapy may help you avoid the symptoms and risks of early menopause without raising your risk for breast cancer.4
2. Compare your options
| Have surgery to remove your ovaries and tubes | Don't have surgery | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Personal stories about having the ovaries removed to prevent ovarian cancer
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I am from one of those families with lots of cancer-including ovarian cancer-in parents, aunts, and cousins. It was a hard decision to have my ovaries removed. I did a lot of research before I made the decision, and now I just feel safer."
— Sandra, age 35
"I have a couple of relatives with breast or ovarian cancer, but I'm not going to have my ovaries removed. Surgery seems like too drastic a step. I would rather take my chances and hope that cancer is not in the cards for me. I know some people couldn't live with the "threat" of cancer hanging over them, but I'm okay with it."
— Dee, age 28
"I have had genetic testing and am BRCA-positive, so my risk for ovarian cancer is very high. I had my ovaries removed because I want to do everything I can possibly do to keep from getting the cancer that runs in my family."
— Amaia, age 31
"My grandmother died of ovarian cancer, and I have a cousin who was just diagnosed with breast cancer. I thought that meant that I was definitely going to get one or both cancers. But I talked to my doctor and found out it's not a definite thing. I don't want to have my ovaries removed, but I am going to have regular checkups and testing. And I have started to take birth control pills too."
— Salma, age 27
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have your ovaries removed
Reasons not to have your ovaries removed
I want to do everything I can to keep from getting ovarian cancer.
The thought of surgery scares me more than the thought of getting cancer.
The idea of early menopause doesn't bother me.
I don't want to go into menopause any earlier than I have to.
I am done having children.
I still want to have children.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having my ovaries removed
NOT having my ovaries removed
5. What else do you need to make your decision?
Check the facts
1. A decision about whether to have my ovaries removed depends a lot on how strong my family history of ovarian cancer is.
- True
- False
- I'm not sure
2. If I have a strong family history of ovarian cancer, having my ovaries removed will not lower my chances of getting the disease.
- True
- False
- I'm not sure
3. If I haven't started menopause yet, having my ovaries removed will send me into menopause. This means I could start having menopause symptoms and I won't be able to get pregnant.
- True
- False
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Wendy Y. Chen, MD, MPH, MD, MPH - Medical Oncology, Hematology |
- Fleming GF, et al. (2009). Epithelial ovarian cancer. In RR Barakat et al., eds., Principles and Practice of Gynecologic Oncology, 5th ed., pp. 763-835. Philadelphia: Lippincott Williams and Wilkins.
- National Cancer Institute (2013). Ovarian Cancer Prevention PDQ-Health Professional Version. Available online: http://nci.nih.gov/cancertopics/pdq/prevention/ovarian/healthprofessional.
- National Cancer Institute (2012). Genetics of Breast and Ovarian Cancer (PDQ)-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/genetics/breast-and-ovarian/healthprofessional.
- Domchek S, Kaunitz AM (2016). Use of systematic hormone therapy in BRCA mutation carriers. Menopause, 23(9): 1026-1027. DOI: 10.1097/GME.0000000000000724. Accessed February 6, 2017.
- Cannistra SA, et al. (2015). Ovarian cancer, fallopian tube carcinoma, and peritoneal carcinoma. In VT DeVita Jr et al., eds., DeVita, Hellman, and Rosenberg's Cancer Principles and Practices of Oncology, 10th ed., pp. 1075-1099. Philadelphia: Walters Kluwer.
- National Cancer Institute (2010). Ovarian Cancer Prevention PDQ-Health Professional Version. Available online: http://nci.nih.gov/cancertopics/pdq/prevention/ovarian/healthprofessional.
- National Cancer Institute (2011). Genetics of Breast and Ovarian Cancer (PDQ)-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/genetics/breast-and-ovarian/healthprofessional.
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Current as of: May 3, 2017
