The Premature Extirpation of the Ovaries

12 August, 2020
The premature extirpation of the ovaries is a preventative surgery in the case of women who are at a higher risk of developing hormone-dependent cancer. It's a decision that shouldn't be taken lightly.

The premature extirpation of the ovaries–technically referred to as oophorectomy–is a surgical procedure where doctors remove a woman’s ovaries. It may be a bilateral oophorectomy–meaning both ovaries are removed–or unilateral.

This extirpation of the ovaries may be necessary when cancer is affecting the ovaries. However, doctors may recommend it as a preventative measure in women that are at higher risk of developing breast cancer or ovarian cancer – even if she has yet to develop symptoms.

The ovaries are organs situated at the end of the Fallopian tubes and which belong to a woman’s reproductive system. There we find the ovules that, month after month, the ovaries release for fertilization in the uterus.

The ovaries are the principal source of feminine sexual hormones. Since they produce both estrogen and progesterone, the extirpation of the ovaries inevitably affects a woman’s hormonal balance.

Reasons for the premature removal of the ovaries

During a woman’s reproductive life, her ovaries are responsible for releasing estrogen and progesterone. These sexual hormones don’t only affect a woman’s reproductive system, they also affect other parts of the body, such as the breasts.

Breasts possess estrogen and progesterone receptors that cause them to change their structure. For example, just before menstruation, women may feel that their breasts become firmer. This is due to an instinctive preparation of the mammary glands for lactation.

A series of gene mutations known as BRCA1 y BRCA2 predispose women to develop breast cancer as well as ovarian cancer. Carriers of either of these mutations have a 50 to 85% chance of developing breast cancer at some point in their lives. At the same time, women who carry the BRCA1 mutations have a 20 to 40% chance of developing ovarian cancer.

The issue is that the sexual hormones that are synthesized in the ovaries are great catalysts for these tumors. So, the premature extirpation of the ovaries arises as an option for detaining the development of these oncological illnesses.

A drawing of the ovaries.
The ovaries produce ovules, but they also contain the glands that produce estrogen and progesterone.

You may also want to read: Screening Tests for Breast Cancer

What does the premature extirpation of the ovaries mean?

The removal of a woman’s ovaries is “premature” when it occurs before she reaches menopause. During the reproductive stage, women need their ovaries to regulate their menstrual cycle. Without the ovaries, menopause occurs prematurely because of the absence of hormone production.

However, despite the effect, doctors may sometimes consider this premature extirpation of the ovaries to be indispensable. In other words, when women are at high risk of developing breast or ovarian cancer in the future.

The preventative extirpation of the ovaries in the case of breast cancer

According to the National Cancer Institute, preventative removal of the ovaries reduces the possibilities of new cases of breast cancer in women that are at high risk by 50%. The same source also indicates that the surgery is only beneficial if it takes place prior to menopause.

The extirpation of the ovaries before menopause causes a reduction in the production of estrogen in the body. So, the tumors that need estrogen in order to grow are unable to develop.

The preventative extirpation of the ovaries in the case of ovarian cancer

The prophylactic removal of the ovaries, either before or after menopause, can reduce the risk of ovarian cancer by up to 90% in women that are at high risk. However, it’s important to keep in mind that the theory regarding the origin of this cancer has changed.

In the past, experts believed that ovarian tumors were primary and the original cells were present in the tumor. However, they could also be secondary to another site in the pelvis, such as the fimbria in the Fallopian tubes. The invasion of the uterus could be secondary, and that would imply not only removing the ovaries, but also the Fallopian tubes.

BRCA gene mutations.
BRCA genes are a determining factor in the development of breast cancer and ovarian cancer.

Read the following article: How is Ovarian Cancer Detected?

Hormones and the premature removal of the ovaries

The premature extirpation of the ovaries opens the door to premature menopause. That’s because it deprives women of the sexual hormones that regulate the sexual cycle. Therefore, menstruation and fertility both cease.

At the same time, estrogen also protects a woman’s heart and bones.

  • Estrogen controls blood cholesterol indirectly. So, the absence of estrogen reduces HDL cholesterol and increases bad LDL cholesterol.
  • Sexual hormones prevent the loss of bone mass. Without estrogen, the loss of bone mass speeds up, leading to the early onset of osteoporosis, which can lead to fractures.

A doctor’s advice is essential

Before undergoing the premature extirpation of the ovaries, it’s important to discuss the pros and cons of this surgery with your doctor. The long-term effects are considerable, and it’s important to base your decision on science.

If your family medical history indicates that you’re at risk for breast or ovarian cancer, be sure to talk to your doctor. Ask pertinent questions and make sure that your doctors have experience in these kinds of cases.

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