Polycystic ovary syndrome (PCOS) is one of the most common disorders affecting women of childbearing age. It’s characterized by serious hormone imbalances that can disrupt the functioning of almost every part of the body. This leads to symptoms like irregular periods, cystic ovaries, weight gain, acne, infertility, excessive hair growth on the face, head hair loss, mood swings, and more. 

The effects of PCOS can also lead to long-term complications like type 2 diabetes, high blood prssure, cardiovascular disease, and ovarian cancer if left untreated. Though there isn’t a pill you can take or a surgery you can have that gets rid of your PCOS, there are ways of managing it! 

At PCOS Weight Loss and on the A Cyster and Her Mister podcast, we discuss how to reduce insulin resistance, ease inflammation, and balance hormones to naturally reverse your PCOS symptoms. However, some procedures can be done when symptoms or risk factors are severe.

One of those procedures is an oophorectomy, which is a surgery that involves removing the ovaries and sometimes the fallopian tubes. This surgery has pros and cons for women with PCOS, so I am dedicating this post to discussing the benefits and drawbacks of an oophorectomy to help you make an informed decision about your treatment. 

Here’s what you need to know:

Pros and Cons Of Removing Ovaries For PCOS

When you’re considering any medical procedure, it’s important to weigh the pros and cons. Few things come with no side effects or drawbacks, so doing your own research is always a smart plan. I’ll be discussing mainly what’s called a “bilateral oophorectomy,” which means a surgery that removes both ovaries, but there are other types of oophorectomies too:

• Unilateral Oophorectomy: When one ovary is removed
• Bilateral Oophorectomy: When both ovaries are removed 
• Salpingo-Oophorectomy: When one ovary and one fallopian tube are removed
• Bilateral Salpingo-Oophorectomy: When both ovaries and fallopian tubes are removed 

These procedures are used for a specific purpose, but I want to note that no oophorectomy will cure PCOS. Below, I’ll show you why people choose to do it. Then, we’ll get into the cons.

Pros Of Ovary Removal For PCOS

Reduced Risk of Ovarian Cancer 

The main benefit of removing the ovaries is reducing the risk of ovarian cancer by 85%. Many women with PCOS who also have a family history of ovarian cancer consider an oophorectomy for this very reason, and I get it, cancer is one of the scariest parts of having PCOS. 

Removing the ovaries can even help with breast cancer too, reducing the risk of that by 72%. These decreased risks of cancer are one of the primary reasons Cysters consider an oophorectomy. 

Decrease Pelvic Plain

Another reason for this procedure is pelvic pain. Oophorectomies have been shown to help reduce this pain when combined with other treatments like hormone replacement therapy.  

No Future Ovarian Cysts 

Without ovaries, there are no ovarian cysts! Ovarian cysts are extremely painful and they can definitely lower a Cyster’s quality of life. With an oophorectomy, a woman with PCOS will not have ovarian cysts. 

Cons Of Ovary Removal For PCOS

No Future Pregnancies

One of the biggest drawbacks of removing the ovaries is the fact that you’ll no longer be able to bear children. Some Cysters are already past this stage in their life and the loss of future pregnancies isn’t a big deal. However, it’s important to realize that an oophorectomy totally closes that door. 

If you get a unilateral oophorectomy, it won’t be impossible to get pregnant, but fertility will be significantly reduced. Since many women with PCOS already struggle with infertility, pregnancy after any type of oophorectomy can seem impossible. 

Increased Risk of Heart Disease

Another significant con of an oophorectomy is the increased risk of heart disease. Research shows that women are 8% more likely to die from coronary artery disease after 55 if they’ve had an oophorectomy. If you remember, women with PCOS are already at a greater risk of cardiovascular disease than healthy women, so this is definitely a concern. 

Loss of Natural Hormone Production

The female reproductive system is responsible for a lot of natural hormone production. When you eliminate the ovaries, obviously your endocrine system is going to be negatively affected. Because of this, Cysters who undergo oophorectomies participate in hormone replacement therapy after surgery. 

If you’re a woman living with PCOS, chances are you’ve dealt with the side effects of hormone imbalance for most of your life, so surgery that worsens that imbalance can be a huge downside. Though HRT can help build and maintain some hormone balance, I still consider this loss of natural production a big detractor of ovary removal surgery—especially since this therapy has to continue until at least age 50.  

There are many viable ways Cysters can restore hormone balance totally naturally through diet, exercise, lifestyle, and mindset changes, but not if you don’t have the biological ability to produce your own hormones. So, oophorectomies take away the possibility of natural healing, and synthetic measures have to be taken to get hormones back on track.  

Decrease in Cognitive Function 

Estrogen is one of the primary hormones HRT manages for a Cyster who has had ovary removal surgery. This is because, without the ovaries, estrogen deficiency post-surgery is common. If you’re a Cyster with estrogen dominance currently, this may sound like a good thing, but it’s nothing to celebrate. 

Though estrogen therapy can replace some or all of the estrogen you need until menopause, many women still experience side effects. One of the main symptoms of estrogen deficiency is cognitive decline, including things like memory, mental control, reasoning, and attention. There are even studies that show estrogen deficiency could increase your risk of dementia. 

Increase Risk of Hip Fracture

Another symptom of estrogen deficiency is decreased bone mineral density. This increases the risk of all types of bone breaks, but research has found a specifically significant increase in hip fractures after women go through ovary removal surgery. In fact, Cysters without their ovaries are 32% more likely to have hip fractures post-menopause than those who have their ovaries intact. 

Deterioration of Sex Life 

Lots of women report issues with their sex life after having ovary removal surgery. Sexual function, pleasure, and desire are often all affected by an oophorectomy. This has then even snowballed for many Cysters into issues of self-esteem and depression. Which makes sense- this is a significant loss as a result of ovary removal surgery. 

The issue comes from a lack of hormone production of both estrogen and androgens (two of our main sex hormones.) Even women participating in HRT still report issues with sexual function and sexual pleasure. This usually continues into menopause when hormone replacement therapy stops. This means sex life issues often become permanent problems for women post-ovary removal surgery. 

Premature Menopause

Menopause happens naturally around 51. However, when you have ovary removal surgery, you actually experience instant “surgical menopause.” This actually rolls into several menopausal symptoms, including hot flashes, mood swings, sleep problems, headaches, and more. For women already experiencing issues with symptom management with their PCOS, adding menopausal symptoms to the mix can feel super overwhelming! 

What You Need to Know About Hormone Replacement Therapy (HRT)?

Since the ovaries play such a big role in hormone production, you’ll need HRT starting immediately after surgery. Without it, you may experience intense “surgical menopause” symptoms. HRT helps maintain hormone balance and can relieve some of the cons mentioned above by supporting bone density, preventing vaginal dryness, stabilizing mood, and helping regulate metabolism.

However, HRT definitely isn’t a perfect replacement for the ovaries. Many women still experience side effects and struggle to find the right dosage. Libido, cognition, and energy levels can remain challenging for some Cysters post-oophorectomy, even with consistent hormone therapy.

This is important to take into consideration, because oophorectomy can provide relief for some women with PCOS… but others may see a spike in certain symptoms. Relying on synthetic hormones instead of your body’s natural production isn’t always ideal. Before choosing surgery, consider every option available to you and think carefully about what aligns with your long-term goals, health needs, and desired quality of life.

Ovary removal surgery has benefits and drawbacks you need to know about before you make a decision. 

Ovary removal surgery is not a PCOS treatment or cure. It does eliminate one or two risk factors, but it introduces a variety of other concerns that may have you reconsidering your oophorectomy decision. Whatever you’re thinking, make sure you meet with your doctor to discuss your situation and family history. 

If you’re a woman dealing with PCOS, you’re not alone! The Cysterhood App is full of women like you who want to take charge of their lives and reverse the effects of PCOS. The app has the exercises, meal plans, and lifestyle changes you need to help you naturally heal your PCOS. You can find even more info on the PCOS Weight Loss blog and on my podcast! With community and the right moves, you can reverse your PCOS and take back your life.