Removal of one or two ovaries

[Eclectic_Horseman]

People on these forums come from everywhere, and know all kinds of stuff and have all kinds of experiences, and I have found that you guys often have the best advice.

All this is by way of asking a really arcane personal medical question. About 5 years ago I had an abdominal CT scan for diverticulitis. Incidentally, they found a small (approx. 3 cm) cyst on my ovary. I am post-menopausal and had no symptoms. The OB/GYN did a cancer blood test, which was normal and said that we would check again in 5 years.

So here we are at 5 years. I had an MRI for my back and hip, and when they read it, the radiologists said that the cyst appeared to have grown. So I had another cancer blood test (CA-125) which was normal. The OB/GYN ordered a specific MRI and it confirmed that the cyst had enlarged to about 4 cm and might have changed in character to a pre-cancerous type growth.

So I am having the ovary and the fallopian tube removed laparoscopically the middle of this month. The OB/GYN kind of assumed that I would want to have both ovaries and tubes removed so that I “wouldn’t have to worry about it.” I told her that I only wanted to have the one with the cyst removed and she said that there is some protective benefit of having an ovary until about 65 years old or so, but I am past that, so it really wouldn’t matter. I’m more worried about having more surgery unnecessarily. The OB/GYN said that she would just do the one, but that I could let her know if I changed my mind right up to the surgery.

I’ve been unable to find anyone to give me advise on this. What do you all think?

[Equibrit]

This study may help;

Oophorectomy: the debate between ovarian conservation and elective oophorectomy

[Obsidian_Fire]

If it were me, I’d get them both removed. You have a cyst that “may” have pre-cancerous characteristics. If it is, it would be ovarian cancer, right? We all know how deadly that can be due to lack of testing. At least if they are both gone, that’s out of the picture. And I’d much rather have a ‘one and done’ than another surgery at another date. Given the technology these days, laparoscopic, minimally invasive as far as surgery goes, it’s really NBD for the surgeon to remove the other while in there already.

[OzarksRider]

I would get both ovaries out. Like your doctor said, your ovaries aren’t functioning anymore so you won’t miss them. As for worrying about having “more surgery” . . . getting both ovaries removed at once would only add a few more minutes to the procedure, and you wouldn’t notice because you would be under anesthesia. It would be a lot easier than having to go through everything again if that ovary needed to be removed in the future. And you would never have to worry about that ovary becoming cancerous.

[Obsidian_Fire]

I would be asking where HRT might fit into this… nowhere in this study does it mention HRT could be used to mitigate some of these issues. ??? Question for the doctors.

[Eclectic_Horseman]

Pre-cancerous may be an overstatement. Technically, it is something called a “borderline epithelial ovarian neoplasm.”

You are probably right that it is not much more surgery though.

[Eclectic_Horseman]

That’s really helpful. The doctor did not mention the bone density issue, although the underlying study referenced said that hormones secreted were protective for 10 years after menopause, so I guess that ship has sailed. But I do worry about bone density more than heart disease.

I can see from this study why the OB/GYN just shrugged though. Seems like a coin toss.

[lcw579]

I would get them both out. I just lost my sister to ovarian cancer. She was diagnosed in August and dead in October. It is a horrible sneaky disease and if I have the chance to have my ovaries removed I will jump at it.

[Equibrit]

@Obsidian_Fire

I would be asking where HRT might fit into this… nowhere in this study does it mention HRT could be used to mitigate some of these issues. ??? Question for the doctors.

A very complicated subject;

Comparing the risks and benefits of hormone therapy

It’s very easy to pronounce your preferred choice, until you are faced with the need to make a decision. All our situations are different and one person’s choice may not fit all. All you can do is provide information that may help in making that decision.

[Obsidian_Fire]

Yes, it is complicated and unique to each person. I’m not arguing that point whatsoever. It’s a question to ask your doctor.

[BlueDrifter]

Breast cancer here, so I have read a lot. I think I would opt for removal of both. The remaining ovary isn’t producing much estrogen at this point. I am on vaginal estrogen and it is helpful for the sexual/urinary issues. (Eliminating caffeine also helped with urinary “urge” issues – apparently it can irritate the bladder as we get older)

I am not sure you’d miss the remaining ovary with vaginal estrogen as a replacement…

What I really miss is testosterone, which gives us muscle and drive (sex and energy!)

[snowblaze]

It’s recommended to remove the fallopian tubes, because that’s where most lethal “ovarian cancer” originates. The removal of the other ovary would depend on a number of things. I left one, but it quit working within a year.

Here’s a link to an article on the fallopian tubes:
To Prevent Cancer, More Women Should Consider Removing Fallopian Tubes, Experts Say

[Simkie]

I would only take the one. If you’re unhappy with that, returning and removing the second is always an option, but if you’re unhappy after having them both removed, you sure can’t put one back in.

[Bluey]

After 65 ovaries are practically shrunk to nothing and without activity.
No need to keep them for any metabolic reason, why the surgeon was going for both now, until you wanted to keep one.

Did you ask why taking both and what the Dr herself thinks?
That opinion may help you decide.

My Dr was going for both, but one was so out of reach he could not get to it without more trouble than he thought sensible, said we will just have to watch the other.

[Eclectic_Horseman]

@Bluey Yeah, I asked, and the answer was she wanted to remove both so I would never have to worry about it. When I pushed back, she said that my position was not unreasonable but that any protective effects of keeping it were almost certainly over. I worried about having too much space left over and possible seromas, etc. (I have a friend who had polyps removed from his pancreas and had a drain for months.) But from what you are saying, the ovary may be pretty shriveled up anyway. Thanks for your input. That’s helpful.

[Bluey]

@Eclectic_Horseman

@Bluey Yeah, I asked, and the answer was she wanted to remove both so I would never have to worry about it. When I pushed back, she said that my position was not unreasonable but that any protective effects of keeping it were almost certainly over. I worried about having too much space left over and possible seromas, etc. (I have a friend who had polyps removed from his pancreas and had a drain for months.) But from what you are saying, the ovary may be pretty shriveled up anyway. Thanks for your input. That’s helpful.

Sorry to have missed that you had already added that conversation with the Dr, read too fast.
Thank you for repeating it.
As other answers have indicated, either way is reasonable, up to you to weigh what is best in your situation.
Thank you for presenting the question, others can learn from it.

[Fiesta01]

I also had something suspicious on one ovary. (Thankfully wasn’t cancer). I decided to have both ovaries and both tubes taken out.

I was 54 and in pre-menopause. They emphasized that would be a surgical menopause which usually have more severe menopausal symptoms. But I didn’t want to worry anymore about ovarian cancer after this scare.

You’re already in menopause, so the small amount of estrogen that would be lacking from the second ovary, hopefully, wouldn’t terribly exacerbate whatever symptoms you currently experience. I’d go for taking both. JMHO.

Good luck whatever your decion, and please let us know how you’re doing.

[Jackie_amp_Starlette]

Just my 88 year old mom’s story. She had a CAT scan in 2020, 3mm cysts on her ovaries. Since she was in for congestive heart failure, it was set aside.

Fast forward to 2022, and the cysts were the size of small footballs - they found this out with a CAT scan because she had no bladder control.

They thought cancer, did a complete hysterectomy, and it was just cysts.

My thought would be if another one appears on your other ovary you would need to go through all the process again.

Good luck!

[cutter99]

I had a radical hysterectomy a little over three years ago, and had experienced multiple cysts on my ovaries previously. In addition to my very angry uterus, I had multiple cysts on both ovaries when they were removed.

I had experienced cysts bursting over the years, which is extremely painful and for which there is no real treatment except bearing the pain until it is over with.

I have no regrets. Have been on estradiol and testosterone since, but am now weaning off the estradiol at my GP’s recommendation.

I wish I had everything removed when I first had the opportunity to, but I kept saying to myself that I was so close to menopause that I should just ride it out. So thankful for much less pain, much better living, and much less health worries!

[twostinkydogs]

Caveat: I didn’t read through all responses. I recently went through a somewhat similar situation. I had an ovarian torsion that precipitated an MRI that showed 2 large cysts, one on each ovary. The MRI showed one cyst was precancerous. My gynecologist wanted my agreement to take out both ovaries if the precancerous cyst tested cancerous. I ultimately agreed she could take both only if they both looked bad. It turned out neither cyst was cancerous and she left both of my ovaries, but she did remove my fallopian tubes.

I share that because it wasn’t a “yes you must take them out” before surgery…it was a “I will take one or both out IF the tissue is cancerous”. I didn’t think you could accurately identify cancerous through an MRI, only through testing of the actual body part/tissue. I can look up my notes if it would be helpful.