When Cancer Treatment Requires Removal of the Ovaries and Fallopian Tubes

Taking out both ovaries causes menopause. That’s because there is a lack of ovarian function. If estrogen is not prescribed, vaginal dryness and vaginal atrophy, or thinning, may occur. This will cause you to have discomfort with intercourse. It will also make pelvic exams uncomfortable. If you are under 40 and have early stage endometrial cancer or early stage cervix cancer, you may not need to have your ovaries removed.

Water-soluble lubricants and over-the-counter moisturizers can help with comfort. Your health care team may also prescribe a vaginal estrogen. This will help with thinning.

Bilateral salpingo-oophorectomy (BSO) — This surgery takes out the fallopian tubes and ovaries. It may be done during ovarian and endometrial cancer treatment at the same time as the hysterectomy. Or it may be done by itself without removing the uterus and cervix. When it is done by itself, it may be done with a laparoscope through three small cuts in the abdomen. Regardless of how the ovaries are removed, complete removal of the ovaries will have the same effect on women due to the lack of hormone production when the ovaries are removed.

Vaginal dryness is one of the long-term effects of this surgery. Also, the lack of estrogen can decrease your level of sexual desire or libido. Less desire can also be the result of lifestyle factors such as stress of the cancer diagnosis itself or fatigue from the treatment.

The surgery will cause “surgical menopause.” If the ovaries were functioning before the surgery (before menopause), then the symptoms often will be very noticeable. If you are already menopausal, then the symptoms may not be much different than your usual menopausal symptoms. After surgery (or with menopause alone), you may have hot flashes. Hot flashes are surges of heat felt within the core of the body which often will radiate out mostly towards the head and upper body, frequently causing visible flushing and sweating. These can be frequent and cause discomfort during the day and evening. They can also interrupt your sleep as night sweats (drenching sweats) and lead to fatigue and moodiness. Talk to your health care team about treatment options to reduce menopause symptoms. Those symptoms can impact your quality of life and overall sexual desire. Common recommendations include:

  • estrogen-based products when not contraindicated
  • testosterone-based products
  • gabapentin
  • low dose antidepressants
  • methyl dopa
  • non-medical products such as vitamin E, soy, or black cohosh