NCCN guidelines for cancer recommend risk-reducing bilateral salpingoophorectomy after age 35 for BRCA positive patients. In non-BRCA breast cancer patients, routine BSO is not medically necessary.
Potential side effects of the procedure (please discuss with your gynecologist or primary care physician):
- Bone thinning (osteoporosis). Removing your ovaries reduces the amount estrogen’ estrogren strengthens bones. Consideration of calcium with Vitamin D supplementation and monitoring of bone density with DEXA scans should be undertaken.
- Discomforts of menopause. Hot flashes, vaginal dryness, sexual problems, sleep disturbance are problems for some women during menopause. Removing ovaries doesn’t immediately cause these problems, but it does mean that menopausal symptoms will occur earlier
- Increased risk of heart disease. Your risk of heart disease is slightly increased after oophorectomy.
- Lingering risk of cancer. Just like bilateral mastectomy, prophylactic oophorectomy doesn’t completely eliminate your risk of cancer. A patient could develop a cancer that looks and acts identical to ovarian cancer can develop after the ovaries and fallopian tubes are removed- termed a primary peritoneal carcinoma.
Prophylactic oophorectomy might relieve much of your anxiety about developing breast or ovarian cancer, but it can also affect you emotionally. Even one didn’t plan on having children, you might mourn the loss of your fertility. Some women also have a strong sense of femininity tied to your fertility and reproductive cycle.
- Increased risk of cognitive impairment or dementia. The association is stronger with younger age at oophorectomy, is independent of the indication for oophorectomy, and may be offset by estrogen treatment.
- Increased risk of parkinsonism and Parkinson’s disease. The association is stronger with younger age at oophorectomy and is independent of the indication for oophorectomy, but is not offset by estrogen treatment.
- Increased risk of long-term depressive and anxiety symptoms. The association is stronger with younger age at oophorectomy and is independent of the indication for oophorectomy, but is not offset by estrogen treatment.