Oophorectomy is a minor surgery and serious complications stemming directly from the surgery are rare. Despite this it has very serious long term consequences stemming mostly from the hormonal effects of the surgery and extending well beyond menopause.
The reported risks and adverse effects range from premature death, parkinsonism, osteoporosis and bone fractures, decline in psychological wellbeing, and decline in sexual function.
Hormone replacement therapy does not always improve the adverse effects.
Removal of ovaries causes hormonal changes and symptoms similar to, but generally more severe than, menopause.
Women who have had an oophorectomy are usually encouraged to take hormone replacement drugs to prevent other conditions often associated with menopause.
Women younger than 45 who have had their ovaries removed face a mortality risk 170% higher than women who have retained their ovaries.
Retaining the ovaries when a hysterectomy is performed is associated with better long term survival.
Hormone therapy for women with oophorectomies performed before age 45 improves the long term outcome and all cause mortality rates.
These symptoms are commonly addressed through hormone therapy, utilizing various forms of estrogen, testosterone, progesterone or a combination of them.
When the ovaries are removed a woman is at a seven times greater risk of cardiovascular disease, but the mechanisms are not precisely known.
The hormone production of the ovaries currently cannot be sufficiently mimicked by drug therapy. The ovaries produce hormones a woman needs throughout her entire life, in the quantity they are needed, at the time they are needed, and released directly into the blood stream in a continuous fashion, in response to and as part of the complex endocrine system.
Oophorectomy is associated with an increased risk of osteoporosis and bone fractures.
However, the risk is limited to oophorectomy performed before menopause or during the early perimenopause. Reduced levels of testosterone in women is predictive of height loss, which may occur as a result of reduced bone density.
In women under the age of 50 who have undergone oophorectomy, hormone replacement therapy (HRT) is often used to offset the negative effects of sudden hormonal loss (e.g., early-onset osteoporosis) as well as menopausal problems like hot flushes (also called "hot flashes") that are usually more severe than those experienced by women undergoing natural menopause.
Adverse effect on sexuality
Oophorectomy significantly impairs sexual well-being. Substantially more women reported libido loss, difficulty with sexual arousal, and vaginal dryness and hormone replacement therapy was not found to improve these symptoms.
In addition, testosterone levels in women are associated with a greater sense of sexual desire, and oophorectomy greatly reduces testosterone levels..
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