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Oophorectomy: the debate between ovarian conservation and elective oophorectomy

Erekson, Elisabeth A. MD, MPH1; Martin, Deanna K. MPH1; Ratner, Elena S. MD2

doi: 10.1097/gme.0b013e31825a27ab
Personal Perspective

Abstract: Ovarian cancer remains the fifth deadliest cancer among women because of its early asymptomatic nature and lack of efficacious screening methods, leading to frequent late-stage diagnosis. Elective oophorectomy is an option for women undergoing benign hysterectomy as a means of reducing their ovarian cancer risk. Benefits also include reduced risk of repeat surgical operation due to adnexal masses and reduced anxiety related to perceived risk of ovarian and breast cancer. The potential negative side effects of elective oophorectomy, such as decreased cognition and sexual function and increased risk of osteoporosis and cardiac mortality, offer support for ovarian conservation. The implications of this elective procedure and the possible consequences without it require physicians to review the pros and cons with patients in light of the patient’s individual circumstances and ovarian cancer risk.

Considering a women’s risk of cardiovascular disease, dementia, osteoporosis, and family history must be used to guide decisions for elective oophorectomy and ovarian conservation at the time of benign hysterectomy.

From the Sections of 1Urogynecology and Reconstructive Pelvic Surgery and 2Gynecologic Oncology, Yale University School of Medicine, New Haven, CT.

Received January 23, 2012; revised and accepted April 12, 2012.

Funding/support: Dr. Ratner is supported by grant K12 HD047018 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Elisabeth A. Erekson, MD, MPH, Yale University, Section of Urogynecology, 333 Cedar St, PO Box 208063, New Haven, CT 06519. E-mail: elisabeth.erekson@yale.edu

© 2013 by The North American Menopause Society.