[2] Partial oophorectomy or ovariotomy is a term sometimes used to describe a variety of surgeries such as ovarian cyst removal, or resection of parts of the ovaries.
In the 1890s people believed oophorectomies could cure menstrual cramps, back pain, headaches, and chronic coughing, although no evidence existed that the procedure impacted any of these ailments.
Oophorectomy and salpingo-oophorectomy are not common forms of birth control in humans; more usual is tubal ligation, in which the fallopian tubes are blocked but the ovaries remain intact.
The formal medical name for removal of a woman's entire reproductive system (ovaries, fallopian tubes, uterus) is "total abdominal hysterectomy with bilateral salpingo-oophorectomy" (TAH-BSO); the more casual term for such a surgery is "ovariohysterectomy".
The first successful operation of this type, account of which was published in the Eclectic Repertory and Analytic Review (Philadelphia) in 1817, was performed by Ephraim McDowell (1771–1830), a surgeon from Danville, Kentucky.
[10] Conversely, unilateral oophorectomy is commonly performed for a medical indication (73%; cyst, endometriosis, benign tumor, inflammation, etc.)
[citation needed] Bilateral oophorectomy has been traditionally done in the belief that the benefit of preventing ovarian cancer would outweigh the risks associated with removal of ovaries.
[citation needed] Oophorectomy for endometriosis is used only as last resort, often in conjunction with a hysterectomy, as it has severe side effects for women of reproductive age.
[citation needed] Laparotomic adnexal surgeries are associated with a high rate of adhesive small bowel obstructions (24%).
[11] Oophorectomy is associated with significantly increased all-cause long-term mortality except when performed for cancer prevention in carriers of high-risk BRCA mutations.
[22] Hormone therapy for women with oophorectomies performed before age 45 improves the long-term outcome and all-cause mortality rates.
[23][28] Women who have had bilateral oophorectomy surgeries lose most of their ability to produce the hormones estrogen and progesterone, and lose about half of their ability to produce testosterone, and subsequently enter what is known as "surgical menopause" (as opposed to normal menopause, which occurs naturally in women as part of the aging process).
[citation needed] When the ovaries are removed, a woman is at a seven times greater risk of cardiovascular disease,[30][31][32] but the mechanisms are not precisely known.
[40] 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 such as early-onset osteoporosis as well as menopausal problems like hot flashes that are usually more severe than those experienced by women undergoing natural menopause.
[42] In addition, oophorectomy greatly reduces testosterone levels, which are associated with a greater sense of sexual desire in women.
Low-dose selective serotonin reuptake inhibitors such as Paxil and Prozac alleviate vasomotor menopausal symptoms, i.e., "hot flashes".
[46] In general, hormone replacement therapy is somewhat controversial due to the known carcinogenic and thrombogenic properties of estrogen; however, many physicians and patients feel the benefits outweigh the risks in women who may face serious health and quality-of-life issues as a consequence of early surgical menopause.
[49] This result can probably be generalized to other women at high risk in whom short-term (i.e., one- or two-year) treatment with estrogen for hot flashes may be acceptable.