From the Guidelines
A unilateral oophorectomy generally has minimal long-term effects for most women, with the remaining ovary typically compensating to maintain normal endocrine function, although some women may experience earlier menopause and slightly reduced fertility. The long-term effects of a unilateral oophorectomy can be understood by considering the impact on ovarian reserve and hormone production.
Key Considerations
- The remaining ovary usually produces sufficient hormones to maintain regular menstruation and fertility, as seen in studies on female reproductive health after cancer treatment 1.
- However, women who undergo unilateral oophorectomy may experience earlier menopause, with some studies suggesting a reduction in menopause age by approximately 1-2 years compared to the general population.
- Potential long-term effects also include slightly reduced fertility due to decreased ovarian reserve, though many women conceive naturally with one ovary, as noted in guidelines for assessing and managing female reproductive complications 1.
- Some studies suggest a small increased risk of cardiovascular disease and osteoporosis later in life due to the reduction in lifetime estrogen exposure, highlighting the importance of regular health check-ups.
Fertility and Hormonal Consequences
- Women who undergo unilateral oophorectomy before completing childbearing should discuss fertility preservation options with their healthcare provider, considering the potential impact on ovarian function and fertility.
- The impact of unilateral oophorectomy varies significantly based on the woman's age at surgery, with procedures performed before menopause having more potential long-term hormonal consequences than those done after menopause when ovarian function has already declined naturally, as discussed in the context of chemotherapy-induced ovarian failure and radiation effects on ovarian function 1.
Monitoring and Follow-Up
- Regular gynecological check-ups are important to monitor the remaining ovary's health and address any concerns or potential complications early on, ensuring the best possible outcomes for women who have undergone unilateral oophorectomy.
From the Research
Long-term Effects of Unilateral Oophorectomy
- The long-term effects of unilateral oophorectomy have been less intensively investigated compared to bilateral oophorectomy 2.
- Women who underwent unilateral oophorectomy had a similar age at menopause and similar clinical pregnancy rate compared to women with two ovaries 2.
- However, decreased ovarian reserve affecting the quantity but not the quality of the ovarian pool after IVF was observed in the unilateral oophorectomy group 2.
- An increased risk of neurological disease and even an increased risk of mortality was observed in women with a single ovary 2.
- The risk of parkinsonism and of cognitive impairment or dementia increased following oophorectomy, with significant linear trends of increasing risk for either outcome with younger age at oophorectomy 3.
Comparison with Bilateral Oophorectomy
- Bilateral oophorectomy has been associated with long-term harmful consequences, including an increased risk of cardiovascular and neurological disease, and mortality 4.
- The effects of unilateral oophorectomy on brain aging are less clear, but may be related to the age at which the oophorectomy is performed 3, 5.
- Hormone replacement therapy may be indicated after oophorectomy to mitigate some of these risks, although the optimal type and duration of therapy are unclear 4, 6.
Future Research Directions
- Further studies are needed to confirm the findings on the long-term effects of unilateral oophorectomy and to identify plausible mechanisms of action 2.
- Research on the effects of unilateral oophorectomy on cognitive and motor aging, as well as the potential benefits and risks of hormone replacement therapy, is also needed 3, 5.