Our Summary

This study was conducted to compare the quality of life related to menopause after two different types of surgery: risk-reducing salpingectomy (removal of fallopian tubes) and risk-reducing salpingo-oophorectomy (removal of fallopian tubes and ovaries). The study involved women aged 25-45 who were carriers of the BRCA1/2 gene variant, which increases the risk of developing breast and ovarian cancer.

Based on the preferences of the women involved, some underwent the salpingectomy surgery, while others had the salpingo-oophorectomy. The research showed that three years after surgery, those who had their ovaries removed (salpingo-oophorectomy) experienced a higher increase in menopausal symptoms compared to those who only had their fallopian tubes removed (salpingectomy). Even among women who received hormone replacement therapy (HRT) after surgery, those who had the salpingo-oophorectomy still had more menopausal symptoms.

In simple terms, the study concluded that the quality of life related to menopause was better for women who only had their fallopian tubes removed compared to those who also had their ovaries removed. The difference was most noticeable in the first year after surgery.

FAQs

  1. What is the difference between a salpingectomy and a salpingo-oophorectomy?
  2. Does the removal of ovaries in addition to fallopian tubes increase menopausal symptoms?
  3. Does hormone replacement therapy (HRT) alleviate menopausal symptoms after a salpingo-oophorectomy?

Doctor’s Tip

A helpful tip a doctor might give to a patient considering salpingo-oophorectomy is to discuss the potential impact on menopausal symptoms and quality of life. It is important to weigh the benefits of reducing cancer risk against the potential increase in menopausal symptoms and consider all available options, including hormone replacement therapy, to manage any symptoms that may arise. It is also important to have a thorough discussion with your healthcare provider about your personal preferences and concerns before making a decision.

Suitable For

Typically, patients recommended for salpingo-oophorectomy are those who are at high risk for developing ovarian cancer, such as carriers of the BRCA1/2 gene variant, or those with a strong family history of ovarian cancer. This surgery may be recommended as a risk-reducing measure to decrease the chances of developing ovarian cancer in the future. In some cases, it may also be recommended for patients with ovarian cysts, endometriosis, or other gynecologic conditions.

Timeline

Timeline:

Before surgery:

  • Patient undergoes genetic testing to determine if they carry the BRCA1/2 gene variant
  • Patient receives counseling and information about the risks and benefits of risk-reducing surgery
  • Patient decides whether to undergo a salpingectomy or salpingo-oophorectomy

After surgery:

  • Immediately after surgery, patient may experience pain, discomfort, and fatigue
  • In the first year post-surgery, patient may experience menopausal symptoms such as hot flashes, night sweats, mood changes, and vaginal dryness
  • Patient may need to adjust to the physical and emotional changes associated with menopause
  • Patient may be prescribed hormone replacement therapy (HRT) to manage menopausal symptoms
  • Three years post-surgery, patient’s quality of life related to menopause is assessed
  • Patients who underwent salpingo-oophorectomy may experience a higher increase in menopausal symptoms compared to those who had a salpingectomy
  • Even with HRT, women who had their ovaries removed still experience more menopausal symptoms
  • Overall, those who only had their fallopian tubes removed have a better quality of life related to menopause compared to those who also had their ovaries removed

What to Ask Your Doctor

  1. What are the risks and benefits of risk-reducing salpingectomy versus risk-reducing salpingo-oophorectomy for someone in my situation?
  2. How will each type of surgery affect my risk of developing breast and ovarian cancer in the future?
  3. What are the potential long-term effects on my overall health and quality of life after each type of surgery?
  4. How will each surgery impact my hormonal balance and menopausal symptoms?
  5. What are the options for managing menopausal symptoms after each type of surgery?
  6. How will each surgery affect my fertility and reproductive options?
  7. Are there alternative treatments or procedures that I should consider before making a decision?
  8. How often will I need to follow up with you after the surgery to monitor my health and well-being?
  9. Can you provide me with more information or resources to help me make an informed decision about which surgery is right for me?
  10. Are there any clinical trials or research studies that I may be eligible for related to risk-reducing surgery and ovarian cancer risk?

Reference

Authors: Van Bommel MHD, Steenbeek MP, Inthout J, Van Garderen T, Harmsen MG, Arts-De Jong M, Maas AHEM, Prins JB, Bulten J, Van Doorn HC, Mourits MJE, Tros R, Zweemer RP, Gaarenstroom KN, Slangen BFM, Brood-Van Zanten MMA, Vos MC, Piek JMJ, van Lonkhuijzen LRCW, Apperloo MJA, Coppus SFPJ, Hoogerbrugge N, Hermens RPMG, De Hullu JA. Journal: BJOG. 2025 May;132(6):782-794. doi: 10.1111/1471-0528.18075. Epub 2025 Jan 17. PMID: 39823150